Journal List > Korean J Adult Nurs > v.31(6) > 1139712

Jeong and Kim: Post-traumatic Growth among Stroke Patients: Impact of Hope, Meaning in Life, and Social Support

Abstract

Purpose

This study explored the level of Post-Traumatic Growth (PTG) in stroke patients receiving rehabilitation treatment and identified the effects of hope, meaning in life, and social support on PTG.

Methods

A sample of 165 participants was surveyed in a cross-sectional study. Data were collected from January 17, 2018 to April 9, 2018 using self-report structured questionnaires and analyzed using descriptive statistics and hierarchical regression analysis with SPSS/WIN 24.0 program.

Results

The mean score for PTG in stroke patients was 2.82±1.14(range 0~5). Living with family(t=-2.37, p=.019), having a religion (t=2.91 p=.004), higher income(F=8.94, p<.001), shorter period in stroke diagnosis(≤6 month) (F=3.88, p=.010), having no speech defect (t=-2.24, p=.026), and good functional status (F=3.99, p=.020) were associated with higher PTG. The higher levels of hope(r=.73, p<.001), higher meaning in life (r=.64, p<.001), and higher social support (r=.49, p<.001) were related to higher PTG. Hierarchical regression analysis showed that hope(β=.43, p<.001), meaning in life(β=.25, p=.001), and social support (β=.12, p=.044) were effective factors of PTG in stroke patients. These variables accounted for 42%p of the variance in PTG(F=20.52, p<.001).

Conclusion

The study provides insights into how hope, meaning in life, and social support promote PTG in stroke patients. To increase PTG in stroke patients receiving rehabilitation treatment, health care providers should consider developing intervention programs to help increase hope, meaning in life, and social support.

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Table 1.
General Characteristics of Participants and Differences in Post-traumatic Growth according to General Characteristics of Participants (N=165)
Characteristics Categories n (%) Mean± SD (range) Post-traumatic growth
Mean± SD t or F (p) Scheffé
Gender Men 93 (56.4) 2.78±1.11 -0.44
Women 72 (43.6) 2.86±1.17 (.663)
Age (year) 50 21 (12.7) 61.33±9.54 2.37±1.12 2.24
50~<60 50 (30.3) (37~79) 2.96±0.97 (.086)
60~<70 63 (38.2) 2.98±1.17
≥70 31 (18.8) 2.58±1.25
Living status Alone 50 (30.3) 2.51±1.24 -2.37
With family 115 (69.7) 2.96±1.06 (.019)
Primary caregiver Spouse 61 (37.0) 2.99±1.13 1.57
Family except for spouse 35 (21.2) 2.67±1.08 (.199)
Personal care attendants 34 (20.6) 2.95±1.05
Self 35 (21.2) 2.54±1.24
Religion Yes 84 (50.9) 3.07±1.02 2.91
No 81 (49.1) 2.56±1.20 (.004)
Education High school 69 (41.8) 2.83±1.23 0.06
≥ High school 96 (58.2) 2.81±1.07 (.952)
Occupation Yes 24 (14.5) 3.18±1.02 1.68
No 141 (85.5) 2.76±1.15 (.095)
Monthly income (10,000 won) 100 a 60 (36.4) 2.41±1.25 8.94
100~<300 b 70 (42.4) 2.92±1.05 (<.001)
≥300 c 35 (21.2) 3.32±0.84 a< c
Stroke type Infarction 117 (70.9) 2.85±1.16 0.56
Hemorrhage 48 (29.1) 2.74±1.08 (.580)
Period in stroke diagnosis (month) ≤6 a 21 (12.7) 23.51±15.74 3.57±0.91 3.88
7~12 b 32 (19.4) (4~73) 2.74±1.07 (.010)
13~36 c 82 (49.7) 2.75±1.10 a> b, c, d
≥37 d 30 (18.2) 2.56±1.26
Number of attack 1 142 (86.1) 2.85±1.16 0.92
≥2 23 (13.9) 2.62±0.99 (.359)
Parethesia site None 38 (23.0) 2.81±1.14 0.13
Right 51 (30.9) 2.76±1.10 (.942)
Left 70 (42.5) 2.88±1.19
Both 6 (3.6) 2.71±1.06
Speech defect Yes 37 (22.4) 2.45±1.16 -2.24
No 128 (77.6) 2.92±1.11 (.026)
Comorbidity 0 17 (10.3) 1.43±0.93 2.50±1.14 -1.22
≥1 148 (89.7) (0~5) 2.86±1.13 (.223)
Functional status Poor a 60 (36.4) 2.53±1.22 3.99
Moderate b 84 (50.9) 2.91±1.05 (.020)
Good c 21 (12.7) 3.26±1.03 a< c

SD=standard deviation.

Table 2.
The Level of Post-traumatic Growth, Hope, Meaning in Life, and Social Support (N=165)
Variables Categories Mean± SD Min~Max
Post-traumatic growth (range 0~5) Total 2.82±1.14 0.13~5.00
Changed perception of self 2.77±1.25 0~5
Relating to others 3.09±1.23 0~5
New possibilities 2.64±1.28 0~5
Spiritual change 2.54±1.61 0~5
Hope (range 1~4) Total 2.69±0.64 1~4
Pathway thinking 2.76±0.69 1~4
Agency thinking 2.61±0.67 1~4
Meaning in life (range 1~7) Total 4.28±1.25 1~7
Presence of meaning 4.30±1.29 1~7
Search for meaning 4.26±1.34 1~7
Social support (range 1~5) Total 3.49±0.81 1.17~5.00
Family support 4.02±1.03 1~5
Friends support 3.14±1.07 1~5
Medical staff support 3.31±1.05 1~5

SD=standard deviation.

Table 3.
Correlation among Post-traumatic Growth, Hope, Meaning in Life, and Social Support (N=165)
Variables Hope Meaning in life Social support
Total Family Friends Medical staff
r (p) r (p) r (p) r (p) r (p) r (p)
Post-traumatic growth .73 (<.001) .64 (<.001) .49 (<.001) .46 (<.001) .36 (<.001) .30 (<.001)
 Changed perception of self .77 (<.001) .69 (<.001) .49 (<.001) .47 (<.001) .39 (<.001) .29 (<.001)
 Relating to others .61 (<.001) .52 (<.001) .51 (<.001) .51 (<.001) .36 (<.001) .32 (<.001)
 New possibilities .65 (<.001) .57 (<.001) .30 (<.001) .26 (.001) .30 (<.001) .14 (.075)
 Spiritual change .38 (<.001) .32 (<.001) .25 (.001) .21 (.007) .11 (.151) .27 (.001)
Hope 1
Meaning in life .70 (<.001) 1
Social support .49 (<.001) .41 (<.001) 1
Table 4.
Effects of Hope, Meaning in Life, Social Support on Post-traumatic Growth (N=165)
Variables Model 1 Model 2
B SE β t (p) 95% CI B SE β t (p) 95% CI
(Constant) 1.91 0.27 7.15 (<.001) 1.38~2.44 -1.17 0.32 -3.68 (<.001) -1.80~-0.54
Living status (reference: alone) 0.12 0.21 .05 0.57 (.573) -0.29~0.52 0.10 0.14 .04 0.70(.485) -0.18~0.39
Religion (reference: no) 0.40 0.16 .18 2.47 (.015) 0.08~0.72 0.25 0.11 .11 2.18(.031) 0.02~0.48
Monthly income (100~<300) (reference: <100) 0.44 0.21 .19 2.14 (.034) 0.03~0.86 0.08 0.15 .03 0.50(.618) -0.22~0.37
Monthly income (≥300) (reference: <100) 0.76 0.25 .27 3.09 (.002) 0.27~1.24 0.23 0.18 .08 1.31(.194) -0.12~0.58
Period in stroke diagnosis (≤6 month) (reference: ≥37 month) 0.80 0.29 .24 2.71 (.008) 0.22~1.38 0.68 0.21 .20 3.29(.001) 0.27~1.09
Period in stroke diagnosis (7~12 month) (reference: ≥37 month) 0.00 0.27 .00 0.00 (.997) -0.53~0.53 0.23 0.19 .08 1.24(.216) -0.14~0.61
Period in stroke diagnosis (13~36 month) (reference: ≥37 month) 0.05 0.22 .02 0.22 (.828) -0.39~0.49 0.08 0.16 .04 0.53(.596) -0.22~0.39
Speech defect (reference: no) -0.33 0.20 -.12 -1.61 (.109) -0.73~0.07 -0.18 0.14 -.07 -1.29 (.200) -0.46~0.10
Functional status (moderate) (reference: poor) 0.30 0.18 .13 1.65 (.101) -0.06~0.65 -0.01 0.13 -.01 -0.08 (.933) -0.26~0.24
Functional status (good) (reference: poor) 0.55 0.27 .16 2.03 (.044) 0.02~1.09 -0.02 0.20 -.01 -0.10 (.922) -0.41~0.37
Hope 0.76 0.13 .43 5.69(<.001) 0.50~1.03
Meaning in life 0.23 0.07 .25 3.45(.001) 0.10~0.35
Social support 0.17 0.08 .12 2.03(.044) 0.00~0.33
Adjusted R2 .19 .61
△ Adjusted R2 (p) .42 (<.001)
F (p) 4.87 (<.001) 20.52 (<.001)

Durbin-Watson=1.99, Kolmogorov-Smirnov (Z=0.61, p=.846), Breusch-Pagan (x2=18.25, p=.148).

B=unstandardized estimates; SE=standardized error; β=standardized estimates; CI=confidence interval.

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