Resilience is an independent correlate of the course of quality of life in patients with first-ever ischemic stroke.

ABSTRACT

OBJECTIVES: To explore the changes in quality of life from the acute hospitalization period to 6 months after discharge in patients with first-ever ischemic stroke and to identify the association between resilience and the course of quality of life. DESIGN: A prospective longitudinal cohort study. SETTING: This study was conducted in Shanghai, China. PARTICIPANTS: Two hundred and seventeen stroke patients were recruited for an initial questionnaire survey from two tertiary hospitals from February 2017 to January 2018. INTERVENTION None. MEASUREMENTS Quality of life was measured using the Stroke Scale Quality of Life. Resilience was assessed using the Connor-Davidson Resilience Scale. Other validated measurement instruments included the modified Rankin Scale and Hospital Anxiety and Depression Scale. A multilevel model was used for the analysis of repeated measurements and to determine the association between resilience and quality of life. RESULTS: Quality of life scores significantly improved over the 6 months after discharge (B = 7.31, p < .0001). The multilevel model indicated that resilience was positively correlated with the course of quality of life (B = .133, p < .0001), independent of stroke severity (B = -.051, p = .0006), neurological function (B = -.577, p < .0001), hospitalization days (B = .023, p = .0099), anxiety (B = -.100, p =< .0001), depression (B = -.149, p < .0001), time (B = .360, p < .0001), and the interactions of time with hospitalization days (B = -.008, p = .0002), neurological function (B = .021, p < .0024), depression (B = -.014, p = .0273), and time (B = -.031, p < .0001). CONCLUSIONS: Resilience played an important role in predicting the self-reported course of quality of life in stroke patients. Our findings emphasized the reasonableness and importance of developing suitable resilience-targeted clinical strategies for improving prognosis in stroke patients.