Predictors of functional independence and stress level of stroke survivors at discharge from inpatient rehabilitation

• Published in: The Journal of cardiovascular nursing Vol. 23; no. 4; p. 371
• Main Authors: Ostwald, Sharon K, Swank, Paul R, Khan, Myrna M
• Format: Journal Article
• Language: English
• Published: United States 01.07.2008
• Subjects: Activities of Daily Living - psychology; Adaptation, Psychological; Aged; Aged, 80 and over; Analysis of Variance; Attitude to Health; Cross-Sectional Studies; Female; Health Services Needs and Demand; Humans; Inpatients - psychology; Inpatients - statistics & numerical data; Male; Middle Aged; Nursing Methodology Research; Patient Discharge - statistics & numerical data; Predictive Value of Tests; Regression Analysis; Risk Factors; Severity of Illness Index; Stress, Psychological - diagnosis; Stress, Psychological - etiology; Stress, Psychological - psychology; Stroke - complications; Stroke Rehabilitation; Surveys and Questionnaires; Survivors - psychology; Survivors - statistics & numerical data; Texas
• ISSN: 1550-5049
• DOI: 10.1097/01.JCN.0000317435.29339.5d

Stroke is the primary cause of long-term disability among older adults. This study identifies predictors of functional independence and perceived stress for stroke survivors discharged home from inpatient rehabilitation with a spousal caregiver. Stroke survivors (N = 97) were interviewed immediately after discharge to obtain scores on the National Institutes of Health Stroke Scale, Functional Independence Measure (FIM), Stroke Impact Scale, Geriatric Depression Scale-15, Perceived Stress Scale, and Perceived Health Status. Demographic and stroke-related data were abstracted from their inpatient rehabilitation charts. Descriptive and regression analyses determined the relationships among variables and the models that best predicted functional independence and perceived stress. Stroke survivors perceived a 50% recovery in their function upon discharge from inpatient rehabilitation. National Institutes of Health Stroke Scale, age, socioeconomic status, and number of complications predicted 63% of the variance of the total FIM score (F6,88 = 24.64; P < .0001). Total FIM, depression, and Stroke Impact Scale Emotion subscale predicted 45% of the Perceived Stress Scale score (F6,88 = 12.04; P < .0001). Variables that predict the stroke survivors' recovery are complex as the severity of the stroke combines with demographic and economic variables and depression to predict functional independence and perceived stress. These factors need to be considered when preparing a discharge plan for stroke survivors who are discharged home from rehabilitation.