Research On The Relationship Between Social Capital And Quality Of Life Among Stroke Patients

Background:Stroke is also called the cerebral vascular accident,which is a kind of brain blood circulation disorder sudden onset of the disease,and there areobvious high morbidity, high mortality, high morbidity phenomenon,has become a serious impact on human health one of chronic disease.Stroke occurs mainly in the elderly population,especially in the elderly population over 60 years,has been part of a common disease,once the disease will bring heavy economic pressure and burden of care to family and society.The study found that,in 2010 the number of the global new stroke patients was about 16.9 millions, the survival of cerebral apoplexy patients were about 33 millions,and stroke deaths were about 5.9 millions.Data showed, 1.5 millions-2 millions of the new cases of stroke in China each year, about 1.5millions people died each year from cerebralvascular disease, cerebral vascular disease in patients with existing about7 millions people. In stroke patients with survival, 75% ~ 80% will have different degrees of disability, and the severe disability for more than 40%, there are about 30% the possibility of relapse in 2 to 5 years. Post stroke due to disease factors, physical disability, economic burden of care and other reasons, will lead to a series of problems in patients with anxiety, depression, interpersonal harmony activities of daily living and quality of life decline.In recent years, social capital theory has gradually become a focus of academic research in the field of health,in the foreign medical field, scholars have made studies on the health effects of a large number of social capital.At present,the study on relationship between social capital core elements and stroke has been carried out by scholars at home and abroad.These researches show that a higher level of social participation,social support has positive effects on stroke,which mainly reflected in reducing the risk of stroke,improve the quality of life after stroke and the activities of daily living,improve the effect of rehabilitation. Therefore,the social capital has a positive effect on stroke prevention and rehabilitation process.Aim: Through investigation to understand the social capital situation, quality of life situation of stroke patients. Analysis of factors affecting the quality of life in patients with stroke was used to, explore the relationship between social capital and quality of life. Through the study of the relationship between social capital and the quality of life, we explore the core elements and the key measures to improve the quality of life of patients with stroke from the social capital angle.Methods: Based on a systematic review of the literature and expert consultation on the study, we developed the research plan and site investigation of the relationship between social capital of stroke patients and quality of life. In Aug.2014 to Oct.2014, through a multi-stage random sampling method, in Fuyang City, Hefei City and Tongling City, the extracted a county and a district investigation. After the completion of data collection and collation,using Epi Data3.1 software for data entry anddatabases, using SPSS18.0 software for statistical analysis. Quantitative data were expressed the mean ± standard deviation/median ± quarterback spacing,which normal dirtributed data using ANOVA/t test for comparsion, non-normal distributed data using non-parametric test. Qualitative data were expressed by ratio or proportion and compared by the chi square test or Fisher’s exact method. Influence factors using multiple linear regression analysis.Correlation analysis using Spearman correlation coefficients.Social capital scale using reliability and validity test.Results:(1) This study investigated 420 patients with stroke, 402 questionnaires were recovered, 390 questionnaires were effective,the response rate was 92.9%.(2) Social capital questionnaire reliability and validity: the entire questionnaire Cronbach’s α coefficient was 0.882, the construct validity, extracted six main components, a total of 75.547% of the total variance explained.(3) Situation of social capital in stroke patients: stroke patients and their families / relatives have relatively close contact 307(78.8%), and friends more closely have 202 people(51.8%), the majority of the surrounding neighbors have recognized 316(81.0%), and relatively close neighbor exchanges have 125 people(32.0%). Personal support, in the face of difficulties in stroke patients will get more spiritual support of 323 people(82.8%), will be more economical supported 329 people(84.4%). Organization / informal groups support, in the face of difficulties in stroke patients will get more spiritual support of 121 people(31%), will get more financial support 119 people(30.5%). Stroke patients to family / relatives, friends, neighbors, doctors and community committees / village people a higher level of trust were 342(87.7%), 304(77.9%), 310(79.4%), 315(80.7%) and 299(76.6%). The majority of stroke patients will help family members / relatives of 278 people(71.3%), most will help neighbors who have 245(62.8%),most will help friends 241 people(61.8%), most will help a stranger 130 people(33.3%). Stroke patients feel where the relationship more cordial and very harmonious were 172 people(44.1%) and 101 people(25.9%), I care about the community / village more stroke patients 194(49.7%),thinking that other people care about the community / village more stroke patients who have 204(52.3%), on the move out stroke patients now community / village more dismay of 228 people(58.5%).(4) Quality of life in patients with stroke status and influence factors: the quality of life of stroke patients in this survey scores converted score of 526.92 ± 168.56 points, converted divided into 65.86 ± 21.07 points. Scaled scores for each sort in descending order are communication, ADL / IADL, memory and thinking, hand function, moving ability, emotion, participation and power. The main factors affecting the quality of life:age(B =-0.736, P =0.018), weeklyexercise(B = 20.541, P <0.001), stroke type(B = 21.314, P = 0.003), medication(B =-21.920, P = 0.003).(5)Therelationshipbetweensocialcapital andqualityof lifeinpatientswithstroke:socialcontact(B=20.937, P<0.001), reciprocity(B=21.750, P<0.001),cohesionandsenseof belonging(B=18.487, P<0.001) has effect on the quality of life.The higher the social contacts, reciprocity, the level of cohesion and a sense of belonging, the better the quality of life of stroke patients. Social support, trust no effect on the quality of life in patients with stroke.(6) Relationship between social capital and the quality of life in the 8 dimension: dimensions of social contact, cohesion and sense of belonging and quality of life were positively correlated, reciprocity and quality of lifethe emotions, communication, ADL/IADL, mobile ability, hand function, participation in the 6 dimension is positively related to.Conclusions:(1) Social Capital Scale reliability and validity in this study is good, researching for the required standards.(2) Patients with stroke in social contactdegree is high, close most stroke patients and family / relatives. Personal supportlevels were significantly higher than that of the organization / informal support group level, but theperson support for a single source. The degree of trust is generally higher. In addition to the stranger, reciprocal degree is higher, the family / reciprocal degree relatives of the highest. The general level of cohesion and sense of belonging.(3)The factors affecting the quality of life of patients with stroke are: age, weekly exercise, stroke type, and medication.(4) Social ties, reciprocity, cohesion and sense of belonging to the quality of life of stroke patients have a positive effect, and there is a correlation with the multiple dimensions of quality of life.Suggestions:(1) Strengthening social ties, promoting social support, make the stroke patients get more with the outside communication opportunities and support and help, and comprehensively improve the quality of life;(2) Improve the reciprocity, cohesion and sense of belonging level, enhancing of stroke patients group and the sense of responsibility, playing their part in the collective confidence and enthusiasm, to strive for an early rehabilitation;(3) Paying attention to giving play to the role of social capital in the meso, ensure that resources flow in the inter agency sharing, so that the maximum benefit of social capital;(4) The positive development of the macro social capital,through the capital integration and distribution, in order to improve life for stroke patients quality to open up the new way.