Unmet needs and quality of life in first-stroke patients: The mediating effects of activities of daily living, depression, and social support.

Abstract

Background: Stroke is a primary cause of disability on a global scale. The resultant functional impairments consequent to stroke give rise to a range of unmet needs among patients, especially those experiencing their first stroke. The unmet needs of patients may have a significant negative impact on their quality of life (QoL). However, the mechanisms underlying this relationship remain poorly understood.

Objective: Examine the mediating effects of activities of daily living (ADL), depression, and social support on the relationship between unmet needs and QoL in first-stroke patients.

Methods: A convenience sample of 400 patients with first-ever stroke was recruited. Data were collected using the Longer-term Unmet Needs after Stroke monitoring tool, the Barthel Index, the Patient Health Questionnaire-9, the Social Support Rating Scale, and the Stroke-Specific Quality of Life Scale. A parallel mediation analysis was conducted using Model 4 of the SPSS PROCESS macro.

Results: The results showed that unmet needs were negatively correlated with QoL. The mediation analysis revealed a significant direct effect of unmet needs on QoL, as well as indirect effects through ADL and depression. Social support did not show a significant mediating effect.

Conclusion: Unmet needs affect QoL both directly and indirectly through ADL and depression. These findings underscore the importance of routine assessment and targeted management of unmet needs during post-stroke care. Interventions aimed at enhancing physical functioning and alleviating depression may be effective strategies to improve QoL in this population.