Mediating roles of social support on poststroke depression and quality of life in patients with ischemic stroke

Journal of Clinical Nursing

Volumn 19, Issue 19-20, 2010, Pages 2752-2762

  Huang, Chiung Yu ^a   Hsu, Mei Chi ^a   Hsu, Shin Pin ^b   Cheng, Pei Ching ^b   Lin, Shu Fen ^b   Chuang, Chia Hui ^b  

^a I SHOU UNIVERSITY   (Taiwan)

^b E DA HOSPITAL   (Taiwan)

Author keywords

Depression; Nursing; Quality of life; Social support; Stroke

Indexed keywords

ARTICLE; CROSS-SECTIONAL STUDY; DEPRESSION; HUMAN; PSYCHOLOGICAL ASPECT; QUALITY OF LIFE; SOCIAL SUPPORT; STROKE;

CROSS-SECTIONAL STUDIES; DEPRESSION; HUMANS; QUALITY OF LIFE; SOCIAL SUPPORT; STROKE;

EID: 77956839139     PISSN: 09621067     EISSN: 13652702     Source Type: Journal    
DOI: 10.1111/j.1365-2702.2010.03327.x     Document Type: Article

References (67)

1. Atkinson M, Zibin S, Chuang H. Characterizing quality of life among patients with chronic mental illness: a critical examination of the self-report methodology. American Journal of Psychiatry 1997, 154:99-105.
2. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology 1986, 51:1173-1182.
3. Barrera M, Sandler Ramsy TB. Preliminary development of a scale of social support: studies on college students. American Journal of Community Psychology 1981, 9:435-447.
4. Berkman LF, Glass T. Social integration, social networks and health. Social Epidemiology 2000, 137-173. Berkman LF, Kawachi I. eds, Oxford University Press, New York, pp
5. Bugge C, Hagen S, Alexander H. Measuring stroke patients' health status in the early post-stroke phase using the SF36. International Journal of Nursing Studies 2001, 38:319-327.
6. Burg MM, Barefoot J, Berkman L, Catellier DJ, Czajkowski S, Saab P, Huber M, DeLillo V, Mitchell P, Skala J, Taylor CB. Low perceived social support and post-myocardial infarction prognosis in the enhancing recovery in coronary heart disease clinical trial: the effects of treatment. Psychosomatic Medicine 2005, 67:879-888.
7. Chang C-P, Tsai Y-F, Chen Y-C, Hwang S-Li. Factors related to depression among burns patients. The Journal of Nursing 2001, 48:37-48.
8. Chemerinski E, Robinson RG, Kosier JT. Improved recovery in activities of daily living associated with remission of poststroke depression. Stroke 2001, 32:113-117.
9. Cohen J. A power primer. Psychological Bulletin 1992, 112:155-159.
10. Dennis M, O'Rourke S, Lewis S, Sharpe M, Warlow C. Emotional outcomes after stroke: factors associated with poor outcome. Journal of Neurology, Neurosurgery and Psychiatry 2000, 68:47-52.
11. Health Statistics 2008, Department of Health, Executive Yuan, Taipei, Taiwan
12. Social Indicators Contents: Age-specific Distribution of Population 1997, http://www.dgbas.gov.tw/dgbas03/bs2/91chy/table/s003.xls, Available at: (accessed 14 February 2003)
13. Eastwood M, Rifat S, Nobbs H. Mood disorder following cerebrovascular accident. British Journal of Psychiatry 1989, 154:195-200.
14. Falba TF, Teng HM, Sindelar J, Gallo WT. The effect of involuntary job loss on smoking intensity and relapse. Addiction 2005, 100:1330-1339.
15. Ferrans C, Powers M. Quality of life index: development and psychometric properties. Advances in Nursing Science 1985, 8:15-24.
16. Fuh JL, Liu H-C, Wang S-J, Liu C-Y, Wang P-N. Poststroke depression among the Chinese elderly in a rural community. Stroke 1997, 28:1126-1129.
17. Gainotti G, Antonucci G, Marra C, Paolucci S. Relation between depression after stroke, antidepressant therapy and functional recovery. Journal of Neurology, Neurosurgery and Psychiatry 2001, 71:258-261.
18. Gallo WT, Bradley EH, Falba TA, Dubin J, Cramer L, Kasl SV. Involuntary job loss as a risk factor for subsequent myocardial infarction and stroke: findings from the Health and Retirement Survey. American Journal of Industrial Medicine 2004, 45:408-416.
19. Gogineni A, Alsup R, Gillespie DF. Mediation and moderation in social work research. Social Work Research 1995, 19:57-63.
20. Göz F, Karaoz S, Goz M, Ekiz S, Cetin I. Effects of the diabetic patients' perceived social support on their quality-of-life. Journal of Clinical Nursing 2007, 16:1353-1360.
21. Gupta A, Pansari K, Shetty H. Post-stroke depression. International Journal of Clinical Practice 2002, 56:531-537.
22. Hackett ML, Yapa C, Parag V, Anderson CS. Frequency of depression after stroke: a systematic review of observational studies. Stroke 2005, 36:1330-1340.
23. Harris AH, Cronkite R, Moos R. Physical activity, exercise coping and depression in a 10-year cohort study of depressed patients. Journal of Affective Disorders 2006, 93:79-85.
24. Hopman WM, Verner J. Quality of life during and after inpatient stroke rehabilitation. Stroke 2003, 34:801-805.
25. House JS. Social isolation kills, but how and why? Psychosomatic Medicine 2001, 63:273-274.
26. Hsieh YW, Wang CH, Wu SC, Chen PC, Sheu CF, Hsieh CL. Establishing the minimal clinically important difference of the Barthel Index in stroke patients. Neurorehabilitation and Neural Repair 2007, 21:233-238.
27. Hsueh IP, Lin JH, Jeng JS, Hsieh CL. Comparison of the psychometric characteristics of the functional independence measure, 5 item Barthel Index and 10 item Barthel Index in patients with stroke. Journal of Neurology, Neurosurgery and Psychiatry 2002, 73:188-190.
28. Hupcey JE. Clarifying the social support theory-research linkage. Journal of Advanced Nursing 1998, 27:1231-1241.
29. Ikeda A, Iso H, Kawachi I, Yamagishi K, Inoue M, Tsugane S. Social support and stroke and coronary heart disease: the JPHC study cohorts II. Stroke 2008, 39:768-775.
30. Jansa J, Pogacnik T, Gompertz P. An evaluation of the Extended Barthel Index with acute ischemic stroke patients. Neurorehabilitation and Neural Repair 2004, 18:37-41.
31. Jönsson AC, Lindgren I, Hallström B, Norrving B, Lindgren A. Determinants of quality of life in stroke survivors and their informal caregivers. Stroke 2005, 36:803-808.
32. Kauhanen M-L, Korpelainen JT, Hiltunen P, Brusin E, Mononen H, Määttä R, Nieminen P, Sotaniemi KA, Myllylä VV. Poststroke depression correlates with cognitive impairment and neurological deficits. Stroke 1999, 30:1875-1880.
33. Kelly-Hayes M, Robertson JT, Broderick JP, Duncan PW, Hershey LA, Roth EJ, Thies WH, Trombly CA. The American Heart Association stroke outcome classification. Stroke 1998, 29:1274-1280.
34. Kneebone II, Dunmore E. Psychological management of post-stroke depression. British Journal of Clinical Psychology 2000, 39:53-65.
35. Kraemer HC, Wilson GT, Fairburn CG, Agras WS. Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry 2002, 59:877-883.
36. Kwakkel G, Wagenaar RC, Kollen BJ, Lankhorst GJ. Predicting disability in stroke - a critical review of the literature. Age and Ageing 1996, 25:479-489.
37. Laurenceau JP, Hayes AM, Feldman GC. Some methodological and statistical issues in the study of change processes in psychotherapy. Clinical Psychology Review 2007, 27:682-695.
38. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist 1969, 9:179-186.
39. Liebetrau M, Steen B, Skoog I. Depression as a risk factor for the incidence of first-ever stroke in 85-year-olds. Stroke 2008, 39:1960-1965.
40. Lin PC, Yen M, Fetzer SJ. Quality of life in elders living alone in Taiwan. Journal of Clinical Nursing 2008, 17:1610-1617.
41. Mackenzie AE, Chang AM. Predictors of quality of life following stroke. Disability and Rehabilitation 2002, 24:259-265.
42. Mahoney FI, Barthel D. Functional evaluation: the Barthel Index. Maryland State Medical Journal 1965, 14:56-61.
43. Mast BT, MacNeill SE, Lichtenberg PA. Post-stroke and clinically defined vascular depression in geriatric rehabilitation patients. American Journal of Geriatric Psychiatry 2004, 12:84-92.
44. Nichols-Larsen DS, Clark PC, Zeringue A, Greenspan A, Blanton S. Factors influencing stroke survivors' quality of life during subacute recovery. Stroke 2005, 36:1480-1484.
45. Paolucci S, Antonucci G, Grasso MG, Morelli D, Troisi E, Coiro P, De Angelis D, Rizzi F, Bragoni M. Post-stroke depression, antidepressant treatment and rehabilitation results: a case-control study. Cerebrovascular Diseases 2001, 12:264-271.
46. Patel MD, Tilling K, Lawrence E, Rudd AG, Wolfe CDA, McKevitt C. Relationships between long-term stroke disability, handicap and health related quality of life. Age and Ageing 2006, 35:273-279.
47. Paul SL, Strum JW, Dewey HM, Donnan GA, Macdonell RAL, Thrift AG. Long term outcome in the north east Melbourne Stroke Incidence Study. Predictors of quality of life at 5 years after stroke. Stroke 2005, 36:2082-2086.
48. Radloff LS, Locke BZ. The community mental health assessment survey and the CES-D Scale. Community Surveys of Psychiatric Disorders 1985, 177-187. Weissman MM, Myers JKRoss CG. eds, Rutgers University Press, New Brunswick, NJ, pp
49. Robinson R, Starr L, Price T. A two year longitudinal study of mood disorders following stroke: prevalence and duration at six months follow-up. British Journal of Psychiatry 1984, 144:256-262.
50. Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation 1999, 99:2192-2217.
51. Schreurs KMG, de Ridder DTD. Integration of coping and social support perspectives: implications for the study of adaptation to chronic diseases. Clinical Psychology Review 1997, 17:89-112.
52. Shinar D, Gross CR, Price TR, Banko M, Bolduc PL, Robinson RG. Screening for depression in stroke patients: the reliability and validity of the Center for Epidemiologic Studies Depression Scale. Stroke 1986, 17:241-245.
53. Shumaker S, Brownell A. Toward a theory of social support: closing conceptual gaps. Journal of Social Issues 1984, 40:11-36.
54. Sobel ME. Effect analysis and causation in linear structural equation models. Psychometrika 1990, 55:495-515.
55. Spalleta G, Guida G, De Angelis D, Caltagirone C. Predictors of cognitive level and depression severity are different in patients with left and right hemispheric stroke within the first year of illness. Journal of Neurology 2002, 249:1541-1551.
56. Stahl D, Sum CF, Lum SS, Liow PH, Chan YH, Verma S, Chua HC, Chong SA. Screening for depressive symptoms: validation of the center for epidemiologic studies depression scale (CES-D) in a multiethnic group of patients with diabetes in Singapore. Diabetes Care 2008, 31:1118-1119.
57. Sturm JW, Donnan GA, Dewey HM, Macdonell RA, Gilligan AK, Thrift AG. Determinants of handicap after stroke: the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke 2004, 35:715-720.
58. Suenkeler IH, Nowak M, Misselwitz B, Kugler C, Schreiber W, Oertel WH, Back T. Timecourse of health-related quality of life as determined 3, 6 and 12 months after stroke. Relationship to neurological deficit, disability and depression. Journal of Neurology 2002, 249:1160-1167.
59. Sung SC, Yeh MY. Factors related to quality of life in depressive outpatients in Taiwan. Psychiatry and Clinical Neurosciences 2007, 61:610-615.
60. Tsouna-Hadjis E, Vemmos KN, Zakopoulos N, Stamatelopoulos S. First stroke recovery process: the role of family social support. Archives of Physical Medicine and Rehabilitation 2000, 81:881-887.
61. Verheyden G, Nieuwboer A, De Wit L, Feys H, Schuback B, Baert I, Jenni W, Schupp W, Thijs V, De Weerdt W. Trunk performance after stroke: an eye catching predictor of functional outcome. Journal of Neurology, Neurosurgery and Psychiatry 2007, 78:694-698.
62. Whooley MA, de Jonge P, Vittinghoff E, Otte C, Moos R, Carney RM, Ali S, Dowray S, Na B, Feldman MD, Schiller NB, Browner WS. Depressive symptoms, health behaviors and risk of cardiovascular events in patients with coronary heart disease. Journal of the American Medical Association 2008, 300:2379-2388.
63. Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). 1993, http://www.who.int/substance_abuse/research_tools/whoqolbref/en/, Available at, accessed 23 October 2009
64. A safer future: global public health security in the 21st century. 2007, http://www.who.int/whr/previous/en/index.html, Available at, accessed 23 October 2009
65. Yang M-L. Self Concept, Social Supports and Depression Related Factors in Disabled Patients with Stroke 2003, Unpublished master thesis, Chung Shan Medical University, Taichung City, Taiwan
66. Yuan Y, Zeng X, Luo Y, Li Z, Wu T. Chuanxiong-type preparations for acute ischemic stroke. Cochrane Database of Systematic Reviews 2008, 4. 10.1002/14651858.CD005569.pub2, Art. No, doi
67. Zheng Y, Ye D-Q, Pan H-F, Li W-X, Li L-H, Li J, Li X-P, Xu J-H. Influence of social support on health-related quality of life in patients with systemic lupus erythematosus. Clinical Rheumatology 2009, 28:265-269.