Predictors of psychosocial adjustment and its subdomains in young adults with hematologic malignancy: A cross-sectional study.

PURPOSE: This study aims to identify the factors influencing psychosocial adjustment and its subdomains. METHODS: A descriptive cross-sectional study was conducted with 176 young adults (men 55.7%, 30.5 ± 5.9 years) diagnosed with a hematologic malignancy in South Korea. Psychological adjustment, symptom experience, and type D personality were assessed using self-report questionnaires. Clinical characteristics were extracted from the medical record. Stepwise multiple regression was conducted to identify the factors influencing psychosocial adjustment. RESULTS: The predictors of difficulties in psychosocial adjustment were high symptom experience, type D personality, being unemployed, low functional status, and short time since the last chemotherapy. By subdomain of psychosocial adjustment, predictors of low healthcare orientation were high symptom experience, woman, and type D personality, and predictors of low vocational environment were high symptom experience, being unemployed, short duration of disease, low functional status, and diagnosis. The factors influencing low domestic environment were high symptom experience, being unemployed, and low functional status, and the factor influencing low sexual relationships was high symptom experience. The predictor of low extended family relationships was high symptom experience; predictors of low social environment were high symptom experience and short duration of disease; and predictors of low psychological distress were high symptom experience, type D personality, and being unemployed. CONCLUSION: As young adults with higher symptom experiences, type D personality, low functional status, and shorter time since the last chemotherapy, and who are unemployed experience difficulties in psychosocial adjustment, healthcare professionals should evaluate their psychosocial adjustment and develop strategies to improve the same.

Congruency and its related factors between patients' fall risk perception and nurses' fall risk assessment in acute care hospitals.

INTRODUCTION: Inpatients need to recognize their fall risk accurately and objectively. Nurses need to assess how patients perceive their fall risk and identify the factors that influence patients' fall risk perception. PURPOSE: This study aims to explore the congruency between nurses' fall risk assessment and patients' perception of fall risk and identify factors related to the non-congruency of fall risk. DESIGNS: A descriptive and cross-sectional design was used. The study enrolled 386 patients who were admitted to an acute care hospital. Six nurses assessed the participants' fall risk. Congruency was classified using the Morse Fall Scale for nurses and the Fall Risk Perception Questionnaire for patients. FINDINGS: The nurses' fall risk assessments and patients' fall risk perceptions were congruent in 57% of the participants. Underestimation of the patient's risk of falling was associated with gender (women), long hospitalization period, department (orthopedics), low fall efficacy, and history of falls before hospitalization. Overestimation of fall risk was associated with age group, gender (men), department, and a high health literacy score. In the multiple logistic regression, the factors related to the underestimation of fall risk were hospitalization period and department, and the factors related to the overestimation of fall risk were health literacy and department. CONCLUSIONS: Nurses should consider the patient's perception of fall risk and incorporate it into fall prevention interventions. CLINICAL RELEVANCE: Nurses need to evaluate whether patients perceive the risk of falling consistently. For patients who underestimate or overestimate their fall risk, it may be helpful to consider clinical and fall-related characteristics together when evaluating their perception of fall risk.

Demographic, clinical and psychological predictors of malnutrition among people with liver cancer.

PURPOSE: This study aimed to explore the nutritional status and examine the demographic, clinical, nutritional, and psychosocial characteristics associated with malnutrition among people with liver cancer. METHODS: A descriptive cross-sectional design was used. Data were collected from a convenience sample of 162 liver cancer outpatients at a tertiary university hospital. Nutritional status was evaluated using the Patient-Generated Subjective Global Assessment (PG-SGA). Self-administered structured questionnaires were administered, and medical records were reviewed for demographic, clinical, nutritional, and psychosocial characteristics. RESULTS: Based on PG-SGA scores, 27 patients (16.7%) were classified into the malnutrition group. The stages of liver cancer, chemotherapy, physical and psychological symptom distress, global distress index, levels of alpha-fetoprotein and protein induced by vitamin K absence or antagonists, body mass index, appetite, hemoglobin and albumin levels, and depression were statistically significantly associated with malnutrition. Logistic regression model revealed that physical symptom distress, liver cancer stage, depression, and body mass index influenced statistically significantly malnutrition. CONCLUSIONS: In this study, clinical, nutritional, and psychosocial characteristics predicted malnutrition among people with liver cancer. Nurses should consider these characteristics when evaluating the nutritional status of people with liver cancer.

Factors Influencing Sleep Disturbances in Adolescent Smokers in South Korea.

ABSTRACT: This study aimed to describe sleep disturbances and identify associated factors in adolescent smokers in South Korea. This study adopted a cross-sectional design and recruited 520 students aged 12-17 years from 35 schools to participate in a smoking cessation program. To compare demographic, smoking-related, psychological, and problem behavior characteristics between adolescent smokers with sleep disturbances and without sleep disturbances, chi-square tests and independent t tests were used. Logistic regression analysis was performed to identify the factors associated with sleep disturbances in adolescent smokers. Approximately 45.8% of adolescent smokers reported sleep disturbances. Sleep disturbances were more frequent among girls than among boys and more frequent among high school students than among middle school students. Other factors included cigarette use within 1 month, nicotine dependence, smoking cessation self-efficacy, depression, Internet addiction, and suicidal ideation. Gender (girls), school level (high school), depression, Internet addiction, and daily cigarette use (11 or more cigarettes) were significantly associated with sleep disturbances in adolescent smokers. To improve the sleep quality of adolescent smokers, health professionals should focus on sleep disturbances and associated factors and develop appropriate intervention programs.

Nurses' Perception and Performance of End-of-Life Care in a Tertiary Hospital.

Purpose: This study aimed to identify levels of perception and performance of end-of-life care among nurses and to investigate correlations between perception and performance. Methods: This cross-sectional descriptive survey included 321 nurses from a tertiary hospital in Seoul, Korea. The participants had at least 6 months of work experience and had been involved in end-of-life care at least once, in either ward or intensive care unit settings. A structured questionnaire was utilized to assess their perception and performance of end-of-life care. Results: The mean score for perception of end-of-life care was 3.23±0.34, while the score for performance of end-of-life care was 3.08±0.34. There was a significant positive correlation between nurses' perception of end-of-life care and their performance in this area (r=0.78, P<0.001). Conclusion: It is necessary to change perceptions regarding end-of-life care and to develop systematic and standardized education programs including content such as assessing the hydration status of dying patients, evaluating mental aspects such as suicidal ideation, and providing spiritual care for nurses working in end-of-life departments.

Effect of a Hospital-To-Home Transitional Intervention Based on an Interaction Model of Client Health Behavior for Adult Patients with Stroke.

To develop and identify the effectiveness of a hospital-to-home transitional intervention based on an interaction model of client health behavior in adult patients with stroke. A non-equivalent control group pretest-posttest. Thirty-eight patients participated (18=intervention, 20=control); the intervention group received 12 weeks of the intervention. The intervention influenced anxiety, disease severity, health behavior adherence, patient satisfaction, and quality of life in adult patients with stroke. Transitional programs have potential to improve the health behaviors of subjects, and community health nurses can assist in the implementation of these programs. Health behaviors and quality of life scores were significantly higher in the intervention group than in the control group; these findings support the need for continuity of nursing care during the transitional period for patients with stroke. Given the challenges faced by adult stroke patients after stroke, community nurses should pay attention to patients' transitional experiences.

Effect of Home-Based Self-Management Intervention for Community-Dwelling Patients with Early Parkinson's Disease: A Feasibility Study.

PURPOSE: This study aimed to evaluate the effect of a home-based self-management intervention in community-dwelling patients with early Parkinson's diseases (PD). DESIGN: A randomized-controlled design. METHODS: Thirty-two patients participated (15=intervention, 17=control), and the intervention group received 16 weeks of the intervention. FINDINGS: Physical activity and non-motor symptoms improved more in the intervention group than in the control group. CONCLUSION: Home-based self-management intervention was effective in improving physical activity and non-motor symptoms for them. CLINICAL EVIDENCE: Home-based intervention - comprising education, telephone counseling, smartphone-based message and information, and smart wearable devices - was feasible for patients with early PD.

Predictors of Quality of Life in Patients With Degenerative Cervical Myelopathy Receiving Nonsurgical Management Due to Chronic Pain.

BACKGROUND: Most patients with degenerative cervical myelopathy (DCM) experience pain, and their quality of life (QoL) is poor. AIMS: This study aimed to identify predictors of QoL, including demographic, clinical, physical, and psychosocial characteristics, in chronic pain patients with DCM receiving non-surgical management. DESIGN: A descriptive study design was used. SETTING: Participants were recruited at the pain clinic at a university hospital in Seoul, South Korea. PARTICIPANTS/SUBJECTS: The subjects included 157 inpatients and outpatients with DCM receiving non-surgical management. METHODS: We administered a written, structured, self-reported questionnaire, which included standard validated measures for the main variables of interest. RESULTS: The median number of pain sites was two, and the average and most pain severities were 4.63 ± 2.35 and 5.71 ± 2.32 out of 10 within one month, respectively. Stepwise multiple regression analysis revealed that depression, education level, and headache were factors influencing physical QoL. Depression, education level, and marital status were factors influencing psychological QoL, whereas depression and education level were factors influencing social relationships QoL. Finally, the factors influencing environmental QoL were depression, educational level, and marital status. CONCLUSIONS: Demographic characteristics, including educational level and marital status, clinical characteristics, including pain site, and psychological characteristics, including depression, were identified as factors influencing QoL in chronic pain patients with DCM receiving non-surgical management. CLINICAL IMPLICATIONS: Healthcare professionals should consider demographic, clinical, and psychological characteristics when evaluating patients... QoL. In addition, it is necessary to pay attention to the QoL of participants who are single and have lower levels of education, headache pain, and high levels of depression. These patients are likely to have low QoL and strategies to improve their QoL should be developed.

Predictive Model of Self-management in Patients With Stroke Based on the Information-Motivation-Behavioral Skills Model.

BACKGROUND: Patients who had a stroke are required to manage risk factors, and self-management for risk factor control in stroke is essential. Recent studies using the information-motivation-behavioral skills model reported that the model is effective for predicting and explaining self-management behavior in chronically ill patients. OBJECTIVES: This study aimed to develop and verify the predictive model of self-management based on the information-motivation-behavioral skills model in patients with stroke. METHODS: This was a descriptive, cross-sectional study; path analysis was conducted to develop and verify the hypothesized predictive model. We recruited 242 patients who had a stroke using convenience sampling from the neurological outpatient clinic. RESULTS: The model's fit indices were adequate. Stroke self-management knowledge, social support, and self-efficacy had a direct effect on stroke self-management, and stroke self-management knowledge and attitude and social support had an indirect effect on stroke self-management, mediated by self-efficacy. Stroke self-management knowledge and attitude, social support, and self-efficacy explained 27.5% of the total variance in stroke self-management. CONCLUSIONS: The information-motivation-behavioral skills model is potentially a predictive model for self-management for patients who had a stroke. Considering the level of stroke knowledge and attitude, social support, and self-efficacy together may help to understand the required level of self-management. In addition, using this model for the development of self-management interventions for patients who had a stroke could be a strategy for improving self-management in patients with stroke.

Relationships among Symptoms, Disability, Type D Personality, and Quality of Life in Patients with Migraine: A Cross-Sectional Study in South Korea.

BACKGROUND: Type D personality as a personality vulnerable to stress consists of negative affectivity and social inhibition, and it is related to symptoms and decreased quality of life in patients with chronic illness. AIM: This study aimed to explore the relationships among migraine symptoms, disability, type D personality, and quality of life in patients with migraine. METHODS: A convenience sample of 135 patients with migraine was collected at the neurologic outpatient clinics of two tertiary hospitals in South Korea. Frequency and severity of migraine symptoms, Migraine Disability Assessment, type D personality, and quality of life were investigated using a structured questionnaire. A descriptive cross-sectional design was used. RESULTS: Sixty-one (45.2%) were classified as type D personality. The intensity of the most severe migraine and Migraine Disability Assessment scores in subjects with type D personality were significantly higher than those in subjects without type D personality. In addition, the quality of life score of subjects with type D personality was significantly lower than in subjects without type D personality. The intensity of the migraine, Migraine Disability Assessment score, and type D personality were significant factors influencing quality of life on stepwise multiple regression analysis. CONCLUSIONS: Type D personality was related to migraine symptoms, disability, and quality of life in patients with migraine.

Predictors of long-term medication adherence in stroke survivors: A multicentre, prospective, longitudinal study.

BACKGROUND: Although the optimal use of prescribed medications for stroke survivors is critical for preventing secondary stroke, longitudinal observations of the natural course of medication persistence and adherence in Korean stroke survivors are rare. Furthermore, studies are needed to identify strong predictors influencing medication adherence and to determine whether these predictors change over time. AIMS AND OBJECTIVES: To evaluate the longitudinal medication persistence and adherence at 3 months and 1 year after discharge in all stroke patients and to identify predictors of long-term medication adherence in patients who can self-medicate. DESIGN: A multicentre, prospective, longitudinal descriptive study. METHODS: A total of 600 consecutive ischaemic stroke patients were recruited from three stroke centres across Korea, from 1 September, 2017 to 28 February, 2019. Various factors related to medication adherence suggested by the World Health Organisation were investigated through face-to-face interviews at each centre during hospitalisation. Medication persistence and adherence were assessed at 3 months and 1 year after discharge using the eight-item Morisky Medication Adherence Scale through telephone interviews. RESULTS: Of 537 survivors at 3 months, 526 (98.0%) were persistent and 472 (89.7%) were adherent. Of 493 survivors at 1 year, 477 (96.8%) were persistent and 392 (82.2%) were adherent. Medication belief, income and health literacy were statistically significant predictors of three-month medication adherence, which predicted one-year medication adherence with older age and low income. CONCLUSIONS: Among Korean stroke survivors, three-month and one-year medication persistence and adherence were relatively good. Medication beliefs and three-month medication adherence were important and modifiable factors predicting three-month adherence and one-year adherence, respectively. RELEVANCE TO CLINICAL PRACTICE: To increase long-term adherence to medication, various strategies are needed to improve beliefs about medication, taking into account the patient's age and level of knowledge. These interventions need to be initiated during hospitalisation to form early medication habits after discharge.

Relationships among sexual function, marital intimacy, type D personality and quality of life in patients with ovarian cancer, with spouses.

OBJECTIVE: This study aimed to identify the relationships among sexual function, marital intimacy, type D personality and quality of life (QoL) in patients with ovarian cancer, with spouses. METHODS: A descriptive cross-sectional design was used, and 104 patients were recruited using convenience sampling, from the inpatient and outpatient gynaecological clinics of two tertiary medical centres using structured questionnaires. RESULTS: Of the 104 participants, 31.7% were classified as having a type D personality. The type D group had lower marital intimacy, higher symptoms and lower QoL than the non-type D personality group. The results of a hierarchical regression analysis showed that monthly income, symptoms, marital intimacy and type D personality were independent factors that influenced QoL in patients with ovarian cancer, with spouses. CONCLUSION: Demographic characteristics, symptoms, marital intimacy and type D personality should be considered in patients with ovarian cancer, with spouses when evaluating QoL. Intervention strategies considering these characteristics could improve QoL for patients with ovarian cancer patient, with spouses.

Health Literacy-Based Self-Management Intervention for Patient-Family Caregiver Dyads Undergoing Hemodialysis.

PURPOSE: The aim of this study was to determine the effect of a health literacy-based self-management intervention for patient-family caregiver dyads undergoing hemodialysis. DESIGN: A quasi-experimental design was used. METHODS: The intervention group ( n = 20) received a health literacy-based self-management intervention for patient-family caregiver dyads, whereas the control group ( n = 23) received standard informational messages through a short messaging service for 8 weeks. All participants were assessed for hemodialysis knowledge, self-efficacy, family support, self-management, the ratio of interdialytic weight gain to dry weight, and serum phosphorus and potassium levels at pretest and posttest. RESULTS: Participants in the intervention group exhibited higher scores on hemodialysis knowledge, self-efficacy, family support, and self-management than those in the control group. In addition, the ratio of interdialytic weight gain to dry weight decreased significantly in the intervention group. CONCLUSIONS: The health literacy-based self-management intervention for patient-family caregiver dyads undergoing hemodialysis was effective in improving hemodialysis knowledge, self-efficacy, family support, self-management, and the ratio of interdialytic weight gain to dry weight. CLINICAL RELEVANCE: Because health literacy is an important factor influencing self-management, interventions for patients undergoing hemodialysis should consider the health literacy level of patients and their family caregivers.

Self-management model based on information-motivation-behavioral skills model in patients with chronic obstructive pulmonary disease.

AIM: To develop and test a predictive model of self-management based on the theory of the information-motivation-behavioural skills model and previous literature on self-management for patients with chronic obstructive pulmonary disease (COPD). DESIGN: A descriptive, correlational, cross-sectional design was used. METHODS: A convenience sample recruited 248 patients with COPD from the pulmonary medicine clinic in South Korea between July 2020 and June 2021. We used self-administrated, structured questionnaires for dyspnoea, health status, knowledge, attitude, social support, self-efficacy and self-management. Data were analysed using path analysis to test a self-management model for patients with COPD. RESULTS: Gender, COPD self-management knowledge, social support and COPD self-efficacy had a direct effect on COPD self-management. Dyspnoea, Global Initiative for Chronic Obstructive Lung Disease stage, health status, COPD self-management attitude and social support had an indirect effect on self-management in patients with COPD. These variables explained 43.2% of the total variance for self-management in patients with COPD. CONCLUSIONS: When assessing self-management of COPD; demographic and clinical factors, knowledge, attitudes, social support and self-efficacy included in the information-motivation-behavioural skills model should be considered together.

Effect of mobile health intervention for self-management on self-efficacy, motor and non-motor symptoms, self-management, and quality of life in people with Parkinson's disease: Randomized controlled trial.

OBJECTIVES: To evaluate the effects of a mobile health intervention for self-management on self-efficacy, motor and non-motor symptoms, self-management, and quality of life in people with Parkinson's disease. METHODS: A randomized controlled design was used. The participants were randomly assigned to an intervention or a control group. The intervention group (n = 20) received mobile health intervention comprising mobile applications, smartwatches, smartphone-based short text messages and information, and telephone counselling; whereas the control group (n = 23) received short text messages and telephone counselling for 16 weeks. RESULTS: After 16 weeks, self-efficacy and non-motor symptom scores in the intervention group significantly improved compared to those in the control group. However, no significant differences were observed in the motor symptoms, self-management, and quality of life between the groups. CONCLUSIONS: The mobile health intervention for self-management is effective for self-efficacy and non-motor symptoms in people with Parkinson's disease.

Relationship between type D personality, symptoms, cancer stigma, and quality of life among patients with lung cancer.

PURPOSE: This study aimed to investigate the influence of type D personality on quality of life in patients with lung cancer. METHODS: A correlational, cross-sectional research design was used. A convenience sample of 136 patients with lung cancer were recruited from an outpatient pulmonology clinic. Data collection was performed using a structured questionnaire between July and August 2019. Data analyses included descriptive statistics, an independent t-test, a one-way ANOVA, the χ2 test, an ANCOVA, Pearson's correlation coefficients, and hierarchical regression analysis, which were performed using the SPSS WIN 25.0 program. RESULTS: Type D personality was identified in 18.4% of the participants. Patients with type D personality had poorer quality of life and experienced more cancer stigma and more severe symptoms. Type D personality had the strongest association with quality of life among patients with lung cancer, followed by cancer stigma and symptoms. Poor quality of life was associated with non-married status and higher Eastern Cooperative Oncology Group grade. CONCLUSIONS: Type D personality, stigma, symptoms, and demographic and clinical factors should be considered when assessing quality of life in patients with lung cancer. Interventions that reflect these factors, including type D personality, may help enhance quality of life for patients with lung cancer in oncology nursing practice.

Factors Associated with Medication Beliefs in Patients with Parkinson's Disease: A Cross-Sectional Study.

OBJECTIVE: Medication beliefs are a significant determinant of medication adherence in chronic illness. This study aimed to identify demographic, clinical, and medication-related factors associated with medication beliefs in patients with Parkinson's disease (PD). METHODS: We used a descriptive cross-sectional design with a convenience sample of 173 PD patients who had been taking antiparkinson drugs for more than one year. RESULTS: The subjects who believed PD medication was more necessary had more severe illness, younger age of onset, longer illness duration, and longer duration of levodopa therapy. They had higher levels of non-motor symptoms and depression, number of medication uses, number of drugs, and levodopa equivalent dose, and they reported fluctuation of motor symptoms and dyskinesia. The subjects who used catechol-O-methyltransferase (COMT) inhibitors, dopamine agonists, amantadine, and monoamine oxidase-B (MAO-B) inhibitors had significantly higher necessity scores than those who did not use them. The subjects who had higher concerns about PD medications had higher levels of non-motor symptoms and depression. The subjects using amantadine and anticholinergics had significantly higher concern scores than those who did not use them. Positive necessity-concerns differentials were associated with severe illness, the presence of motor fluctuation and dyskinesia, and the use of COMT inhibitors. Based on stepwise multiple regression, the most significant factors influencing necessity beliefs were severe illness, followed by depression and motor fluctuation. CONCLUSION: Severe illness, higher levels of depression, and motor fluctuation are independent factors influencing patients' beliefs regarding medication necessity. Therefore, these characteristics should be considered in medication belief assessment and interventions for PD patients.

Predictive Model for Quality of Life in Patients 1 Year After First Stroke.

BACKGROUND: Because the recurrence rate of stroke increases 1 year after its initial occurrence, it is important to predict quality of life at this stage, although most functions are likely recovered. OBJECTIVES: We aimed to construct and verify a model of quality of life in patients 1 year post stroke by considering their characteristics at the time of the stroke based on the Wilson and Cleary model and previous literature. METHODS: Participants comprised 288 patients who had experienced their first ischemic stroke and were enrolled in 3 regional stroke centers in South Korea. Data were analyzed using path analysis to identify a model of patients' quality of life 1 year post stroke. RESULTS: Age, National Institutes of Health Stroke Scale score, the modified Rankin Scale score, and anxiety had a direct effect on quality of life, whereas type D personality and social support had an indirect effect. Type D personality, age, National Institutes of Health Stroke Scale score, social support, the modified Rankin Scale score, and anxiety explained 32.9% of the total variance in quality of life. CONCLUSIONS: When predicting quality of life in a patient 1 year after a stroke, it is important to consider variables such as type D personality, age, National Institutes of Health Stroke Scale score, social support, the modified Rankin Scale score, and anxiety at the time of the first stroke. Interventions to improve the quality of life of patients with stroke should consider these factors.

A prediction model of health-related quality of life in young adult patients with stroke.

AIMS AND OBJECTIVES: This study aimed to establish and test a predictive model for explaining the health-related quality of life of young adult patients with stroke. BACKGROUND: Individual characteristics, biological and physiological variables, social support, emotional and cognitive symptoms, physical function disability and general health perception may be interrelated and may directly or indirectly affect the health-related quality of life of young adult patients with stroke. DESIGN: A cross-sectional study. METHODS: 237 young outpatients with stroke were recruited and surveyed. Data collection used a structured questionnaire from July-November 2018. The collected data were analysed using SPSS version 25.0® and AMOS 23.0. This study is based on STROBE guidelines. RESULTS: The hypothetical model's fit indices were adequate. Stroke severity, social support, fear of stroke recurrence, physical function disability and general health perceptions directly affected the health-related quality of life. Additionally, stroke severity, depression and fear of stroke recurrence also indirectly affected it. These variables explained 60.3% of the variance in this quality. CONCLUSIONS: Variables such as severity of stroke, depression, fear of stroke recurrence, social support, physical function disability and general health perception were found to be related to the HRQoL of young adult patients with stroke. RELEVANCE TO CLINICAL PRACTICE: A variety of physical, psychological, functional and social factors related to health-related quality of life should be systematically monitored. Furthermore, nurses need to develop and apply detailed nursing interventions that take into account all these variables.

Influence of Type D Personality on Health Promoting Behaviours and Quality of Life in Stroke Patients: A Cross-Sectional Study in South Korea.

OBJECTIVES: Type D personality is vulnerable to stress and is associated with high symptom severity, unhealthy behaviors, and low quality of life (QoL) in patients with chronic diseases. This study aimed to identify the influence of type D personality on health promoting behaviors and QoL in patients with ischemic stroke in South Korea. MATERIALS AND METHODS: A descriptive, cross-sectional design was used. This study collected data from a convenience sample of 170 patients with ischemic stroke. Demographic and clinical characteristics, health promoting behaviors, and QoL were compared between the type D personality group and the non-type D group. Stepwise multiple regression analysis was performed to identify factors influencing patients' QoL. RESULTS: Of the 170 subjects, 39 (22.9%) were classified as having type D personality. Type D personality was associated with higher National Institutes of Health Stroke Scale scores at admission and discharge, higher modified Rankin Scale (mRS) scores at 3 months after stroke, lower scores for health promoting behaviors, and lower QoL. Regression analysis showed that mRS score 3 months after stroke was the most significant factor influencing QoL, followed by health promoting behaviors, type D personality, speech deficits, and family income. CONCLUSIONS: Type D personality should be considered together with health promoting behaviors and QoL in patients with ischemic stroke. Interventions considering type D personality may be helpful in improving health promoting behavior and QoL for the stroke patients.