Study On The Correlation Between The Symptom Experience,Disease Adaptation And Quality Of Life In Patients With Mild-to-Moderate Ischemic Stroke

Objectives1.To investigate the current status of symptom experience,disease adaptation and quality of life in patients with mild-to-moderate ischemic stroke.2.To clarify the main factors influencing quality of life in patients with mild-tomoderate ischemic stroke.3.Exploring the correlation among symptom experience,disease adaptation and quality of life in patients with mild to moderate ischemic stroke.4.To explore the mediating effect of disease adaptation between symptom experience and quality of life in patients with mild-to-moderate ischemic stroke,so as to provide new ideas for improving patient symptom management,improving their quality of life,and better disease outcome.MethodsThis was a cross-sectional study in which 217 patients with mild-to-moderate ischemic stroke who met the inclusion criteria and were treated at a Grade IIIA hospital in Dalian from January to July 2022 were selected as the study population.The research tools included general information questionnaire,Stroke Patient Report Outcomes Scale,Acceptance of Illness Scale,and Stroke Specific Quality of Life Scale.SPSS26.0 was used for descriptive statistical analysis,single factor analysis,linear regression and Pearson correlation analysis.AMOS28.0 was used to establish the structural equation model,and P < 0.05 was considered as statistically significant.Results1.In this study,217 questionnaires were distributed and 207 questionnaires were collected,with an effective recovery rate of 95.39%.The results of this study showed that the symptom experience score of patients with mild-to-moderate ischemic stroke was(2.12±0.61).The mean scores of each dimension,from highest to lowest were physical symptoms and daily living ability(2.27±0.69),abnormal gait(2.21±0.83),slurred speech and fatigue(2.14±0.74),cognitive function(2.06±0.73),psychological symptoms(2.02±0.65).The score of pain dimension was(1.96±0.76);Age,number of attacks,number of hospitalizations and comorbidities were the influencing factors of symptom experience of patients.2.The score of disease adaptation in patients with mild-to-moderate ischemic stroke was(19.64±5.70).Among 207 patients,109(52.7%)had a low level of disease adaptation,88(42.5%)had a medium level of disease adaptation,There were 10 people with a high level of disease adaptation,accounting for 4.8%.The three items with the lowest scores were item 4 "Illness has made me more dependent on others than I thought" with a score of 2.09±0.97,item 7 "I will not be able to be happy enough to be self-sufficient" with a score of 2.21±1.11,item 5 "illness has made me a burden to my family and friends".The score was(2.30±1.13).The item with the highest score was "I can’t do what I like because of health problems",with a score of(2.75±1.10).3.The total score of quality of life in patients with mild-to-moderate ischemic stroke was(133.72±28.58),and the standardized score was 53.49%.The three dimensions with the lowest average scores were vitality(2.50±0.80),personality(2.57±0.74)and family role(2.62±0.75).4.Univariate analysis showed statistically significant differences in the quality of life scores of patients with mild-to-moderate ischemic stroke in terms of age,education,number of hospital admissions,number of strokes,duration of illness,and presence of comorbidities.Multiple linear regression analysis showed that the main factors influencing quality of life in patients with mild-to-moderate ischemic stroke were age,number of admissions,number of strokes,presence of comorbidities,duration of illness,elementary school education or less,and disease adaptation,combining to explain56.9% of the total variance.5.In patients with mild-to-moderate ischemic stroke,symptom experience was negatively correlated with disease adaptation(-0.634,P < 0.01),symptom experience was negatively correlated with quality of life(-0.614,P < 0.01),and disease adaptation was positively correlated with quality of life(0.642,P < 0.01).6.The mediating model of disease adaptation between symptom experience and quality of life in patients with mild to moderate stroke was constructed,which showed that disease adaptation played a partial mediating role between symptom experience and quality of life in patients with mild-to-moderate stroke,and the mediating effect accounted for 38.9% of the total effect.Conclusions1.The symptom experience of patients with mild-to-moderate ischemic stroke is at a medium level,disease adaptation is at a low level,and quality of life is at a medium to low level,suggesting that the clinical health care staff should pay attention to the multiple symptoms of stroke patients,make multi-dimensional assessment of different symptoms,help patients to form a correct disease concept,and focus on identifying the various needs of patients with mild to moderate ischemic stroke,so as to improve the confidence and compliance of patients in participating in treatment.To promote good rehabilitation outcomes of patients.2.The quality of life of patients with mild to moderate ischemic stroke is affected by age,number of admissions,number of strokes,comorbidities,course of disease,education level,disease adaptation,and symptom experience.Medical workers should pay more attention to patients with older age,low education level,high number of admissions,comorbidities,long course of disease and repeated episodes,and work with family caregivers to develop individualized nursing intervention programs to help patients improve their quality of life.3.Symptom experience is negatively correlated with disease adaptation in patients with mild-to-moderate ischemic stroke.Symptom experience was negatively correlated with quality of life.There is a positive correlation between disease adaptation and quality of life.Clinical medical and nursing staff can formulate intervention strategies according to the correlation between the three,take effective measures to control symptoms and reduce patients’ symptom experience,improve patients’ disease adaptation level,and improve patients’ quality of life and prognosis.4.There is a mediating role of disease adaptation between symptom experience and quality of life in patients with mild-to-moderate ischemic stroke.Symptom experience may not only reduce patients’ quality of life through direct effects,but also indirectly by reducing the level of disease adaptation.Healthcare professionals can explore effective solutions to improve patients’ quality of life after stroke from two perspectives: improving patients’ symptom experience and improving patients’ level of disease adaptation,providing new thoughts for effective symptom management,improving patients’ quality of life and improving disease outcome.