Factors Influencing Disabled Stroke Survivors’ Quality of Life in Rural China: Based on the Structural Characteristics and Psychometric Properties of the SF-36 Assessment
Abstract
:1. Introduction
The SF-36 and Stroke Survivors
2. Materials and Methods
2.1. Participants
2.2. Assessment Instrument Scaling
2.3. Statistical Analyses
3. Results
3.1. The Validity of the SF-36’s Factor Structure
3.2. Reliability of the SF-36’s Scales
3.3. Multivariate Analysis for Independent Risk Factors Influencing Quality of Life
4. Discussion
4.1. The New Factor Structure
4.2. Clinical Application of the New SF-36 Factor Structure
4.3. Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
I Physical functioning |
Vigorous activities |
Moderate activities |
Lifting or carrying groceries |
Climbing several flights of stairs |
Climbing one flight of stairs |
Bending, kneeling or stooping |
Walking more than a mile |
Walking several blocks |
Walking one block |
Bathing or dressing yourself |
II Role physical (RP) |
RP-Cut down the amount of time on work or other activities |
RP-Accomplished less than you would like |
RP-Limited in the kind of work or other activities |
RP-Had difficulty performing the work or other activities |
III Role emotion (RE) |
RE-Cut down the amount of time on work or other activities |
RE-Accomplished less than you would like |
RE-Didn’t do work or other activities as carefully as usual |
IV Social functioning |
Extent that physical health or emotional problems interfered with normal social activities |
Time that physical health or emotional problems interfered with social activities |
V Bodily pain |
Bodily pain |
Pain interfering with normal work |
VI Mental health |
Very nervous |
Down in the dumps |
Downhearted and blue |
Happy |
Calm and peaceful |
VII Vitality |
Feel full of pep |
Have a lot of energy |
Feel worn out |
Feel tired |
VIII General health |
Get sick a little easier than other people |
Expect health to get worse |
As healthy as anybody |
Excellent health |
Health status |
References
- Zhou, M.; Wang, H.; Zeng, X.; Yin, P.; Zhu, J.; Chen, W.; Li, X.; Wang, L.; Wang, L.; Liu, Y.; et al. Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2019, 394, 1145–1158. [Google Scholar] [CrossRef] [PubMed]
- Feigin, V.L.; Stark, B.A.; Johnson, C.O.; Roth, G.A.; Bisignano, C.; Abady, G.G.; Abbasifard, M.; Abbasi-Kangevari, M.; Abd-Allah, F.; Abedi, V.; et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease study 2019. Lancet Neurol. 2021, 20, 795–820. [Google Scholar] [CrossRef] [PubMed]
- Katan, M.; Luft, A. Global burden of stroke. Semin. Neurol. 2018, 38, 208–211. [Google Scholar] [CrossRef]
- Wafa, H.A.; Wolfe, C.; Emmett, E.; Roth, G.A.; Johnson, C.O.; Wang, Y. Burden of stroke in Europe: Thirty-year projections of incidence, prevalence, deaths, and disability-adjusted life years. Stroke 2020, 51, 2418–2427. [Google Scholar] [CrossRef] [PubMed]
- Wang, W.; Jiang, B.; Sun, H.; Ru, X.; Sun, D.; Wang, L.; Wang, L.; Jiang, Y.; Li, Y.; Wang, Y.; et al. Prevalence, incidence, and mortality of stroke in China: Results from a nationwide population-based survey of 480,687 adults. Circulation 2017, 135, 759–771. [Google Scholar] [CrossRef] [PubMed]
- Langhorne, P.; Coupar, F.; Pollock, A. Motor recovery after stroke: A systematic review. Lancet Neurol. 2009, 8, 741–754. [Google Scholar] [CrossRef]
- Twardzik, E.; Colabianchi, N.; Duncan, L.; Lisabeth, L.D.; Brown, S.H.; Clarke, P.J. “Well in in this neighborhood I have walked, not at all”: Stroke survivors’ lived experience in the outdoor environment. Soc. Sci. Med. 2022, 305, 115107. [Google Scholar] [CrossRef]
- Twardzik, E.; Clarke, P.J.; Lisabeth, L.D.; Brown, S.H.; Roth, D.L.; Judd, S.E.; Colabianchi, N. Enhanced street crossing features are associated with higher post-stroke physical quality of life. Top. Stroke Rehabil. 2022, 1–11. [Google Scholar] [CrossRef]
- Stretton, C.M.; Mudge, S.; Kayes, N.M.; McPherson, K.M. What does real-world walking mean to people with stroke? An interpretive descriptive study. Disabil. Rehabil. 2022, 44, 315–322. [Google Scholar] [CrossRef]
- Kwon, S.; Park, J.H.; Kim, W.S.; Han, K.; Lee, Y.; Paik, N.J. Health-related quality of life and related factors in stroke survivors: Data from Korea National Health and Nutrition Examination Survey (KNHANES) 2008 to 2014. PLoS ONE 2018, 13, e195713. [Google Scholar] [CrossRef]
- Ali, A.; Tabassum, D.; Baig, S.S.; Moyle, B.; Redgrave, J.; Nichols, S.; McGregor, G.; Evans, K.; Totton, N.; Cooper, C.; et al. Effect of exercise interventions on health-related quality of life after stroke and transient ischemic attack: A systematic review and meta-analysis. Stroke 2021, 52, 2445–2455. [Google Scholar] [CrossRef] [PubMed]
- Wang, R.; Langhammer, B. Predictors of quality of life for chronic stroke survivors in relation to cultural differences: A literature review. Scand. J. Caring Sci. 2018, 32, 502–514. [Google Scholar] [CrossRef] [PubMed]
- Lins, L.; Carvalho, F.M. SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Med. 2016, 4, 2103743725. [Google Scholar] [CrossRef] [PubMed]
- McHorney, C.A.; Ware, J.J.; Lu, J.F.; Sherbourne, C.D. The MOS 36-item Short-Form Health Survey (SF-36) III: Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med. Care 1994, 32, 40–66. [Google Scholar] [CrossRef]
- Chittleborough, C.R.; Baldock, K.L.; Taylor, A.W.; Phillips, P.J. Health status assessed by the SF-36 along the diabetes continuum in an Australian population. Qual. Life Res. 2006, 15, 687–694. [Google Scholar] [CrossRef]
- Ohsawa, I.; Ishida, T.; Oshida, Y.; Yamanouchi, K.; Sato, Y. Subjective health values of individuals with diabetes in Japan: Comparison of utility values with the SF-36 scores. Diabetes Res. Clin. Pract. 2003, 62, 9–16. [Google Scholar] [CrossRef]
- de Vet, H.C.; Ader, H.J.; Terwee, C.B.; Pouwer, F. Are factor analytical techniques used appropriately in the validation of health status questionnaires? A systematic review on the quality of factor analysis of the SF-36. Qual. Life Res. 2005, 14, 1203–1218. [Google Scholar] [CrossRef]
- Hobart, J.C.; Williams, L.S.; Moran, K.; Thompson, A.J. Quality of life measurement after stroke: Uses and abuses of the SF-36. Stroke 2002, 33, 1348–1356. [Google Scholar] [CrossRef]
- Dallmeijer, A.J.; Dekker, J.; Knol, D.L.; Kalmijn, S.; Schepers, V.P.; de Groot, V.; Lindeman, E.; Beelen, A.; Lankhorst, G.J. Dimensional structure of the SF-36 in neurological patients. J. Clin. Epidemiol. 2006, 59, 541–543. [Google Scholar] [CrossRef]
- Almborg, A.H.; Berg, S. Quality of life among Swedish patients after stroke: Psychometric evaluation of SF-36. J. Rehabil. Med. 2009, 41, 48–53. [Google Scholar] [CrossRef]
- Wu, S.; Yan, T.; Huang, L. The validity and reliability of the abbreviated Mental Test Scale. Chin. J. Phys. Med. Rehabil. 2003, 25, 140–142. [Google Scholar]
- Chen, T.L.L.M. Comparison of the first version and the second version of the SF-36. Chin. J. Soc. Med. 2006, 23, 111–114. (In Chinese) [Google Scholar]
- Ware, J.J.; Kosinski, M.; Bayliss, M.S.; Mchorney, C.A.; Rogers, W.H.; Raczek, A. Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: Summary of results from the Medical Outcomes Study. Med. Care 1995, 33, S264–S279. [Google Scholar]
- Hou, F. Status quo of China’s disability welfare standardization and its standards system. Stand. Sci. 2014, 10, 19–24. (In Chinese) [Google Scholar]
- Gaskin, C.J.; Happell, B. On exploratory factor analysis: A review of recent evidence, an assessment of current practice, and recommendations for future use. Int. J. Nurs. Stud. 2014, 51, 511–521. [Google Scholar] [CrossRef] [PubMed]
- Li, J.; Yu, J.; Chen, X.; Quan, X.; Zhou, L. Correlations between health-promoting lifestyle and health-related quality of life among elderly people with hypertension in Hengyang, Hunan, China. Medicine 2018, 97, e10937. [Google Scholar] [CrossRef]
- Zhang, C.; Cai, Y.; Xue, Y.; Zheng, X.; Yang, X.; Lu, J.; Hou, L.; Li, M. Exploring the predicting factors of quality of life among the empty nesters in Shanxi, China: A structural equation model. Health Qual. Life Outcomes 2021, 19, 156. [Google Scholar] [CrossRef]
- Hair, J.; Black, W.; Babin, B.; Anderson, R. Multivariate Data Analysis; Prentice Hall: Hoboken, NJ, USA, 2009. [Google Scholar]
- Villar, H.A.; Molero, A.F.; Aguado, M.A.; Posada, D.L.P.M. Transcultural validation of a Spanish version of the Quality of Life in Epidermolysis Bullosa questionnaire. Int. J. Environ. Res. Public Health 2022, 19, 7059. [Google Scholar] [CrossRef]
- Ware, J.J. SF-36 health survey update. Spine 2000, 25, 3130–3139. [Google Scholar] [CrossRef]
- Wolinsky, F.D.; Stump, T.E. A measurement model of the Medical Outcomes Study 36-Item Short-Form Health Survey in a clinical sample of disadvantaged, older, black, and white men and women. Med. Care 1996, 34, 537–548. [Google Scholar] [CrossRef]
- Likert, R. A technique for the measurement of attitudes. Arch. Psychol. 1932, 22, 140. [Google Scholar]
- Saklofske, G. Toward an integration of subjective well-being and psychopathology. Soc. Indic. Res. 2001, 54, 81–108. [Google Scholar]
- Keyes, C.L. Mental illness and/or mental health? Investigating axioms of the complete state model of health. J. Consult. Clin. Psych. 2005, 73, 539–548. [Google Scholar] [CrossRef]
- Bowe, A.K.; Owens, M.; Codd, M.B.; Lawlor, B.A.; Glynn, R.W. Physical activity and mental health in an Irish population. Ir. J. Med. Sci. 2019, 188, 625–631. [Google Scholar] [CrossRef] [PubMed]
- Ajzen, I. The Theory of Planned Behavior. Organ. Behav. Hum. Decis. Process. 1991, 50, 179–211. [Google Scholar] [CrossRef]
- Ajzen, I. The theory of planned behaviour: Reactions and reflections. Psychol. Health 2011, 26, 1113–1127. [Google Scholar] [CrossRef]
- Li, Y.; Zhang, S.; Song, J.; Tuo, M.; Sun, C.; Yang, F. Effects of self-management intervention programs based on the Health Belief model and planned behavior theory on self-management behavior and quality of life in middle-aged stroke patients. Evid. Based Complement. Altern. Med. 2021, 2021, 8911143. [Google Scholar] [CrossRef] [PubMed]
- Morris, J.H.; Irvine, L.A.; Dombrowski, S.U.; McCormack, B.; Van Wijck, F.; Lawrence, M. We Walk: A person-centred, dyadic behaviour change intervention to promote physical activity through outdoor walking after stroke: An intervention development study. BMJ Open 2022, 12, e58563. [Google Scholar] [CrossRef] [PubMed]
- Moore, S.A.; Avery, L.; Price, C.; Flynn, D. A feasibility, acceptability and fidelity study of a multifaceted behaviour change intervention targeting free-living physical activity and sedentary behaviour in community dwelling adult stroke survivors. Pilot Feasibil. Stud. 2020, 6, 58. [Google Scholar] [CrossRef] [PubMed]
- Gujral, S.; Aizenstein, H.; Reynolds, C.R.; Butters, M.A.; Erickson, K.I. Exercise effects on depression: Possible neural mechanisms. Gen. Hosp. Psychiatry 2017, 49, 2–10. [Google Scholar] [CrossRef]
- Carek, P.J.; Laibstain, S.E.; Carek, S.M. Exercise for the treatment of depression and anxiety. Int. J. Psychiatry Med. 2011, 41, 15–28. [Google Scholar] [CrossRef]
- Richards, J.; Jiang, X.; Kelly, P.; Chau, J.; Bauman, A.; Ding, D. Don’t worry, be happy: Cross-sectional associations between physical activity and happiness in 15 European countries. BMC Public Health 2015, 15, 53. [Google Scholar] [CrossRef]
- White, R.L.; Babic, M.J.; Parker, P.D.; Lubans, D.R.; Astell-Burt, T.; Lonsdale, C. Domain-specific physical activity and mental health: A meta-analysis. Am. J. Prev. Med. 2017, 52, 653–666. [Google Scholar] [CrossRef] [PubMed]
- Quinn, F.; Johnston, M.; Dixon, D.; Johnston, D.W.; Pollard, B.; Rowley, D.I. Testing the integration of ICF and behavioral models of disability in orthopedic patients: Replication and extension. Rehab. Psych. 2012, 57, 167–177. [Google Scholar] [CrossRef] [PubMed]
- Patel, M.D.; McKevitt, C.; Lawrence, E.; Rudd, A.G.; Wolfe, C. Clinical determinants of long-term quality of life after stroke. Age Ageing 2007, 36, 316–322. [Google Scholar] [CrossRef] [PubMed]
- Ellis, C.; Grubaugh, A.L.; Egede, L.E. Factors associated with SF-12 physical and mental health quality of life scores in adults with stroke. J. Stroke Cerebrovasc. Dis. 2013, 22, 309–317. [Google Scholar] [CrossRef] [PubMed]
- Kauhanen, M.L.; Korpelainen, J.T.; Hiltunen, P.; Nieminen, P.; Sotaniemi, K.A.; Myllyla, V.V. Domains and determinants of quality of life after stroke caused by brain infarction. Arch. Phys. Med. Rehab. 2000, 81, 1541–1546. [Google Scholar] [CrossRef] [PubMed]
- Fillingim, R.B. Individual differences in pain: Understanding the mosaic that makes pain personal. Pain 2017, 158 (Suppl. S1), S11–S18. [Google Scholar] [CrossRef]
- Ross, C.E.; Wu, C.L. The links between education and health. Am. Sociol. Rev. 1995, 60, 719. [Google Scholar] [CrossRef]
Categorization | N (%) | Missing Records (N) |
---|---|---|
Sex | 1 | |
Male (1) | 166 (54.07%) | |
Female (2) | 141 (45.93%) | |
Age | 68.70 ± 12.10 | 14 |
24–59 years | 66 (21.78%) | |
60–69 years | 90 (29.70%) | |
70–79 years | 76 (25.08%) | |
≥80 years | 62 (20.46%) | |
Education | 2 | |
None (1) | 108 (35.29%) | |
Elementary (2) | 128 (41.83%) | |
Secondary or more (3) | 70 (22.88%) | |
Marital status | 2 | |
Unmarried (1) | 116 (37.91%) | |
Married (2) | 190 (62.09%) | |
Employment | 2 | |
Employed | 298 (97.39%) | |
Unemployed | 8 (2.61%) | |
Routine rehabilitation exercise | 5 | |
Never (1) | 144 (47.52%) | |
Sometimes (2) | 128 (42.24%) | |
Usually (3) | 31 (10.23%) | |
Outdoor convenience | 0 | |
Very inconvenient (1) | 155 (50.32%) | |
Inconvenient (2) | 117 (37.99%) | |
Convenient (3) | 36 (11.69%) | |
Disability severity | 9 | |
Extremely severe (totally dependent) (1) | 33 (11.04%) | |
Severe (basically dependent) (2) | 240 (80.27%) | |
Moderate (partially dependent) (3) | 10 (3.34%) | |
Mild (independent) (3) | 16 (5.35%) | |
Duration since stroke | 10.50 ± 6.77 | 5 |
0–4 years | 73 (24.09%) | |
5–9 years | 108 (35.64%) | |
10–14 years | 70 (23.10%) | |
15–19 years | 26 (8.58%) | |
≥20 years | 26 (8.58%) |
Factor 1 | Factor 2 | Factor 3 | Factor 4 | Factor 5 | Factor 6 | Factor 7 | Factor 8 | |
---|---|---|---|---|---|---|---|---|
Ⅰ Physical functioning | ||||||||
Vigorous activities | 0.677 | 0.177 | 0.074 | −0.008 | −0.168 | 0.117 | 0.144 | 0.097 |
Moderate activities | 0.708 | 0.005 | 0.420 | 0.055 | 0.152 | 0.106 | −0.092 | 0.101 |
Lifting or carrying groceries | 0.809 | 0.045 | 0.231 | 0.053 | 0.118 | 0.066 | −0.065 | 0.072 |
Climbing several flights of stairs | 0.784 | 0.006 | 0.133 | 0.029 | 0.000 | 0.080 | 0.145 | 0.028 |
Climbing one flight of stairs | 0.832 | 0.033 | 0.257 | 0.098 | 0.143 | 0.091 | −0.009 | 0.066 |
Bending, kneeling or stooping | 0.814 | 0.070 | 0.002 | 0.043 | 0.005 | 0.044 | 0.096 | 0.101 |
Walking more than 1500m | 0.823 | 0.039 | 0.000 | −0.001 | 0.070 | 0.071 | 0.116 | −0.038 |
Walking several blocks | 0.817 | 0.030 | 0.112 | 0.035 | 0.097 | 0.168 | −0.023 | 0.019 |
Walking one block | 0.746 | 0.040 | 0.225 | 0.082 | 0.133 | 0.112 | −0.094 | 0.195 |
Bathing or dressing yourself | 0.681 | 0.104 | 0.290 | −0.002 | 0.086 | −0.069 | −0.090 | 0.240 |
Ⅱ Role-physical (RP) | ||||||||
RP-Cut down the amount of time in work or other activities | 0.371 | −0.006 | 0.763 | 0.074 | 0.199 | 0.031 | −0.044 | 0.044 |
RP-Accomplished less than you would like | 0.209 | 0.003 | 0.879 | 0.044 | 0.001 | 0.016 | 0.099 | 0.100 |
RP-Limited in the kind of work or other activities | 0.214 | 0.002 | 0.901 | 0.125 | −0.021 | 0.059 | 0.065 | 0.029 |
RP-Had difficulty performing the work or other activities | 0.321 | 0.000 | 0.790 | 0.154 | −0.026 | −0.006 | 0.105 | 0.045 |
Ⅲ Role-emotion (RE) | ||||||||
RE-Cut down the amount of time in work or other activities | 0.031 | 0.056 | 0.110 | 0.963 | 0.086 | 0.044 | 0.041 | 0.026 |
RE-Accomplished less than you would like | 0.103 | 0.054 | 0.125 | 0.952 | 0.143 | 0.035 | 0.074 | 0.039 |
RE-Didn’t do work or other activities as carefully as usual | 0.077 | 0.050 | 0.107 | 0.966 | 0.116 | 0.045 | 0.051 | 0.024 |
Ⅳ Social functioning | ||||||||
Extent that physical health or emotional problems interfered with normal social activities | 0.304 | 0.075 | 0.113 | 0.137 | 0.036 | 0.203 | −0.038 | 0.756 |
Time that physical health or emotional problems interfered with social activities | 0.401 | 0.249 | 0.155 | −0.058 | 0.159 | 0.060 | 0.157 | 0.657 |
Ⅴ Bodily pain | ||||||||
Bodily pain | 0.026 | 0.116 | 0.090 | 0.153 | 0.247 | −0.007 | 0.750 | −0.168 |
Pain interfering with normal work | 0.096 | −0.058 | 0.093 | 0.008 | 0.083 | 0.003 | 0.822 | 0.190 |
Ⅵ Positive mental health | ||||||||
Feel full of pep | 0.188 | 0.248 | 0.020 | 0.072 | 0.280 | 0.586 | 0.066 | 0.157 |
Calm and peaceful | 0.114 | 0.331 | 0.038 | 0.036 | −0.057 | 0.771 | 0.035 | −0.020 |
Have a lot of energy | 0.130 | 0.005 | 0.005 | −0.012 | 0.240 | 0.697 | 0.071 | −0.016 |
Happy | 0.126 | 0.112 | 0.028 | 0.076 | 0.184 | 0.698 | −0.149 | 0.204 |
Ⅶ Negative mental health | ||||||||
Very nervous | 0.037 | 0.627 | −0.062 | 0.065 | −0.060 | 0.173 | 0.046 | −0.097 |
Down in the dumps | 0.071 | 0.811 | 0.001 | −0.013 | 0.098 | 0.133 | −0.022 | 0.027 |
Downhearted and blue | 0.114 | 0.787 | 0.071 | 0.078 | 0.191 | 0.119 | −0.065 | 0.019 |
Feel worn out | 0.066 | 0.783 | 0.002 | 0.084 | 0.173 | 0.031 | 0.075 | 0.120 |
Feel tired | 0.035 | 0.718 | −0.017 | −0.055 | 0.229 | 0.058 | 0.046 | 0.260 |
Ⅷ General health | ||||||||
Get sick a little easier than other people | 0.090 | 0.236 | −0.019 | 0.142 | 0.573 | 0.145 | 0.266 | −0.016 |
Expect health to get worse | −0.016 | 0.170 | −0.025 | 0.148 | 0.697 | 0.091 | 0.225 | 0.132 |
As healthy as anybody | 0.079 | 0.344 | 0.175 | −0.084 | 0.551 | 0.364 | −0.053 | −0.093 |
Excellent health | 0.036 | 0.400 | 0.225 | 0.045 | 0.630 | 0.234 | −0.045 | 0.000 |
Health status | 0.194 | −0.025 | −0.018 | 0.113 | 0.616 | 0.091 | 0.027 | 0.079 |
Sub-Scales | Cronbach’s Alpha | Floor % | Ceiling % | Median | Minimum Score | Maximum Score |
---|---|---|---|---|---|---|
I Physical functioning (PF) | 0.933 | 76.62% | 0.32% | 0 | 0 | 85 |
II Role-physical (RP) | 0.912 | 94.16% | 2.60% | 0 | 0 | 100 |
III Role-emotion (RE) | 0.985 | 70.45% | 26.62% | 0 | 0 | 100 |
IV Social functioning (SF) | 0.669 | 30.52% | 0.32% | 11 | 0 | 100 |
V Bodily pain (BP) | 0.648 | 2.92% | 6.17% | 52 | 12 | 100 |
VI Positive mental health (PMH) | 0.749 | 3.25% | 0.32% | 25 | 0 | 100 |
VII Negative mental health (NMH) | 0.838 | 0.32% | 0.32% | 42 | 0 | 100 |
VIII General health (GH) | 0.758 | 5.84% | 0.32% | 20 | 0 | 100 |
QoL Dimension | Significant Predictors | Standard Beta Coefficient | p |
---|---|---|---|
I Physical functioning (PF) | Outdoor convenience | 0.327 | <0.001 |
Age | −0.227 | <0.001 | |
Disability severity | 0.137 | 0.001 | |
Marital status | −0.137 | 0.015 | |
II Role-physical (RP) | |||
Outdoor convenience | 0.219 | <0.001 | |
III Role-emotion (RE) | |||
Outdoor convenience | 0.259 | <0.001 | |
Age | 0.205 | 0.002 | |
Education | 0.168 | 0.011 | |
IV Social functioning (SF) | |||
Outdoor convenience | 0.347 | <0.001 | |
Rehabilitation exercise | 0.169 | 0.003 | |
Disability severity | 0.165 | 0.003 | |
Gender | 0.124 | 0.022 | |
V Bodily pain (BP) | |||
Outdoor convenience | 0.124 | 0.044 | |
Gender | −0.121 | 0.038 | |
VI Positive mental health (PMH) | |||
Outdoor convenience | 0.193 | <0.001 | |
VII Negative mental health (NMH) | |||
Outdoor convenience | 0.219 | <0.001 | |
rehabilitation exercise | 0.186 | 0.003 | |
Education | −0.137 | 0.021 | |
VIII General health (GH) | |||
Outdoor convenience | 0.222 | <0.001 |
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Xu, Q.; Zheng, D.; Chen, S.; He, Y.; Lin, Z.; Yao, D.; Wang, J.; Zhao, J.; Wu, L.; Liao, Q.; et al. Factors Influencing Disabled Stroke Survivors’ Quality of Life in Rural China: Based on the Structural Characteristics and Psychometric Properties of the SF-36 Assessment. J. Clin. Med. 2023, 12, 3012. https://doi.org/10.3390/jcm12083012
Xu Q, Zheng D, Chen S, He Y, Lin Z, Yao D, Wang J, Zhao J, Wu L, Liao Q, et al. Factors Influencing Disabled Stroke Survivors’ Quality of Life in Rural China: Based on the Structural Characteristics and Psychometric Properties of the SF-36 Assessment. Journal of Clinical Medicine. 2023; 12(8):3012. https://doi.org/10.3390/jcm12083012
Chicago/Turabian StyleXu, Qi, Dingzhao Zheng, Shanjia Chen, Yiqi He, Zhenguo Lin, Dong Yao, Jiamei Wang, Jiapei Zhao, Longqiang Wu, Qiuju Liao, and et al. 2023. "Factors Influencing Disabled Stroke Survivors’ Quality of Life in Rural China: Based on the Structural Characteristics and Psychometric Properties of the SF-36 Assessment" Journal of Clinical Medicine 12, no. 8: 3012. https://doi.org/10.3390/jcm12083012