Factors Influencing Disabled Stroke Survivors’ Quality of Life in Rural China: Based on the Structural Characteristics and Psychometric Properties of the SF-36 Assessment

Abstract

Many stroke survivors’ quality of life is impaired. Few studies of factors influencing their quality of life have been based on the factors tested by the short form 36 instrument. This study did so with 308 physically disabled stroke survivors in rural China. Principal components analysis was applied to refine the dimension structure of the short form 36 assessment, followed by backward multiple linear regression analysis to determine the independent factors influencing quality of life. The structure revealed differed from the generic structure in showing that the mental health and vitality dimensions are not unidimensional. Subjects who reported access to the outdoors as convenient demonstrated better quality of life in all dimensions. Those who exercised regularly achieved better social functioning and negative mental health scores. Other factors influencing a better quality of life in terms of physical functioning were younger age and not being married. Being older and better educated predicted better role-emotion scores. Being female correlated with better social functioning scores, while men scored better on bodily pain. Being less educated predicted higher negative mental health, while being less disabled predicted better physical and social functioning. The results suggest that the SF-36’s dimension structure should be re-evaluated before using it to assess stroke survivors.

An machine learning model to predict quality of life subtypes of disabled stroke survivors

“…Lack of education was also a predictor of type I with worsen QoL classification, while at least a primary education and being older than 78 were predictors of type II with better QoL. This can be explained by the fact that the better‐educated would tend to have higher RE scores, 24 probably because education fosters flexible coping skills that make survivors more adaptable to challenges. 45 In addition, research has shown that older persons tend to have higher RE scores.…”

“… 45 In addition, research has shown that older persons tend to have higher RE scores. 24 It may be that older stroke survivors have lower physical health expectations and may thus cope better emotionally. 46 Physical functioning is normally impaired in older adults, but type II is based on good RE, BP, and GH scores, rather than on physical functioning.…”

“…Detailed information on subjects' enrollment, inclusion and exclusion criteria, and their demographic characteristics has been provided in a previous publication. 24 …”

Translation and validation of the Chinese version of the Japan Frailty Scale

“…Scores for each dimension are calculated by summing item scores and transforming them to a range from 0 (representing the poorest health status) to 100 (indicating the best health status). The SF-36 demonstrates excellent psychometric properties, including high internal consistency and good test–retest reliability ( 30 ). Moreover, it has demonstrated its applicability across diverse age groups and health conditions.…”