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(Stroke. 1998;29:2325-2328.)
© 1998 American Heart Association, Inc.

Original Contributions

State Self-Esteem Following Stroke

Anne M. Chang, MEdSt, RN; Ann E. Mackenzie, PhD, RN

From the Department of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong.

Correspondence to Anne Chang, Department of Nursing, Sino Building, The Chinese University of Hong Kong, Shatin, NT, Hong Kong. E-mail annemchang{at}cuhk.edu.hk

Background and Purpose—Physical rehabilitation after stroke is often highlighted in the absence of consideration of psychosocial factors. This study sought to determine the relationship between state self-esteem and functional independence in patients recovering from stroke.

Methods—In a longitudinal study, data were collected from 152 stroke patients within 48 hours of admission to a rehabilitation hospital and at 2 weeks and 3 months after admission. The Modified Barthel Index was used to assess functional ability. Patients' current feelings of self-worth were assessed with use of the State Self-Esteem Scale. Additional variables included perceived social support, trait self-esteem, age, previous stroke, side of stroke, comorbidity, marital status, and gender.

Results—State self-esteem was significantly correlated to functional independence. The results of linear stepwise regression analysis indicated that functional ability and state self-esteem at 2 weeks, as well as the presence of heart disease, were significant predictors (55%) of functional ability at 3 months. For those with a functional ability score of 81 on admission to the rehabilitation unit, state self-esteem and functional ability at 2 weeks as well as previous stroke explained 53% of the variance in functional ability at 3 months. When functional ability was 80, baseline and 2-week functional ability, state self-esteem at 2 weeks, and age predicted 53% of the variance in functional ability at 3 months.

Conclusions—Functional ability at 2 weeks was a stronger predictor than baseline functional ability in this study. The level of state self-esteem was also a consistent factor in the prediction of functional outcome of patients after stroke.

Key Words: psychology • rehabilitation • stroke outcome

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