Baseline RLOC characteristics across genders.

Background
The reintegration of stroke survivors into society is significantly and independently influenced by the survivors’ physical disabilities and emotional disturbances. In this study, we examined the relationships between stroke survivors’ emotional disturbances, physical functioning, perceived control, and health-related quality of life (QOL) during the early recovery phase, aiming to determine the predictive value of these variables for QOL outcomes.
Methods
This cross-sectional study involved 66 acute stroke patients attending the outpatient rehabilitation unit of a teaching hospital in Kuala Lumpur, Malaysia. The variables of interest we measures using the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression, the Euroqol-5-dimensions-5-levels (EQ-5D-5L) for QOL, the Modified Barthel Index (MBI) for physical functioning, and the Recovery Locus of Control (RLOC) scale for perceived control. Pearson’s correlation and regression analyses were performed to determine the ability of the variables to predict stroke survivors’ QOL.
Results
Most of the patients were between 50 and 59 years old and were in the early stages of poststroke recovery. Although no significant gender differences were found in overall HADS scores (7.69 vs. 7.52), emotional disturbances, particularly anxiety disorders, were more prevalent among males, with 57% reporting symptoms compared to 48% of females. Health-related QOL was significantly correlated with physical functioning (r = −.439, p < .001), anxiety (r = .292, p < .001), and internal locus of control (r = −.224, p < .001). The study also revealed that QOL could be predicted by HADS (F = 4.03, p < .001), RLOC (F = 2.86, p < .001), and MBI (F = 7.46, p < .001) scores.
Conclusion
In addition to physical disabilities, perceived control and emotional disturbances had a substantial influence on stroke survivors’ QOL outcomes. Addressing these psychosocial and behavioural factors within treatment plans is crucial for improving stroke survivors’ poststroke recovery and enhancing their QOL.

背景
卒中幸存者的社会再融入程度显著且独立地受其躯体残疾与情绪障碍影响。本研究旨在探讨卒中康复早期阶段，幸存者的情绪障碍、躯体功能、感知控制与健康相关生活质量（health-related quality of life，QOL）之间的关联，以明确上述变量对QOL结局的预测价值。

方法
本项横断面研究纳入了马来西亚吉隆坡某教学医院门诊康复科的66名急性卒中患者。研究采用医院焦虑抑郁量表（Hospital Anxiety and Depression Scale，HADS）评估焦虑与抑郁状态、欧洲五维健康量表-5级版（Euroqol-5-dimensions-5-levels，EQ-5D-5L）评估健康相关生活质量、改良Barthel指数（Modified Barthel Index，MBI）评估躯体功能、康复心理控制源量表（Recovery Locus of Control，RLOC）评估感知控制水平。随后采用Pearson相关分析与回归分析，明确上述变量对卒中幸存者QOL的预测能力。

结果
研究对象多为50~59岁人群，且处于卒中后早期康复阶段。尽管总体HADS评分未呈现显著性别差异（7.69 vs. 7.52），但情绪障碍尤其是焦虑症状在男性中更为普遍，男性症状报告率达57%，女性为48%。健康相关生活质量与躯体功能（r=-0.439，p<0.001）、焦虑程度（r=0.292，p<0.001）及内控型心理控制源（r=-0.224，p<0.001）均呈显著相关。本研究同时证实，HADS评分、RLOC评分与MBI评分均可有效预测QOL（F=4.03，p<0.001；F=2.86，p<0.001；F=7.46，p<0.001）。

结论
除躯体残疾外，感知控制水平与情绪障碍同样对卒中幸存者的QOL结局具有显著影响。在治疗方案中纳入此类社会心理与行为干预因素，对于改善卒中幸存者的卒中后康复效果及提升其生活质量至关重要。