Abstract
Background
Stroke survivors face various problems that affect their health-related quality of life (HRQoL). Reduced activities of daily living (ADL) may contribute to post-stroke depression (PSD) and low HRQoL, and depression might be associated with low HRQoL. However, these relationships are not well known. This study aimed to analyze correlations among ADL, PSD, and HRQoL in stroke survivors and further explore the mediating role of PSD between ADL and HRQoL.
Methods
This study utilized meta-analytic structural equation modeling (MASEM) on systematically searched articles from six electronic databases, namely PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (China), Wanfang database (China), and SinoMed (China), from inception up to July 31, 2021. Two researchers independently assessed study eligibility, and data from the eligible studies were encoded and assessed for quality. MASEM was utilized to examine correlations among ADL, PSD, and HRQoL, with an estimation of a pooled correlation matrix under a random-effects model. The matrix was directly fitted to a structural equation model using webMASEM.
Results
In total, 8580 articles were screened, and data from 27 studies involving 33 effect sizes were used in the MASEM analysis. Correlations among the three variables were significant (both P < 0.01). Furthermore, PSD partially mediated the correlation between ADL and HRQoL (β = 0.24, 95% confidence interval 0.15–0.30).
Conclusions
The findings suggest that both decreased ADL and PSD may reduce HRQoL, while a decrease in ADL tends to cause depression after stroke. Therefore, ADL and PSD reductions should be improved to achieve better HRQoL of stroke survivors. Future studies should continue to discuss other factors affecting HRQoL to achieve optimal recovery in stroke survivors.
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Abbreviations
- MASEM:
-
Meta-analytic structural equation modeling
- ADL:
-
Activities of daily living
- PSD:
-
Post-stroke depression
- QoL:
-
Quality of life
- HRQoL:
-
Health-related quality of life
- CMV:
-
Common method variance
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This work was supported by the Natural Science Foundation of Shandong province (Grant No. ZR2021MG031).
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Li, J., Yang, L., Lv, R. et al. Mediating effect of post-stroke depression between activities of daily living and health-related quality of life: meta-analytic structural equation modeling. Qual Life Res 32, 331–338 (2023). https://doi.org/10.1007/s11136-022-03225-9
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DOI: https://doi.org/10.1007/s11136-022-03225-9