28. Application of structural equation modeling to determine factors influencing cognitive impairment, depression, and fatigue among stroke survivors

Nguyen Thi Phuong Thao, Nguyen Xuan Thanh, Nguyen Ngoc Tam, Hoang Bui Hai, Vu Thi Thanh Huyen

Nội dung chính của bài viết

Tóm tắt

This study explored the causal relationships between independent factors (individual factors, stroke characteristics) and post-stroke mental health issues through physiological and behavioral mediating factors. The study design is cross-sectional with a total of 162 stroke survivors treated at Vietnam's National Geriatric Hospital between June and December, 2021. We performed structural equation modeling analysis to calculate the standardization coefficient and correlation coefficient for our hypothesis. The structural model and standardized path coefficients had a goodness-of-fit indexes of Root-MeanSquare Error of Approximation (RMSEA) of 0.089, a comparative fit index (CFI) of 0.997, a Tucker-Lewis Index (TLI) of 0.954, and a standardized root mean-square residual (SRMR) of 0.019. Sleep disorder was positively associated with increasing post-stroke depression (Coef: 4.723; p<0.001) and fatigue status (Coef: 3.846; p<0.001). By contrast, alcohol use disorder was found as a factor that decreased fatigue status (Coef:-4.460; p = 0.005). Furthermore, post-stroke disability severity was significantly related to cognitive impairment (Coef: -3.229; p<0.001), depression (Coef: 1.559; p<0.001), and fatigue (Coef: 1.701; p = 0.002). The severity of post-stroke disability was associated with increasing cognition and mental health problems. Alcohol consumption and sleeplessness were found to be mediating effects between gender and age of stroke patients with changes in post-stroke depression and fatigue.

Chi tiết bài viết

Tài liệu tham khảo

1. Vahid-Ansari F, Lagace D, Albert P. Persistent post-stroke depression in mice following unilateral medial prefrontal cortical stroke. Translational psychiatry. 2016; 6(8): e863-e863.
2. Choi-Kwon S, Kim JS. Poststroke fatigue: an emerging, critical issue in stroke medicine. International Journal of Stroke. 2011; 6(4): 328-336.
3. Andersen G, Vestergaard K, Ingemann-Nielsen M, Lauritzen L. Risk factors for post-stroke depression. Acta Psychiatrica Scandinavica. 1995; 92(3): 193-198.
4. Ponchel A, Bombois S, Bordet R, Hénon H. Factors associated with poststroke fatigue: a systematic review. Stroke research and treatment. 2015; 2015.
5. MacIntosh BJ, Edwards JD, Kang M, et al. Post-stroke fatigue and depressive symptoms are differentially related to mobility and cognitive performance. Frontiers in aging neuroscience. 2017; 9: 343.
6. Pan JH, Song XY, Lee SY, Kwok T. Longitudinal analysis of quality of life for stroke survivors using latent curve models. Stroke. 2008; 39(10): 2795-2802.
7. Zhao L, Yang F, Sznajder KK, Zou C, Jia Y, Yang X. Resilience as the Mediating Factor in the Relationship Between Sleep Disturbance and Post-stroke Depression of Stroke Patients in China: A Structural Equation Modeling Analysis. Frontiers in Psychiatry. 2021; 12: 636.
8. Dick J, Guiloff R, Stewart A, et al. Mini-mental state examination in neurological patients. Journal of Neurology, Neurosurgery & Psychiatry. 1984; 47(5): 496-499.
9. Janneke M, Gooskens F, Schepers VP, Schuurmans MJ, Lindeman E, Hafsteinsdóttir TB. Screening for poststroke depression using the patient health questionnaire. Nursing research. 2012; 61(5): 333-341.
10. Nguyen Thi Dung, Nguyen Thi Ly, Bui Chi Anh Minh, Bui Thuy Ngoc, Pham Thi Cuc. Some factors related to fatigue in chronic kidney failure patients undergoing dialysis at two hospitals in Nam Dinh city (2017). Nghiên cứu gốc. Tap chi khoa hoc đieu duong - Truong đai hoc đieu duong Nam Đinh. 14/3/2019 2017; 02/2019(02).
11. Sarfo FS, Akassi J, Adamu S, Obese V, Ovbiagele B. Burden and predictors of poststroke cognitive impairment in a sample of Ghanaian stroke survivors. Journal of Stroke and Cerebrovascular Diseases. 2017; 26(11): 2553-2562.
12. Li J, Wang J, Wu B, et al. Association between early cognitive impairment and midterm functional outcomes among Chinese acute ischemic stroke patients: A longitudinal study. Frontiers in neurology. 2020; 11:20.
13. Sharpe M, Hawton K, Seagroatt V, et al. Depressive disorders in long-term survivors of stroke: associations with demographic and social factors, functional status, and brain lesion volume. The British Journal of Psychiatry. 1994; 164(3): 380-386.
14. Zhang S, Cheng S, Zhang Z, Wang C, Wang A, Zhu W. Related risk factors associated with post-stroke fatigue: a systematic review and meta-analysis. Neurological Sciences. 2021; 42(4): 1463-1471.
15. Jimenez M, Chiuve SE, Glynn RJ, et al. Alcohol consumption and risk of stroke in women. Stroke. 2012; 43(4): 939-945.
16. Delva I, Lytvynenko N, Delva M. Factors associated with post-stroke fatigue within the first 3 month after stroke. Georgian medical news. 2017; (267): 38-42.
17. Pinder R, Sandler M. Alcohol, wine and mental health: focus on dementia and stroke. Journal of Psychopharmacology. 2004; 18(4): 449-456.
18. Lee M-h, Lee S-A, Lee G-h, et al. Gender differences in the effect of comorbid insomnia symptom on depression, anxiety, fatigue, and daytime sleepiness in patients with obstructive sleep apnea. Sleep and Breathing. 2014; 18(1): 111-117.