The study included a total of 823 patients with complete information at discharge and 3 month follow-up interview. A majority of the patients were women (51.5%), non-Hispanic white (79.2%) and aged 55 − 74 (52.3%). Most had a high school education or more (77.6%) and most were currently married (53.8%). A large majority had 1 or more comorbidities (75.6%). The average positive emotion and depressive symptom score at discharge interview was 9.1 (SD 3.1) and 7.7 (SD 7.1), respectively.
The most prevalent type of stroke was ischemic (74.6%), followed by hemorrhagic (15.4%) and other stroke (10.0%). A high percentage of patients with stroke had left (42.5%) or right body involvement (39.5%). A small percentage had bilateral body involvement (2.9%) and 15.1% had no paresis. The average length of hospital stay was 20.1 (SD 10.1) days.
shows associations for sociodemographic characteristics and health related measures at discharge stratified by mean Total FIM and mean Motor and Cognition FIM ratings at follow-up. Functional status did not significantly differ by age category or by gender. Hispanics had significantly lower Total FIM and Motor FIM ratings than either non-Hispanic whites or non-Hispanic blacks. Similarly, married individuals, those with less than a high school education and those with 2 or more comorbidities had significantly lower mean Total FIM and Motor FIM ratings than the unmarried, those with a high school education or more, and those with fewer than 2 comorbidities.
Patient characteristics at discharge from in-patient medical rehabilitation and mean 3 month follow-up FIM ratings.
shows the unadjusted mean Total FIM and mean Motor and Cognition FIM ratings at follow-up by discharge positive emotion category score. The figure indicates a gradient of association, where higher positive emotion was significantly related to higher mean Total FIM and higher mean Motor and Cognition FIM ratings at follow-up. Individuals in the highest positive emotion category (score 10−12) reported a mean Total FIM rating of 107.5, while those in the lowest positive emotion category (score 0−3) reported a mean Total FIM rating of 84.8. Mean ratings for Motor and Cognition FIM by positive emotion category ranged from a low of 58.5 and 26.3 respectively, to a high of 74.6 and 33.0.
The association between discharge positive emotion score and mean Total FIM, Cognition FIM and Motor FIM ratings at 3 month follow-up.
To examine the independent association between discharge positive emotion and follow-up Total FIM rating we tested three generalized linear regression models (). For each model, unstandardized parameter estimates (b) and standard error (SE) were presented, p < 0.05 was considered significant. Time to follow-up interview was not significantly associated with FIM ratings (p = 0.97) and was not included as a variable in any of the models.
The association between discharge positive emotion and Total FIM rating at 3 month follow-up (N = 823).
In each of the multivariate models, discharge positive emotion score was significantly associated with follow up Total FIM rating three months later. In Models 1 and 2, each 1-point increase in positive emotion score was significantly associated with a 0.95 and 1.01 point increase in Total FIM rating, respectively. In Model 3 (full model), each 1-point increase in discharge positive emotion score was significantly associated with a 0.70 point increase in follow up Total FIM rating after adjustment for sociodemographic characteristics and clinical measures of health status. Significant covariates of follow-up Total FIM rating in Model 3 included ethnicity, (i.e., non-Hispanic blacks and Hispanics reported lower follow-up Total FIM ratings than non-Hispanic whites), as well as number of comorbidities, depressive symptoms, increasing length of stay, type of stroke and Total FIM ratings at discharge.
shows the association between discharge positive emotion score and Motor and Cognition FIM, adjusting for sociodemographic characteristics and health-related measures included in (Model 3). The findings showed higher positive emotion score was significantly associated with higher Motor FIM and higher Cognition FIM at follow-up. Common predictors of both Motor and Cognition FIM at follow-up included ethnicity, depressive symptoms and number of comorbidities. Gender, education, length of stay and type of stroke were significantly associated with Motor FIM but not Cognition FIM at follow-up.
Association between discharge positive emotion and Motor FIM and Cognition FIM ratings at 3 month follow-up (N = 823).