Demographic and clinical information.

To estimate the extent to which physical capability, depressive symptoms, balanced self-efficacy (BSE), and other risk factors, that are interrelated with stroke, influence the quality of life (QoL) in stroke survivors. A theoretical model based on Wilson and Cleary’s model tested the specific hypotheses: 1) physical capability has an indirect effect on QoL mediated by BSE; 2) physical capability has an indirect effect on QoL by depressive symptoms; 3) stroke risk factors (hypertension/diabetes/gender) moderate the above relationship. Six hundred and seventy stroke survivors were enrolled from ten different hospitals in Yunnan province from 2019 to 2021. Patients’ mental and physical function was assessed using the Brunnstrom recovery stage (BRS), mini-balance evaluation system test (Mini-BEST), Barthel index (BI), Activities-specific Balance Confidence scale (ABC), and Hamilton depression scale (HAM-D). The structural equation model (SEM) was used to test the moderated mediation model in Mplus 8.0 software. The model showed a good fit (RMSEA = 0.075, SRMR = 0.010). BSE significantly mediated the relationship between physical capability and QoL (β = 0.322, p = 0.002). Hypertension was found a significant moderator of all the direct paths from physical capability to QoL through depressive symptoms (В = 0.412, p = 0.015; В = 0.831, p = 0.020, respectively). This study provides a better insight into the relationship between physical capability and QoL via BSE in stroke survivors, which may help establish appropriate treatment for these individuals.

为探究与脑卒中存在关联的躯体功能、抑郁症状、平衡自我效能（balanced self-efficacy, BSE）及其他危险因素对脑卒中幸存者生存质量（quality of life, QoL）的影响程度，本研究基于Wilson与Cleary模型构建理论框架，验证三项具体假设：1）躯体功能可通过平衡自我效能的中介作用对生存质量产生间接影响；2）躯体功能可通过抑郁症状对生存质量产生间接影响；3）脑卒中危险因素（高血压/糖尿病/性别）对上述关联存在调节作用。本研究于2019年至2021年间，从云南省10家不同医院招募670名脑卒中幸存者，采用Brunnstrom恢复阶段评分（Brunnstrom recovery stage, BRS）、迷你平衡评估系统测试（mini-balance evaluation system test, Mini-BEST）、巴氏指数（Barthel index, BI）、活动特异性平衡信心量表（Activities-specific Balance Confidence scale, ABC）以及汉密尔顿抑郁量表（Hamilton depression scale, HAM-D）对受试者的精神与躯体功能进行评估。使用Mplus 8.0软件构建结构方程模型（structural equation model, SEM），对有调节的中介模型进行检验。结果显示模型拟合效果良好（近似误差均方根RMSEA=0.075，标准化残差均方根SRMR=0.010）；平衡自我效能在躯体功能与生存质量的关联中发挥了显著的中介作用（β=0.322，p=0.002）；高血压对躯体功能通过抑郁症状指向生存质量的全部直接路径均存在显著的调节作用（β=0.412，p=0.015；β=0.831，p=0.020）。本研究阐明了脑卒中幸存者中躯体功能通过平衡自我效能影响生存质量的内在关联，可为该群体的个性化干预方案制定提供参考依据。