Factors Predicting Activity of Daily Living among Young and Middle-aged Adults with Post-stroke

Abstract

Objective: To examine factors predicting activities of daily living (ADL) among young and middle-aged stroke survivors during rehabilitation. Methods: A cross-sectional study was conducted among 192 young and middle-aged stroke patients (aged 18–59 years) receiving inpatient rehabilitation at a tertiary hospital in Wenzhou, China. Research instruments used to collect data included the Barthel Index, Hamilton Depression Rating Scale, Stroke self-efficacy, and Social Support Rating Scale. Pearson's correlation and standard multiple linear regression were used for analysis. Results: The mean activities of daily living (ADL) score was 51.73 ± 24.34, indicating moderate dependence. In multiple regression analysis, The model was statistically significant (F(4, 187)= 119.430, p< .001) and explained 71.9% of the variance in ADL (adjusted R²= .713). Stroke self-efficacy was the strongest positive predictor (β= .740, p< .001), followed by depression as a significant negative predictor (β= −.153, p = .023). Social support (β= −.045, p＞.05 ) and BMI (β= −.034, p = .395) did not significantly predict ADL. Conclusion: Rehabilitation interventions should prioritize enhancing patients' confidence in stroke management and alleviating depressive symptoms to optimize ADL recovery. The findings provide evidence for developing targeted nursing interventions to improve functional outcomes in this population.   Keywords: Activities of Daily Living, Post-Stroke, Self-Efficacy, Depression, Social Support, Young and Middle-Aged Adults