Korean J Adult Nurs.  2019 Dec;31(6):605-617. 10.7475/kjan.2019.31.6.605.

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

• Jeong YJ
• Kim HS

• KMID: 2466227
• DOI: http://doi.org/10.7475/kjan.2019.31.6.605

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.

MeSH Terms

Cross-Sectional Studies
Diagnosis
Health Personnel
Hope*
Humans
Rehabilitation
Stroke*

Reference

1. The Korean Neurological Association. Textbook of neurology. 3rd ed. Seoul: PanMun Education;2017.

2. Arsic S, Eminovic F, Konstantinovic L, Pavlovic D, Kliajic D, Despotovic M. Correlation between functional independence and quality of executive functions in stroke patients. Turkish Journal of Physical Medicine and Rehabilitation. 2015; 61(4):333–8. https://doi.org/10.5152/tftrd.2015.25932.

3. Schöttke H, Giabbiconi CM. Post-stroke depression and post-stroke anxiety: prevalence and predictors. International Psychogeriatrics. 2015; 27(11):1805–12. https://doi.org/10.1017/S1041610215000988.

4. Garton ALA, Sisti JA, Gupta VP, Christophe BR, Connolly Jr ES. Poststroke post-traumatic stress disorder: a review. Stroke. 2017; 48(2):507–12. https://doi.org/10.1161/STROKEAHA.116.015234.

5. Gillen G. Positive consequences of surviving a stroke. American Journal of Occupational Therapy. 2005; 59:346–50. https://doi.org/10.5014/ajot.59.3.346.

6. Tedeschi RG, Calhoun LG. The post-traumatic growth inventory: measuring the positive legacy of trauma. Journal of Traumatic Stress. 1996; 9(3):455–71. https://doi.org/10.1002/jts.2490090305.

7. Bernhardt J, Godecke E, Johnson L, Langhorne P. Early rehabilitation after stroke. Current Opinion in Neurology. 2017; 30(1):48–54. https://doi.org/10.1097/WCO.0000000000000404.

8. Kelly G, Morris R, Shetty H. Predictors of post-traumatic growth in stroke survivors. Disability and Rehabilitation. 2018; 40(24):2916–24. https://doi.org/10.1080/09638288.2017.1363300.

9. Ha JY, Park HS, Lee SJ, Jeon JH, Jo HY, Jee YJ. The recovery experience of young adults and middle aged stroke patients. Korean Journal of Adult Nursing. 2010; 22(3):342–51.

10. Seale GS, Berges IM, Ottenbacher KJ, Ostir GV. Change in positive emotion and recovery of functional status following stroke. Rehabilitation Psychology. 2010; 55(1):33–9. https://doi.org/10.1037/a0018744.

11. Peng Z, Wan L. Posttraumatic growth of stroke survivors and its correlation with rumination and social support. Journal of Neuroscience Nursing. 2018; 50(4):252–7. https://doi.org/10.1097/JNN.0000000000000371.

12. Snyder CR, Harris C, Anderson JR, Holleran SA, Irving LM, Sigmon ST, et al. The will and the ways: development and validation of an individual-differences measure of hope. Journal of Personality and Social Psychology. 1991; 60(4):570–85. https://doi.org/10.1037//0022-3514.60.4.570.

13. Jang H, Kim JS. A metaanalysis on relationship between post- traumatic growth and related variables. Korean Journal of Counseling. 2017; 18(5):85–105. https://doi.org/10.15703/kjc.18.5.201710.85.

14. Gilman R, Schumm JA, Chard KM. Hope as a change mecha-nism in the treatment of posttraumatic stress disorder. Psychological Trauma: Theory, Research, Practice, and Policy. 2011; 4(3):270–7. https://doi.org//10.1037/a0024252.

15. Tae YS, Choi YS, Nam GH, Bae JY. Development of the hope scale for Korean cancer patients. Korean Journal of Adult Nursing. 2017; 29(2):211–23. https://doi.org/10.7475/kjan.2017.29.2.211.

16. Bright FA, Kayes NM, McCann CM, McPherson KM. Understanding hope after stroke: a systematic review of the liter-ature using concept analysis. Topics in Stroke Rehabilitation. 2011; 18(5):490–508. https://doi.org/10.1310/tsr1805-490.

17. Steger MF, Frazier P, Oishi S, Kaler M. The meaning in life questionnaire: assessing the presence of and search for meaning in life. Journal of Counseling Psychology. 2006; 53(1):80–93. https://doi.org/10.1037/0022-0167.53.1.80.

18. Shin SY, Chung NW. The effect of meaning in life and social support on posttraumatic growth: rumination as a mediating variable. Journal of Human Understanding and Counseling. 2012; 33(2):217–35.

19. Grace JJ, Kinsella EL, Muldoon OT, Fortune DG. Post-trau-matic growth following acquired brain injury: a systematic review and metaanalysis. Frontiers in Psychology. 2015; 6:1–16. https://doi.org/10.3389/fpsyg.2015.01162.

20. Song JY, Lee HK. The mediating effect of meaning in life of childhood cancer patients' mothers in the link between their hope and posttraumatic growth. Korean Journal of Counseling. 2010; 11(4):1501–17. https://doi.org/10.15703/kjc.11.4.201012.1501.

21. Tedeschi RG, Calhoun LG. Post-traumatic growth: conceptual foundations and empirical evidence. Psychological Inquiry. 2004; 15(1):1–18. https://doi.org/10.1207/s15327965pli1501_01.

22. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multi-dimensional scale of perceived social support. Journal of Personality Assessment. 1988; 52(1):30–41. https://doi.org/10.1207/s15327752jpa5201_2.

23. Kim YY, Yoo SY, Oh JN. A scoping review on studies related to posttraumatic growth in Korea. Crisisonomy. 2017; 13(5):47–58. https://doi.org/10.14251/crisisonomy.2017.13.5.47.

24. Gangstad B, Norman P, Barton J. Cognitive processing and posttraumatic growth after stroke. Rehabilitation Psychology. 2009; 54(1):69–75. https://doi.org/10.1037/a0014639.

25. Song SH, Lee HS, Park JH, Kim KH. Validity and reliability of the Korean version of the posttraumatic growth inventory. Korean Journal of Health Psychology. 2009; 14:193–214. https://doi.org/10.17315/kjhp.2009.14.1.012.

26. Choi YH, Lee HK, Lee DG. Validation of Korean version of Snyder's dispositional hope scale. Korean Journal of Social and Personality Psychology. 2008; 22(2):1–16.

27. Mitchell PH, Powell L, Blumenthal J, Norton J, Ironson G, Pitula CR, et al. A short social support measure for patients re-covering from myocardial infarction: the ENRICHED social support inventory. Journal of Cardiopulmonary Rehabilitation. 2003; 23(6):398–403. https://doi.org/10.1097/00008483-200311000-00001.

28. Kuenemund A, Zwick S, Rief W, Exner C. (Re-)defining the self-enhanced posttraumatic growth and event centrality in stroke survivors: a mixed-method approach and control comparison study. Journal of Health Psychology. 2016; 21(5):679–89. https://doi.org/10.1177/1359105314535457.

29. Park CJ, Jeong YG, Lee HJ, Kang EH. The role of social support on predictors of post-traumatic growth of patients with stroke- based on seoul and gyeonggi-do metropolitan area. Journal of Special Education & Rehabilitation Science. 2017; 56(3):489–502. https://doi.org/10.23944/Jsers.2017.09.56.3.20.

30. Lee S, Kim YJ. Posttraumatic growth of patients with breast cancer. Journal of Korean Academy of Nursing. 2012; 42(6):907–15. https://doi.org/10.4040/jkan.2012.42.6.907.

31. Fawcett TN, Noble A. The challenge of spiritual care in a multi- faith society experienced as a christian nurse. Journal of Clinical Nursing. 2004; 13(2):136–42. https://doi.org/10.1046/j.1365-2702.2003.00870.x.

32. Kim MJ, Cho HI. A metaanalysis of the relationship between hope and adjustment related variables. The Korean Journal of Educational Psychology. 2015; 29(2):331–60. https://doi.org/10.17286/KJEP.2015.29.2.08.

33. Kortte KB, Stevenson JE, Hosey MM, Castillo R, Wegener ST. Hope predicts positive functional role outcomes in acute rehabilitation populations. Rehabilitation Psychology. 2012; 57(3):248–55. https://doi.org/10.1037/a0029004.

34. Won DR, Kim KH, Kwon SJ. Validation of the Korean version of meaning in life questionnaire. The Korean Journal of Health Psychology. 2005; 10(2):211–25.