Cognitive Appraisals as influencing Quality of life for Stroke Support Persons Providing Home Care

Pai, Hsiang-Chu

Saturday, 16 November 2013

Hsiang-Chu Pai, PhD, RN
Departmentl of Nursing, Min-Hwei College of Health Care Management, Tainan, Taiwan
Yi-Chen Tsai, RN, MSN
Department of Nursing, Chi Mei Medical Center, Tainan, Taiwan

Learning Objective 1: determine the key role of health-rate quality of life among stroke victims’ primary support persons in home care in Taiwan.

Learning Objective 2: determine the effect of cognitive appraisals’ impact on health-rate quality of life among stroke victims’ primary support persons in home care in Taiwan.

Background and objectives: Several previous studies have reported that caregivers have a poor quality of life. The main objectives of this study were to determine the relationship among care giving burdens, cognitive appraisals, and health-related quality of life (HRQOL); and to identify whether the cognitive appraisals influence HRQOL. It will assist in targeting interventions for primary support persons (PSPs).

Design: A cross-sectional, descriptive, correlational design.

Setting: A sample in southern Taiwan.

Participants: Seventy-seven PSPs with a mean age of 59.47, which is younger than stroke survivors’ mean age (78.13) who had an average post-stroke survival rate of 6.12 years.

Methods: Data were obtained through face-to-face interviews using the SF-36 Health Survey, The Caregiver Burden Inventory (CBI), and Cognitive Appraisals Questions for PSP. The Barthel Index (BI), Modified Rankin Scale (MRS), and Glasgow coma scale (GCS) were used to assess the severity of the patient’s disease. Hierarchical multiple regression analysis (HMR) were used to identify predictors of HRQOL.

Results: 61% of the participants rated their health as poor or fair. Patient disease severity (ADL), as well as PSP gender, age, employment, burden, and cognitive appraisal-impact accounted for 45.8% of the variance in PSP physical component summary (PCS) of HRQOL, with age, burden, and appraisal-impact (β = -.46, p = .000; β = -.32, p = .003; β = -.25, p = .015) the strongest of six predictors (F = 9.141, p = .000). Burden and appraisal-impact (β = -.27, p = .040; β = -.25, p = .047) were the strongest of the six predictors, explaining 18.1% of the variance in PSP mental component summary (MCS) of HRQOL (F = 2.400, p = .037).

Conclusions: In the current study, findings highlight the importance of appraisal of the impact for stroke survivor’s PSP HRQOL and suggest identifying variables to target for the improvement of PSP HRQOL.

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