Stroke is the leading cause of adult disability with over 5 million American adults experiencing physical, psychological, and/or social limitations related to stroke. Although depressive symptoms and poor quality of life (QOL) are key outcomes for stroke survivors, little is understood about how these outcomes are affected by stroke survivors' evaluation of their experience. The concept of cognitive appraisal, an evaluation of the meaning of a situation for one's well-being, may explain some of the factors associated with post-stroke depressive symptoms and QOL. The purpose of this study was to determine factors associated with post-stroke depressive symptoms and QOL using a conceptual model derived from the transactional theory of stress originally proposed by Lazarus and Folkman. Three aims guided this study: to determine whether (a) depressive symptoms at 4 months after stroke are predictive of stroke-specific QOL at 10 months; (b) perceived social support, self-esteem, and optimism at 1 month after stroke predict depressive symptoms among stroke survivors at 4 months; and (c) threat appraisal at 1 month after stroke is a mediating variable between perceived social support, self-esteem, and optimism at 1 month after stroke and depressive symptoms at 4 months. A secondary analysis of data from 392 stroke survivors in the Randomized Trial of Treatment for Post-stroke Depression (AIM study) was conducted. Using a descriptive correlational design and multiple regression analyses, longitudinal associations among perceived social support, self-esteem, optimism, threat appraisal, depressive symptoms and stroke-specific QOL were examined. Perceived social support, self-esteem, and optimism were significantly associated with threat appraisal. Threat appraisal was significantly associated with post-stroke depressive symptoms. Stroke-specific QOL was found to be stable between 4 and 10 months. Partial mediation of the relationship between the explanatory variables and depressive symptoms by threat appraisal at one month post-stroke was demonstrated. In conclusion, threat appraisal is an important factor to consider in future research and intervention development in relation to post-stroke depressive symptoms.
|Commitee:||Austin, Joan K., Perkins, Susan M., Pressler, Susan J., Williams, Linda S.|
|School Location:||United States -- Indiana|
|Source:||DAI-B 69/08, Dissertation Abstracts International|
|Keywords:||Poststroke depressive symptoms, Quality of life, Stroke, Threat appraisal|
Copyright in each Dissertation and Thesis is retained by the author. All Rights Reserved
The supplemental file or files you are about to download were provided to ProQuest by the author as part of a
dissertation or thesis. The supplemental files are provided "AS IS" without warranty. ProQuest is not responsible for the
content, format or impact on the supplemental file(s) on our system. in some cases, the file type may be unknown or
may be a .exe file. We recommend caution as you open such files.
Copyright of the original materials contained in the supplemental file is retained by the author and your access to the
supplemental files is subject to the ProQuest Terms and Conditions of use.
Depending on the size of the file(s) you are downloading, the system may take some time to download them. Please be