A Structural Equation Model on Social Readjustment of Stroke Patients: Based on Roy's Adaptation Model

초록

Aim(s): This structural model study aimed to identify the factors affecting social readjustment of stroke patients, to propose a hypothetical model, and to test the developed model with empirical data. Method(s): The hypothetical model was developed based on Roy’s adjustment model (1991) and a review of previous literature on the topic. It consists of four exogenous variables (neurological damage, sex, age, and social support) and five endogenous variables (activities of daily living, acceptance of disability, depression, rehabilitation motivation and social readjustment). The subjects were 321 stroke patients. The data were analyzed using IBM SPSS/WIN 22.0 and AMOS 23.0. Result(s): The fit of the hypothetical model was χ2=222.902, χ2/df=2.533, CFI=.937, TLI=.902, RMSEA=.069, SRMR=.054, which indicates that the model is fairly suitable. 18 of the model’s 28 research hypotheses were supported, and explained 64.1% of stroke patients’ social readjustment. According to the findings, social readjustment is directly and significantly affected by age (SRW=-.379, p<.001), social support (SRW=.295, p<.001), activities of daily living (SRW=.335, p<.001), and depression (SRW=-.244, p<.01). On the other hand, neurological damage (SRW=-.062, p=.358), sex (SRW=.059, p=.282), acceptance of disability (SRW=-.100, p=.218), and rehabilitation motivation (SRW=.055, p=.391) did not have significant direct effect. Conclusion(s): Continuous assistance should be provided to stroke patients who require long-term rehabilitation and care on account of disabilities caused by sudden neurological damage, including active nursing intermediation in physical, psychological, and social aspects, so as to improve their social readjustment gradually. In order to improve stroke patients’ social readjustment, their activities of daily living should be increased, and enhanced social support should be provided to prevent depression.