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Abstract

Objective:

Using a published quality of life model, to investigate the moderating roles played by social functioning and post-stroke depression in buffering the relationship between physical functioning and life satisfaction among elderly Chinese stroke survivors.

Design:

Cross-sectional survey through face-to-face interviews.

Setting:

Fangshan district of the Beijing Municipality in China.

Participants:

A representative random sample of 511 community-dwelling elderly Chinese stroke survivors aged 60 years or above. In total, 127 participants were categorized as stroke survivors with clinical depression and 384 without.

Measures:

Satisfaction With Life Scale, Center for Epidemiologic Studies Depression Scale, International Residential Assessment Instrument Activities of Daily Living Hierarchy scale, International Residential Assessment Instrument Instrumental Activities of Daily Living Performance scale, De Jong Gierveld Loneliness Scale, and Lubben Social Network Scale.

Results:

Analyses revealed that the unique variance shown by social functioning (16%) is more important than physical functioning (5%) or depressive symptoms (12%) in promoting life satisfaction among all elderly stroke survivors. The moderation model denotes the interaction effect between depressed mood and physical functioning (β = .152 to .176, p < .001) for all stroke survivors. For stroke survivors without clinical depression, loneliness (β = .264 to .287, p < .001) and social support (β = .115 to .151, p < .05) buffered the relationship between physical functioning and life satisfaction; whereas for those with clinical depression, only loneliness (β = -.264 to .236, p < .05) moderated the corresponding relationship.

Conclusions:

Social functioning and post-stroke depression buffered the relationship between physical dependence and life satisfaction among elderly Chinese stroke survivors.

Keywords

Life satisfaction social functioning post-stroke depression elderly stroke survivors Chinese

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References

Zubritsky

Abbott

Hirschman

, et al. Health-related quality of life: expanding a conceptual framework to include older adults who receive long-term services and supports. Gerontologist 2013; 53: 205–210.

Clark

. Autonomy, personal empowerment, and quality of life in long-term care. J Appl Gerontol 1988; 7: 279–297.

Fallahpour

Jonsson

Joghataei

, et al. “I am not living my life”: lived experience of participation in everyday occupations after stroke in Tehran. J Rehabil Med 2013; 45: 528–534.

Kitson

Dow

Calabrese

, et al. Stroke survivors’ experiences of the fundamentals of care: a qualitative analysis. Int J Nurs Stud 2013; 50: 392–403.

Hartman-Maeir

Eliad

Kizoni

, et al. Evaluation of a long-term community based rehabilitation program for adult stroke survivors. NeuroRehabilitation 2007; 22: 295–301.

Boosman

Schepers

VPM

Post

MWM

, et al. Social activity contributes independently to life satisfaction three years post stroke. Clin Rehabil 2011; 25: 460–467.

Northcott

Moss

Harrison

, et al. A systematic review of the impact of stroke on social support and social networks: associated factors and patterns of change. Clin Rehabil 2016; 30: 811–831.

Oosterveer

Mishre

van Oort

, et al. Depression is an independent determinant of life satisfaction early after stroke. J Rehabil Med 2017; 49: 223–227.

Blöchl

Meissner

Nestler

. Does depression after stroke negatively influence physical disability? A systematic review and meta-analysis of longitudinal studies. J Affect Disord 2019; 247: 45–56.

10.

Diener

Emmons

Larsen

, et al. The satisfaction with life scale. J Pers Assess 1985; 49: 71–75.

11.

Boey

. Cross-validation of a short form of the CES-D in Chinese elderly. Int J Geriatr Psychiatry 1999; 14: 608–617.

12.

Hirdes

Ljunggren

Morris

, et al. Reliability of the interRAI suite of assessment instruments: a 12-country study of an integrated health information system. BMC Health Serv Res 2008; 8: 277.

13.

Leung

GTY

de Jong Gierveld

Lam

LCW

. Validation of the Chinese translation of the 6-item De Jong Gierveld Loneliness Scale in elderly Chinese. Int Psychogeriatr 2008; 20: 1262–1272.

14.

Lubben

. Assessing social networks among elderly populations. Fam Community Health 1988; 11: 42–52.

15.

Frazier

Tix

Barron

. Testing moderator and mediator effects in counseling psychology research. J Couns Psychol 2004; 51: 115–134.

16.

Cohen

West

, et al. Applied multiple regression/correlation analysis for the behavioral sciences. 3rd ed. Mahwah, NJ: Erlbaum, 2003.

17.

Brown

Hasson

Thyselius

, et al. Post-stroke depression and functional independence: a conundrum. Acta Neurol Scand 2012; 126: 45–51.

18.

Baiyewu

Yusuf

Ogundele

. Depression in elderly people living in rural Nigeria and its association with perceived health, poverty, and social network. Int Psychogeriatr 2015; 27: 2009–2015.

19.

Hilari

Northcott

Roy

, et al. Psychological distress after stroke and aphasia: the first six months. Clin Rehabil 2010; 24: 181–190.

20.

Greco

Steca

Pozzi

, et al. Predicting depression from illness severity in cardiovascular disease patients: self-efficacy beliefs, illness perception, and perceived social support as mediators. Int J Behav Med 2014; 21: 221–229.

21.

Sarfo

Jenkins

Singh

, et al. Post-stroke depression in Ghana: characteristics and correlates. J Neurol Sci 2017; 379: 261–265.

22.

Silva

Corrêa

JCF

da Silva Mello

, et al. Impact of depression following a stroke on the participation component of the International Classification of Functioning, Disability and Health. Disabil Rehabil 2016; 38: 1830–1835.

23.

Tierney

Woods

Weinborn

, et al. Real-world implications of apathy among older adults: independent associations with activities of daily living and quality of life. J Clin Exp Neuropsychol 2018; 40: 895–903.

24.

Dezutter

Wiesmann

Apers

, et al. Sense of coherence, depressive feelings and life satisfaction in older persons: a closer look at the role of integrity and despair. Aging Ment Health 2013; 17: 839–843.

25.

Domènech-Abella

Lara

Rubio-Valera

, et al. Loneliness and depression in the elderly: the role of social network. Soc Psychiatry Psychiatr Epidemiol 2017; 52: 381–390.

26.

Graneheim

Lundman

. Experiences of loneliness among the very old: the Umeå 85 + project. Aging Ment Health 2010; 14: 433–438.

27.

Tomstad

Dale

Sundsli

, et al. Who often feels lonely? A cross-sectional study about loneliness and its related factors among older home-dwelling people. Int J Older People Nurs 2017; 12: 1–10.

28.

Cohen

Wills

. Stress, social support, and the buffering hypothesis. Psychol Bull 1985; 98: 310–357.

29.

Ostwald

Godwin

Cron

. Predictors of life satisfaction in stroke survivors and spousal caregivers after inpatient rehabilitation. Rehabil Nurs 2009; 34: 160–174.

30.

Mather

. The emotion paradox in the aging brain. Ann N Y Acad Sci 2012; 1251: 33–49.

31.

Hall

Chipperfield

Heckhausen

, et al. Control striving in older adults with serious health problems: a 9-year longitudinal study of survival, health, and well-being. Psychol Aging 2010; 25: 432–445.

32.

Shu

Zhu

. The quality of life in China. Soc Indicat Res 2008; 92: 191–225.

33.

Lawler

Mold

McCarthy

. Do older people benefit from having a confidant? An Oklahoma Physicians Resource/Research Network (OKPRN) study. J Am Board Fam Med 2013; 26: 9–15.

34.

Jeon

Kwon

Kim

, et al. The factors associated with health-related quality of life in stroke survivors age 40 and older. Ann Rehabil Med 2017; 41: 743–752.

35.

Graham

Zhou

Zhang

. Happiness and health in China: the paradox of progress. World Dev 2017; 96: 231.

36.

Levesque-Bristol

Maeda

. General need for autonomy and subjective well-being: a meta-analysis of studies in the US and East Asia. J Happiness Stud 2018; 19: 1863–1882.

37.

Wang

Langhammer

. Predictors of quality of life for chronic stroke survivors in relation to cultural differences: a literature review. Scand J Caring Sci 2018; 32: 502–514.

38.

Lau

McKenna

. Perception of quality of life by Chinese elderly persons with stroke. Disabil Rehabil 2002; 24: 203–218.

39.

Hamamura

. Cultural fit and life satisfaction: endorsement of cultural values predicts life satisfaction only in collectivistic societies. J Psychol Chinese Soc 2010; 11: 109–122.

40.

Chou

Yang

Han

. What happens when “younger” helpers meet “older” recipients? A theoretical analysis of interpersonal helping behaviour in Chinese organizations. J Organ Change Manag 2014; 27: 677–691.

41.

Huang

. Correlates of life satisfaction among older people in China: an examination of two cultural variables. Aging Ment Health 2012; 16: 1028–1038.

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Life satisfaction of 511 elderly Chinese stroke survivors: moderating roles of social functioning and depression in a quality of life model