Changes in younger stroke survivors' body perception as indicated in body drawings: A comparison between Expressive Arts-based Intervention and control groups.

Stroke-related deficits affect stroke survivors' perception of their bodies and possibly impede their progress in rehabilitation and well-being. This study adopted a pre-and post-test design to compare the changes in body perception among younger stroke survivors after participating in an 8-week Expressive Arts-based Intervention (EABI) (n = 32) with the control group (n = 30). Each participant partook in structured drawing interviews at baseline (T0) and 8-week follow-up/post-intervention (T1). The data were analyzed using content analysis. More EABI (n = 27) than control (n = 14) participants reported positive changes in body perception and applied lighter colours or created a more symmetrical drawing at T1. They shared that EABI promoted these positive changes by facilitating the reconnection with one's body and self. While some control participants experienced positive changes in body perception, others tended to apply darker colours or the same colour to show negative or no changes in body perception. More control (n = 8) than EABI (n = 3) participants reported negative thoughts about their bodies and negative influences from other individuals and the environment. The findings suggested that EABI can change stroke survivors' body perception. EABI can be considered one of the interventions that may help foster positive changes in body perception.

Psychometric properties of the 12-item Stroke-Specific Quality of Life Scale among stroke survivors in Hong Kong.

The present study examined the psychometric properties of the 12-item Stroke-Specific Quality of Life Scale (SSQOL-12) in 184 stroke survivors in Hong Kong. The participants completed a self-report questionnaire including the SSQOL-12, SF-12 health survey, and validating variables at baseline and 148 stroke survivors completed SSQOL-12 two months later. Confirmatory factor analysis investigated the construct validity, reliability, and measurement invariance of SSQOL-12 across two months. Concurrent, convergent, and divergent validity was examined with respect to SF-12, hope, self-esteem, functional disability, anxiety, and depression. The original 2-factor model did not reveal a superior fit over the 1-factor model and a modified 1-factor model provided an acceptable fit to the data in both waves. The SSQOL-12 factor displayed substantial factor loadings (λ = 0.40-0.87), good internal consistency (Ω = 0.88), temporal stability (r = 0.70), and scalar measurement invariance across time. Stroke-specific quality of life was significantly associated with higher levels of SF-12, hope, and self-esteem and lower levels of functional disability, anxiety, and depression. Most correlations remained significant after controlling for demographic covariates and SF-12. The present findings offered empirical support for the validity and reliability of the unidimensional structure for SSQOL-12 as a measure of stroke-specific quality of life among stroke survivors.

Indirect effects of social support and hope on quality of life via emotional distress among stroke survivors: A three-wave structural equation model.

Objectives: Stroke survivors are prone to functional impairments and reduced quality of life (QoL). This study examined the mediating role of social support and hope in the relationships between functional impairment, emotional distress, and QoL. Methods: A total of 188 stroke survivors in Hong Kong completed assessments on functional impairment, social support, and hope at baseline, with follow-up measurements of emotional distress at 2 months and QoL at 8 months. Structural equation modeling with bootstrapping was used to analyze the direct and indirect effects of functional impairment on emotional distress and QoL via the mediating factors of social support and hope. Results: The partial cascading model provided an adequate fit to the data. Functional impairment had significant negative direct effects on hope and physical QoL and social support had significant positive direct effects on hope and physical QoL. Social support had a significant positive indirect effect on physical QoL via hope and perceived stress and on psychosocial QoL via hope and depression. Functional impairment and hope had a significant negative interaction effect on perceived stress. Conclusion: The findings support a mediating role for hope in the relationship between social support and QoL in stroke survivors. The protective effect of hope on perceived stress was stronger among patients with greater functional impairment.