Resourcefulness Among Initial Ischemic Stroke Patients: A Longitudinal Study of 12 Months

Abstract

Objective

To explore distinct longitudinal trajectories of resourcefulness among initial ischemic stroke patients from diagnosis to 12 months, and to identify whether sociodemographic factors, disease-related factors, self-efficacy, family function, and social support can predict patterns in the trajectories of resourcefulness.

Methods

A prospective longitudinal study was conducted. Initial ischemic stroke patients who met inclusion and exclusion criteria were followed up when still in hospital (Preparing for discharge, Baseline, T1), at 1 month (T2), at 3 months (T3), at 6 months (T4), at 9 months (T5) and 12 months (T6) (±1 week) after discharge. General information, National Institute of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), General Self-Efficacy Scale (GSES), General Family Functioning Subscale (FAD-GF), and Social Support Rate Scale (SSRS) were used in T1. The Resourcefulness Scale^© was evaluated at 6 time points. Growth mixture modeling was used to identify trajectory patterns of resourcefulness. Logistic regression was used to identify predictors of resourcefulness trajectories.

Results

Three longitudinal trajectories of resourcefulness were identified and named as the high-stable class (38.9%, n=71), fluctuation class (41.2%, n=75), and low-stable class (19.9%, n=36), respectively. Dwelling areas (x²=6.805, P=0.009), education (x²=44.865, P=0.000), monthly income (x²=13.063, P=0.001), NIHSS scores (x²=44.730, P=0.000), mRS scores (x²=51.788, P=0.000), Hcy (x²=9.345, P=0.002), GSES (x²=56.933, P=0.000), FAD-GF (x²=41.305, P=0.000) and SSRS (x²=52.373, P=0.000) were found to be statistically significant for distinguishing between different resourcefulness trajectory patterns. Lower education (OR=0.404), higher NIHSS(OR=6.672) scores, and higher mRS(OR=21.418) scores were found to be risk factors for lower resourcefulness, whereas higher education(OR=0.404), GSES(OR=0.276), FAD-GF(OR=0.344), and SSRS(OR=0.358) scores were identified as protective factors enhancing resourcefulness.

Conclusion

This study obtained three patterns of trajectories and identified their predictive factors in initial ischemic stroke. The findings will assist health care professionals in identifying subgroups of patients and when they may be at risk of low resourcefulness and provide timely targeted intervention to promote resourcefulness.

Keywords:

• initial ischemic stroke
• resourcefulness
• longitudinal study
• social ecology theory
• predictive factors
• nursing care

Data Sharing Statement

The data used to support the findings of this study are available from the first author (Lina Guo, [email protected]) and the corresponding author (Yuanli Guo, email address: [email protected]).

Acknowledgments

We express our gratitude to all the respondents.

Author Contributions

All authors made a significant contribution to the work conception, study design, acquisition, analysis and interpretation of data, taking part in drafting, revising or critically reviewing the article. All authors also gave final approval of the version to be published and have agreed on the journal to which the article has been submitted and to be accountable for all aspects of the work.

Disclosure

The authors stated that they have no conflicts of interest in this work.

Additional information

Funding

This study was funded by the National Natural Science Foundation of China (72204225, 72274179); China Postdoctoral Science Foundation (2023M733234); Medical Science and Technology Project of Henan Province (SBGJ202102076, 222102310246, LHGJ20220429); Nursing Science Foundation of the First Affiliated Hospital of Zhengzhou University (HLKY2023001).