Physical function, depressive symptoms, and quality of life with post-acute stroke care

Background: Few studies have investigated changes in physical function, psychological status, and quality of life (QOL) among stroke survivors receiving post-acute care (PAC). Nursing care has an important effect on patient outcomes, but there is very little evidence of nurses’ role in rehabilitation after stroke in Taiwan. Aim: To investigate the trajectories of physical function, depressive symptoms, QOL, and factors associated with QOL in patients who received a hospital-based PAC program over 12 weeks after stroke. Methods: A quasi-experimental design was employed and the study conducted in a teaching hospital in central Taiwan. Measurement tools included the Barthel Index, modified Rankin Scale, Instrumental Activities of Daily Living Scale, Geriatric Depression Scale, and Stroke Impact Scale. Data were collected at weeks one, four, eight and twelve after stroke. Descriptive, inferential, generalized estimating equations, and multiple linear regression analyses were performed. Findings: Overall, 61 stroke survivors (mean age, 67.59 ± 15.64 years) were enrolled: 93.44% of strokes were ischaemic, and 59.02% of participants were male. Forty-one patients had received hospital-based PAC, while 20 had not. The PAC group exhibited significant improvements (all p < 0.05) in physical function recovery, depressive symptoms, and QOL from the 8th week post stroke compared with the regular care group. Functional recovery and depressive symptoms were significantly associated with QOL at weeks four, eight and twelve weeks after stroke. Discussion: The hospital-based PAC program led to improved physical function, depressive symptoms, and QOL in patients over the 12 weeks following stroke. Physical function and depression after stroke were factors significantly associated with the patients’ QOL. Conclusion: Both functional and psychological recovery impact the QOL of stroke survivors. Nurses are responsible for enhancing stroke survivors’ functional activities, recognising and supporting their psychological issues, and improving their QOL via interventions implemented during the PAC rehabilitation program.