Identifying Anxiety, Social Support and Spiritual Well-Being States of Patients Experiencing Cerebrovascular Event: A cross-sectional descriptive study

Identifying Anxiety, Social Support and Spiritual Well-Being States of Patients Experiencing Cerebrovascular Event: A cross-sectional descriptive study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Identifying Anxiety, Social Support and Spiritual Well-Being States of Patients Experiencing Cerebrovascular Event: A cross-sectional descriptive study Ugur Oner, Ahmet Erol, Hediye Utli, Mahmut Dinc This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5319125/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: It has been observed to play an important role in providing holistic care by considering anxiety, social support and spiritual well-being in the care of patients. The present study aimed to determine the anxiety, social support and spiritual well-being states of patients who experience a cerebrovascular event. Methods: The descriptive and cross-sectional study was completed with 231 cerebrovascular patients. The data were collected using the “Patient Information Form”, “Multidimensional Scale of Perceived Social Support”, “Beck Anxiety Inventory” and “Spiritual Well-Being Scale”. Results: The mean age of the patients participating in the study was 60.62±10.44, with 52.4% being female. The patients were seen to obtain 63.09 ± 12.45 points over the Multidimensional Scale of Perceived Social Support, indicating a moderate level of perceived social support. It was found that the total score of the patients was 53.59 ± 11.50 points on the Beck Anxiety Inventory, which showed high levels of anxiety. The patients scores an average of 43.62 ± 8.65 points on the Spiritual Well-Being Scale, indicating a moderate level of spiritual well-being. A positive significant correlation was found between the perceived social support and spiritual well-being levels of the patients. Conclusion: As a result of the present study, it was found that the patients had a moderate level of perceived social support, high level of anxiety and moderate level of spiritual well-being. A positive relationship was found between the patients’ perceived social support and anxiety levels. A positive relationship was determined between the patients’ age and spiritual well-being levels. Anxiety patient cerebrovascular event social support spiritual well-being Introduction Cerebrovascular disease (CVD) is a deficit that can develop suddenly, either focal or generalized, lasts longer than 24 hours, may result in death and cannot be explained by any cause other than vascular reasons [ 1 ]. The prevalence of patients who have experienced CVD is estimated to exceed 60 million around the world. Approximately 16 million people worldwide are diagnosed with CVD each year [ 2 ]. Today, the incidence of CVD is increasing by 8.7% annually with the increasing elderly population [ 3 ]. According to the 2022 data in Türkiye, CVD is the 3rd disease causing death with a rate of 19.2% [ 4 ]. Additionally, CVD has become one of the most significant reasons causing patients over 65 to be hospitalized today [ 2 ]. CVD is not only a physical disease, but also a condition that can lead to various psychological problems. The most frequently reported ones are anxiety and depression [ 5 ]. A systematic study has shown that the rate of anxiety due to CVD is 20.4% in patients [ 6 ]. Similarly, in the studies conducted by Karahan AY. and Kaydok E, as well as Müftüoğlu and colleagues it was found that patients’ anxiety levels were high following CVD [ 7 ]. Studies have looked into the factors affecting anxiety levels following CVD. Accordingly, gender, the severity of the disease, mental disorders, the presence of chronic diseases and smoking were reported to increase patients’ anxiety levels [ 8 ]. Patients may develop various chronic problems such as stroke after CVD, which could lead patients to become dependent on care [ 9 ]. Social support plays a key role in patients’ ability to cope with and adapt to their disease. Evidence shows that patients who receive social support report lower anxiety symptoms [ 6 ], [ 10 ], [ 11 ]. Social support is known as a multidimensional structure. Social support is defined as the material and spiritual assistance provided by the people (spouse, family, and friends) around an individual who is under pressure or in difficulty. Social support is increasingly more associated with the overall health condition, and the course and rehabilitation of diseases. Social support is considered to affect the patient’s physical and psychosocial well-being, the quality of patient care and the result of the disease among patients who experience CVD [ 12 ]. Professional nurses should ensure the patient’s comfort and meet their spiritual needs during the treatment, care and rehabilitation process of patients diagnosed with CVD. Given that CVD is condition that considerably changes and threatens the quality of life, it is important to meet the patient’s spiritual needs. Indeed, spiritual care is known to have a positive effect on patients [ 13 ]. The spiritual care provided by a professional nurse helps the patient to cope with problems such as depression and anxiety experienced following CVD. In addition, it facilitates patients’ recovery and adaptation processes. Considering the potential benefits of spiritual support and spiritual care following CVD for the patient, it is essential that nurses incorporate spiritual care and social support needs into the treatment, care and rehabilitation process. As a matter of fact, one study has reported that patients receiving social support have better psychological health, quality of life, cognition, daily life activities, social participation and spiritual well-being [ 3 ]. When the related literature was reviewed, no study could be found to examine CVD patients’ anxiety, social support and spiritual well-being states together. In this regard, our study is expected to contribute to the literature in terms of evaluating the anxiety, social support and spiritual well-being of patients who experience CVD as well as the correlations among them. The present study was conducted with the aim of determining the anxiety, social support and spiritual well-being of patients who have experienced CVD. Methods Design The study a descriptive and cross-sectional in nature. The population of the study consisted of patients (n = 540) hospitalized in the Neurology, Brain Surgery and Stroke Units of a Training and Research Hospital in XXX. The sample size was calculated as 225 patients with a 95% confidence interval, 5% margin of error and 95% power analysis. The study was completed with 231 patients who met the inclusion criteria and agreed to participate. The data were collected between June and December 2023. Inclusion Criteria Patients who were hospitalized with a CVD diagnosis in the Neurology, Brain Surgery and Stroke Units of a Training and Research Hospital in XXX, aged 18 and over, conscious and open to communication and cooperation were included. Data Collection Instruments The data were collected using the Patient Information Form, “Multidimensional Scale of Perceived Social Support” (MSPSS), “Beck Anxiety Inventory” (BAI) and “Spiritual Well-Being Scale” (SWBS). Patient Information Form Developed by the researchers, the form consists of 12 questions asking about the patients’ age, gender, marital status, education level, occupation, social security, smoking habits, alcohol consumption habits, presence of chronic diseases, state of assistance, type of CVD and the affected hemisphere of the brain. Multidimensional Scale of Perceived Social Support The MSPSS was developed by Zimet and colleagues in the United States of America and its Turkish validity and reliability was established by Eker and colleagues in 2001 [ 14 ]. The MSPSS is a 7-point Likert type scale consisting of 12 items to measure the sufficiency of the social support received from three different sources (family, friends and a significant other). The minimum possible score to be obtained from the scale is 12 and the maximum score is 84. A high score indicates a high level of perceived social support. While the Cronbach’s Alpha coefficient of the original scale was 0.89 [ 14 ], it was found as 0.87 in the present study. Beck Anxiety Inventory The BAI was developed by Beck and colleagues to measure the frequency of individuals’ anxiety symptoms [ 15 ]. Its Turkish validity and reliability study was conducted by Ulusoy and colleagues (1998) [ 16 ]. It is a 7-point Likert type scale consisting of 21 items. The minimum score to be obtained on the scale is 0, while the maximum score is 63. Higher total scores indicate increased anxiety experienced by the individual. The Cronbach’s Alpha coefficient of the original scale was 0.93 [ 16 ] whereas it was found to be 0.89 in the present study. Spiritual Well-Being Scale The SWBS was developed by Daaleman and Frey in 2004 to measure spiritual well-being among individuals [ 17 ]. Serbest and Akgün conducted the Turkish validity and reliability study of the scale [ 18 ]. The 5-point-Likert type scale consists of 2 subscales (life plan and self-efficacy) and 12 items. The minimum and maximum possible scores on the scale are 12 and 60, respectively. Higher scores indicate that individuals have high levels of spiritual well-being. While the Cronbach’s Alpha coefficient of the original scale was 0.95 [ 18 ], it was found as 0.87 in the present study. Data Collection The data were collected through face-to-face interviews. The aim of the study was explained to the patients and they were informed that the data would be kept confidential and that they could leave the study aby time they wanted. Written consent was received from the patients who agreed to participate. The researchers waited in the patient’s room until the questionnaires were completed to prevent influence from accompanying individuals around them. It took approximately 20–25 minutes to fill in the questionnaires. The forms were checked for missing data while collecting the forms. Data Analysis The data obtained were analysed on the SPSS 25.0 software. Numbers, percentages, means, standard deviation, minimum and maximum values were used for the descriptive statistics of the data. Normality was tested using Kolmogorov Simirnov and graphic methods. Mann-Whitney U test, Kruskal-Wallis test, Bonferroni and Spearman correlation analysis were conducted to analyse the data that were not normally distributed. Cronbach’s Alfa reliability coefficients were evaluated to determine the internal consistencies of the scales and subscales. The level of significance was accepted as p < 0.05 for the statistical analyses. Results The mean age of the patients who participated in the study is 60.62 ± 10.44, with 35.5% of them being in the 50–60 age group. Of the patients, 52.4% are female, 81.4% are married, and a majority (54.5%) completed primary education and 42.4% are housewives. It was seen that 80.1% of these patients had social security, 54.1% had smoking history and 94.4% did not consume alcohol. It was also determined that 73.1% of the patients had a chronic disease and 19.9% were diagnosed with Hypertension + Diabetes. It was found that 43.7% of the patients received help from their daughter or son, 68% had had cerebral infarction and 53.2% had their left hemisphere affected (Table 1 ). Table 1 Descriptive Characteristics of Patients (n = 231) Variable Age (Mean ± SD) 60.62 ± 10.44 n (%) Age 39–49 37 (%16.0) 50–60 82 (%35.5) 61–71 79 (%34.2) Those aged over 72 33 (%14.3) Gender Female 121 (%52.4) Male 110 (%47.6) Marital status Married 188 (%81.4) Single 43 (%18.6) Education level İlliterate 69 (29.9%) Primary school 126 (%54.5) High school 27 (%11.7) Undergraduate 9 (%3.9) Occupation Housewife 98 (%42.4) Retired 66 (%28.6) Self-employed 36 (%15.6) Civil servant 26 (%11.3) Worker 5 (%2.2) Social security Yes 185 (%80.1) No 46 (%19.9) Smoking habits Yes 98 (%42.4) No 106 (%45.9) Cessation 27 (%11.7) Alcohol consumption habits Yes 6 (%2.6) No 218 (%94.4) Cessation 7 (%3.0) Presence of chronic diseases Yes 169 (%73.1) No 62 (%26.9) Various chronic diseases * Hypertension + Diabetes 46 (%19.9) Hypertension 39 (%16.9) Diabetes 23 (%10.0) Heart failure + Diabetes 17 (%7.4) Heart failure 16 (%9.4) Heart failure + Hypertension 15 (%6.5) Coronary artery disease 8 (%3.5) Kidney failure 5 (%2.2) The person providing care for the patient Daughter/son 101 (%43.7) Spouse 54 (%23.4) Spouse + daughter + son 54 (23.4%) Daughter-in-law 9 (%3.9) Caregiver 6 (%2.6) None 7 (3.0%) Type of CVD Cerebral infarction 157 (%68.0) Cerebral haemorrhage 74 (%32.0) The affected hemisphere of the brain Right hemisphere 108 (%46.8) Left hemisphere 123 (%53.2) The total mean score on the MSPSS was found as 63.09 ± 12.45 in the present study, indicating a moderate level of perceived social support. The highest mean score among the subscales belonged to “family” (22.11 ± 4.31), the second highest mean score was on “friends” (21.30 ± 4.68), while the lowest mean was found to belong to “a significant other” (19.67 ± 5.24) (Table 2 ). The total mean score of the participants on the BAI was found as 53.59 ± 11.50, which showed that the patients experiences a high level of anxiety (Table 2 ). The patients’ total mean score was calculated as 43.62 ± 8.65 on the SWBS and it was concluded that they had a moderate level of spiritual well-being. The mean score on the self-efficacy subscale on this scale was 24.75 ± 5.30, indicating a moderate level of self-efficacy for life, while it was 18.87 ± 4.20 on the life plan subscale, which revealed that the participants had a moderate level of perception of making sense of their lives (Table 2 ). Table 2 Comparison of MSPSS, BAI and SWBS Total and Subscale Scores Scale Mean ± SD* Median (Min-Max) ** Cronbach Alfa MSPSS 63.09 ± 12.45 63.00 (21.00–83.00) 0.873 Family 22.11 ± 4.31 23.00 (6.00–28.00) 0.718 Friends 21.30 ± 4.68 22.00 (6.00–28.00) 0.686 Significant other 19.67 ± 5.24 20.50 (6.00–28.00) 0.764 BAI 53.59 ± 11.50 49.00 (29.00–74.00) 0.896 SWBS 43.62 ± 8.65 40.00 (18.00–58.00) 0.872 Self-efficacy 24.75 ± 5.30 23.00 (11.00–35.00) 0.818 Life plan 18.87 ± 4.20 18.00 (7.00–25.00) 0.773 * SD: Standard Deviation, **Scale total min-max point Table 3 displays the comparisons of the patients’ socio-demographic characteristics and their total and subscale mean scores on the MSPSS, BAI and SWBS. It was found that patients aged between 61 and 71 had higher mean scores on the family and self-efficacy subscales compared to those aged over 72 ( p = 0.020; p = 0.003 ). Patients in the 39–49 years age group had higher mean scores on BAI total as well as the friends and self-efficacy subscales than those aged over 72 ( p = 0.011 ; p = 0.022; p = 0.008 ). The total BAI mean score for patients aged 39–49 was higher than that of patients in the age groups 50–60 and 61–71 ( p = 0.000 ). The total mean scores on the self-efficacy subscale were higher among the patients aged 50–60 compared to those aged over 72 and among male patients compared to female patients ( p = 0.012 ). Patients who were high school graduates had significantly higher mean scores on total BAI and friends subscale than the patients who were illiterate ( p = 0.000 ; p = 0.012; p = 0.006 ). Total BAI and SWBS mean scores of high school graduates were found to be significantly higher than those of patients who completed primary education ( p = 0.036; p = 0.046; p = 0.027 ). Patients with an occupation as civil servants had a higher total mean score on the MSPSS compared to those who were workers ( p = 0.049 ). Patients with an occupation as civil servants had a higher total mean score on the BAI than those who were retired ( p = 0.004 ). Patients who were housewives had a higher mean score on the life plan subscale than workers ( p = 0.048 ). The total SWBSS mean score of self-employed was higher compared to the patients who were workers ( p = 0.010 ). Patients who had a chronic disease were found to have higher mean scores on the total MSPSS, total BAI, total SWBS, as well as the subscales of family, friends and self-efficacy compared to those who did not have a chronic disease. The total MSPSS mean scores and family subscale mean scores of the patients diagnosed with hypertension + diabetes were higher than those diagnosed with diabetes alone ( p = 0.045; p = 0.046 ). The mean score on the “significant other” subscale was found to be higher among the patients diagnosed with hypertension + diabetes than those diagnosed with heart failure + diabetes ( p = 0.006 ). Patients diagnosed with hypertension and heart failure + diabetes were found to have a higher total mean score on the BAI compared to those diagnosed with diabetes alone ( p = 0.039 ). Patients who received help from their daughter/son were seen to have higher scores on the total MSPSS, total SWBS, as well as the family, friends, self-efficacy and life plan subscales compared to those who received help from a caregiver ( p = 0.016; p = 0.012; p = 0.008; p = 0.029; p = 0.020; p = 0.048 ). Patients who received help from their spouse were found to have higher mean scores on the family and life plan subscales compared to those receiving help from their daughter-in-law ( p = 0.031; p = 0.029 ). Patients who received help from their spouse were determined to have higher mean scores on the total MSPSS, as well as the family, friends and life plan subscales than patients receiving help from a caregiver ( p = 0.029; p = 0.001; p = 0.026; p = 0.043 ). It was found that the total BAI mean score of cerebral haemorrhage patients was higher than that of patients with cerebral infarction. Patients with left hemisphere brain damage had higher mean scores on the total MSPSS, family, friends and life plan subscales than those who had their right hemisphere affected. Table 3 Comparisons of the Patients’ Socio-Demographic Characteristics and Their Total and Subscale Mean Scores on The MSPSS, BAI and SWBS Variable Family Friends Significant other MSPSS Total BAI Total Self-efficacy Life Plan SWBS Total Median (Min-Max) Median (Min-Max) Median (Min-Max) Median (Min-Max) Median (Min-Max) Median (Min-Max) Median (Min-Max) Median (Min-Max) Age 39–49 23.00 (17.00–26.00) 23.50 (15.00–26.00) 21.00 (13.00–25.00) 68.50 (45.00–77.00) 63.00 (41.00–68.00) 21.50 (19.00–31.00) 15.00 (10.00–23.00) 36.50 (29.00–54.00) 50–60 23.00 (6.00–28.00) 21.50 (7.00–27.00) 21.50 (8.00–28.00) 61.00 (21.00–82.00) 46.00 (32.00–69.00) 24.50 (11.00–34.00) 19.50 (7.00–24.00) 46.50 (18.00–57.00) 61–71 24.00 (12.00–28.00) 23.00 (9.00–28.00) 20.00 (6.00–28.00) 66.00 (27.00–83.00) 48.00 (33.00–69.00) 24.00 (12.00–35.00) 19.00 (13.00–24.00) 45.00 (26.00–58.00) Those aged over 72 23.00 (6.00–28.00) 22.00 (6.00–28.00) 20.50 (6.00–28.00) 63.00 (21.00–83.00) 49.00 (29.00–74.00) 23.00 (11.00–35.00) 18.00 (7.00–25.00) 40.00 (18.00–58.00) Mann-Whitney /KW KW:10.729, p = 0.013** KW:10.259, p = 0.016** KW:0.226, p = 0.973** KW:4.635, p = 0.218** KW:25.529, p < 0.001** KW:14.149, p = 0.003** KW:4.311, p = 0.230** KW:10.754, p = 0.013** Gender Female 23.00 (8.00–28.00) 22.00(6.00–27.00) 21.00(8.00–28.00) 63.00 (23.00–82.00) 50.00(34.00–74.00) 22.00 (11.00–34.00) 18.00(7.00–25.00) 40.00 (18.00–56.00) Male 24.00 (6.00–28.00) 22.00(7.00–28.00) 19.00(6.00–28.00) 63.00 (21.00–83.00) 47.00(29.00–68.00) 23.00 (12.00–35.00) 18.00(11.00–24.00) 41.00 (25.00–58.00) Mann-Whitney /KW z=-1.041, p = 0.298* z=-0.508, p = 0.612* z=-0.294, p = 0.769* z=-0.678, p = 0.498* z=-0.857, p = 0.391* z=-2.159, p = 0.031* z=-0.112, p = 0.911* z=-1.055, p = 0.291* Education level İlliterate 23.00 (6.00–28.00) 21.50 (6.00–28.00) 20.50 (6.00–28.00) 61.50 (23.00–83.00) 48.50 (32.00–66.00) 23.00 (12.00–34.00) 18.00 (10.00–25.00) 40.00 (26.00–57.00) Primary school 23.00 (6.00–28.00) 22.00 (7.00–28.00) 21.00 (8.00–27.00) 63.00 (21.00–82.00) 48.00 (29.00–74.00) 23.00 (11.00–35.00) 18.00 (7.00–24.00) 38.00 (29.00–54.00) High school 24.00 (17.00–26.00) 22.00 (17.00–27.00) 17.00 (13.00–23.00) 63.00 (50.00–76.00) 59.00 (46.00–66.00) 23.00 (19.00–31.00) 17.00 (10.00–23.00) 40.00 (18.00–58.00) Undergraduate 23.00 (6.00–28.00) 22.00 (6.00–28.00) 20.50 (6.00–28.00) 63.00 (21.00–83.00) 49.00 (29.00–74.00) 23.00 (11.00–35.00) 18.00 (7.00–25.00) 40.00 (18.00–58.00) Mann-Whitney /KW KW:7.419, p = 0.060** KW:10.912, p = 0.012** KW:2.037, p = 0.565** KW:7.826, p = 0.084** KW:26.529, p = 0.000** KW:16.486, p = 0.001** KW:5.345, p = 0.148** KW:12.515, p = 0.006** Occupation Housewife 22.50 (6.00–28.00) 22.00 (6.00–27.00) 20.50 (8.00–28.00) 62.00 (23.00–82.00) 50.50 (34.00–74.00) 22.50 (11.00–34.00) 18.00 (7.00–25.00) 40.00 (18.00–56.00) Retired 24.00 (12.00–28.00) 20.00 (10.00–28.00) 21.00 (9.00–28.00) 60.00 (34.00–83.00) 42.00 (29.00–65.00) 23.00 (13.00–35.00) 18.00 (10.00–24.00) 46.00 (26.00–58.00) Self-employed 24.50 (12.00–28.00) 23.00 (9.00–27.00) 19.00 (6.00–27.00) 65.50 (27.00–80.00) 51.00 (32.00–66.00) 24.00 (12.00–33.00) 20.00 (11.00–24.00) 44.00 (25.00–57.00) Civil servant 26.00 (20.00–26.00) 26.00 (17.00–27.00) 23.00 (16.00–25.00) 76.00 (53.00–77.00) 60.00 (59.00–68.00) 25.00 (19.00–25.00) 16.00 (10.00–22.00) 41.00 (29.00–47.00) Worker 20.50 (6.00–24.00) 18.00 (7.00–24.00) 15.00 (8.00–24.00) 53.50 (21.00–72.00) 52.50 (46.00–65.00) 20.00 (19.00–22.00) 13.00 (10.00–18.00) 33.00 (29.00–40.00) Mann-Whitney /KW KW:7.812, p = 0.232** KW:8.925, p = 0.063** KW:6.942, p = 0.139** KW:10.178, p = 0.038** KW:13.247, p = 0.010** KW:6.167, p = 0.072** KW:12.553, p = 0.014** KW:10.079, p = 0.039** Presence of chronic diseases Yes 23.50 (8.00–28.00) 22.50 (8.00–27.00) 20.00 (6.00–28.00) 63.00 (21.00–82.00) 50.00(29.00–74.00) 24.00 (12.00–35.00) 18.00(7.00–25.00) 44.00 (18.00–56.00) No 21.00 (6.00–28.00) 19.00 (7.00–26.00) 19.50 (6.00–28.00) 57.00 (21.00–72.00) 40.00 (29.00–69.00) 22.00 (11.00–34.00) 17.00 (12.00–24.00) 40.00 (25.00–54.00) Mann-Whitney /KW z:-2.450, p = 0.001* z:-3.056, p = 0.042* z:-0.067, p = 0.567* z:-2.639, p = 0.026* z:8.033, p = 0.018* z:-2.345, p = 0.021* z:-1.214, p = 0.344* z:-3.028, p = 0.019* Various chronic diseases Hypertension + Diabetes 25.00 (19.00–28.00) 22.00 (14.00–28.00) 23.50 (10.00–28.00) 69.50 (49.00–83.00) 48.00 (33.00–64.00) 26.50 (12.00–34.00) 22.00 (10.00–24.00) 48.00 (26.00–57.00) Hypertension 23.50 (13.00–28.00) 23.00 (15.00–28.00) 21.00 (9.00–26.00) 68.50 (37.00–82.00) 58.50 (33.00–69.00) 24.00 (14.00–32.00) 19.50 (10.00–25.00) 41.50 (26.00–56.00) Diabetes 20.00 (12.00–27.00) 21.00 (6.00–27.00) 23.00 (10.00–27.00) 64.00 (31.00–80.00) 44.00 (34.00–65.00) 22.00 (11.00–34.00) 17.00 (7.00–24.00) 39.00 (18.00–58.00) Heart failure + Diabetes 24.00 (6.00–26.00) 21.00 (8.00–26.00) 10.00 (8.00–24.00) 53.00 (23.00–76.00) 60.00 (36.00–66.00) 22.00 (18.00–32.00) 19.00 (14.00–23.00) 40.00 (35.00–55.00) Heart failure 22.00 (6.00–27.00) 22.00 (8.00–27.00) 19.00 (9.00–26.00) 61.00 (23.00–80.00) 61.00 (40.00–66.00) 21.00 (17.00–32.00) 18.00 (14.00–23.00) 40.00 (35.00–53.00) Heart failure + Hypertension 20.00 (14.00–24.00) 21.50 (9.00–24.00) 23.00 (16.00–24.00) 63.50 (41.00–72.00) 65.00 (50.00–74.00) 21.00 (19.00–24.00) 14.00 (14.00–20.00) 36.00 (35.00–39.00) Coronary artery disease 21.00 (18.00–21.00) 18.00 (13.00–18.00) 16.00 (13.00–18.00) 52.00 (47.00–57.00) 41.00 (39.00–55.00) 21.00 (19.00–22.00) 15.00 (12.00–16.00) 34.00 (33.00–38.00) Kidney failure 23.00 (8.00–23.00) 22.00 (6.00–22.00) 14.00 (10.00–14.00) 59.00 (31.00–59.00) 50.00 (34.00–50.00) 29.00 (11.00–34.00) 18.00 (7.00–24.00) 47.00 (18.00–58.00) Mann-Whitney /KW KW:25.850, p = 0.001** KW:7.323, p = 0.480** KW:21.335, p = 0.006** KW:21.239, p = 0.007** KW:19.514, p = 0.012** KW:14.105, p = 0.079** KW:7.699, p = 0.154** KW:7.347, p = 0.743** The person providing care for the patient Daughter/son 23.00 (6.00–28.00) 21.50 (8.00–28.00) 21.50 (8.00–27.00) 63.50 (23.00–82.00) 48.00 (29.00–74.00) 23.00 (11.00–35.00) 18.50 (7.00–25.00) 42.50 (18.00–56.00) Spouse 24.00 (12.00–28.00) 23.00 (9.00–28.00) 17.00 (6.00–28.00) 61.00 (27.00–83.00) 46.00 (32.00–68.00) 22.00 (12.00–32.00) 18.00 (10.00–24.00) 40.00 (26.00–55.00) Spouse + daughter + son 24.00 (20.00–27.00) 23.00 (13.00–28.00) 23.50 (10.00–27.00) 69.50 (47.00–80.00) 44.50 (33.00–69.00) 27.50 (13.00–34.00) 18.50 (12.00–24.00) 47.50 (25.00–58.00) Daughter-in-law 21.00 (15.00–25.00) 19.00 (9.00–24.00) 18.00 (16.00–24.00) 57.00 (41.00–72.00) 51.00 (48.00–65.00) 21.00 (19.00–24.00) 15.00 (14.00–20.00) 38.00 (34.00–39.00) Caregiver 6.00 (6.00–12.00) 7.00 (6.00–8.00) 9.00 (8.00–13.00) 23.00 (21.00–31.00) 57.00 (46.00–66.00) 21.00 (19.00–23.00) 14.00 (12.00–16.00) 35.00 (31.00–39.00) None 20.00 (20.00–20.00) 17.00 (17.00–17.00) 16.00 (16.00–16.00) 53.00 (53.00–53.00) 58.00 (58.00–58.00) 19.00 (19.00–19.00) 10.00 (10.00–10.00) 29.00 (29.00–29.00) Mann-Whitney /KW KW:26.722, p = 0.000** KW:15.945, p = 0.007** KW:6.406, p = 0.710** KW:17.347, p = 0.004** KW:1.255, p = 0.940** KW:17.074, p = 0.004** KW:19.624, p = 0.001** KW:20.201, p = 0.001** Type of CVD Cerebral infarction 23.00 (6.00–28.00) 22.00 (7.00–28.00) 20.50 (6.00–28.00) 62.00 (21.00–83.00) 46.00 (29.00–74.00) 23.50 (11.00–35.00) 18.00 (7.00–25.00) 41.00 (18.00–58.00) Cerebral haemorrhage 22.50 (12.00–28.00) 22.50 (6.00–28.00) 20.00 (8.00–27.00) 63.00 (31.00–82.00) 59.50 (36.00–69.00) 21.00 (14.00–32.00) 17.00 (10.00–23.00) 38.00 (26.00–55.00) Mann-Whitney /KW z:-0.2.77, p = 0.782* z:-1.397, p = 0.162* z:-0.193, p = 0.847* z:-0.176, p = 0.860* z:-3.589, p = 0.000* z:-0.277, p = 0.782* z:-0.660, p = 0.509* z:-0.507, p = 0.612* The affected hemisphere of the brain Right hemisphere 22.00 (6.00–28.00) 19.00 (6.00–28.00) 20.00 (9.00–28.00) 60.00 (23.00–83.00) 47.00 (29.00–69.00) 23.00 (13.00–35.00) 17.00 (10.00–24.00) 40.00 (26.00–57.00) Left hemisphere 24.00 (6.00–28.00) 22.00 (7.00–27.00) 22.00 (6.00–28.00) 66.00 (21.00–82.00) 50.00 (32.00–74.00) 23.00 (11.00–34.00) 19.00 (7.00–25.00) 41.00 (18.00–58.00) Mann-Whitney /KW z:-2.003, p = 0.045* z:-2.804, p = 0.005* z:-1.004, p = 0.315* z:-2.332, p = 0.020* z:-1.549, p = 0.121* z:-0.621, p = 0.534* z:-2.802, p = 0.005* z:-0.937, p = 0.349* * z: Mann-Whitney U test, ** KW: Kruskal Wallis test. According to Table 4 , there is a moderate positive significant correlation was found between the patients’ total MSPSS scores and total SWBS scores (rho:521*, p = 0.000 ). No significant correlation was found between the patients’ total MSPSS scores and total BAI scores in the present study (rho:0.073*, p > 0.05 ). Table 4 The Relationship Between MSPSS, BAI and SWBS Total Scores Variables MSPSS BAI SWBS rho p rho p rho p MSPSS (1) - - 0.073 0.267 0.521 0.000 BAI (5) 0.073 0.267 - - 0.051 0.443 SWBS (6) 0.521 0.000 0.051 0.443 - - Conclusions In the present section, social support, anxiety and well-being levels of CVD patients were examined; and the discussion is presented based on the findings obtained. It was concluded that 73.1% of the individuals who experienced CVD had a chronic disease, 19.9% were diagnosed with Hypertension + Diabetes and 10% with diabetes alone. It was found that 43.7% received help from their daughter/son and 23.4% from their spouse (Table 1 ). When the risk factors for CVD are examined, it is seen that the first three risk factors are hypertension, obesity and diabetes [ 19 ], which supports our study. In addition, studies conducted in Türkiye have reported that the caregivers of patients who have experienced CVD are generally their daughter/son and spouse [ 20 ], [ 21 ]. It has been determined in the present study that social support is at a moderate level and the highest score is on the family subscale in CVD (Table 2 ). In the literature review, it was seen that the number of studies examining the relationship between CVD and social support level is only limited. This proves the significance of our study. The literature reports that the level of social support is moderate, with the highest score being attributed to the family subscale among patients who have experienced CVD [ 12 ], [ 22 ]. It is also stated that social support levels are moderate and the highest score is on the family subscale in various chronic diseases such as breast cancer, lung cancer, multiple sclerosis and diabetes [ 11 ], [ 23 ]–[ 25 ]. These findings are consistent with our study and indicate that the greatest support is received from family. This could be associated with the family structure and strong kinship ties in Turkish society. Conditions such as stroke, which majorly affect the rest of the life and cause permanent damage, could occur in patients who have undergone CVD. Thus, patients may become dependent on care following CVD. In such a state, it is vital to provide patients with social support. While individuals enjoy their life assuming various responsibilities and roles before the disease, they may become dependent on homecare with decreased relationships with their social environment resulting in limited social circles, individuals and relationships. In such a scenario, the patient’s immediate family becomes prominent in terms of social support in the treatment, care and rehabilitation process. The finding that the family subscale mean score was high in our study is considered to be related to this fact. The present study has shown that the level of anxiety is high among patients who underwent CVD (Table 2 ). When the literature is reviewed, it is seen that anxiety levels of CVD patients are high [ 6 ], [ 10 ] or moderate [ 26 ] in studies conducted both in Türkiye [ 7 ], [ 8 ] and other countries. CVD is a progressive condition that causes functional impairment in daily social life activities, repeated hospitalization and socioeconomic burden. Ensuring adaptation to the disease is critical in terms of effective management of the problems encountered in this process. Anxiety is among the primary mood (affective) disorders that complicates patient adaptation after CVD. Therefore, it is believed that nursing interventions should be planned and implemented to determine and minimize the anxiety levels of patients who have undergone CVD. It has been determined that spiritual well-being levels of CVD patients are moderate in the present study (Table 2 ). The literature contains only a limited number of studies examining the spiritual well-being states of patients who have experienced CVD. Studies carried out in Türkiye report high levels of spiritual well-being [ 13 ] while a study conducted in China found it at a moderate level [ 3 ]. Chronic diseases like CVD cause psychological changes and spiritual distress due to the extended treatment process. Individuals’ spiritual well-being, on the other hand, can vary depending on the problems caused by the diseases and the treatment process. Enhancing the individual’s spiritual well-being is reported to increase the chance of recovery by improving their hope for life and participation in treatment. In this respect, implementation of interventions to reduce anxiety and improve spiritual well-being in patients who experience CVD is critically important. When socio-demographic characteristics of patients who have undergone CVD were examined, the factors affecting their perceived social support levels were found to include being a civil servant, having a chronic disease, being diagnosed with hypertension and diabetes, receiving help from their daughter/son, receiving help from their spouse, having their left hemisphere affected in the brain (Table 3 ). One study examining the level of social support in CVD in the literature found that social support levels increase parallel with the individual’s education level. The study reported that the patient’s gender, being married-single, the person providing care for the patient and the affected side of the brain had no effect on the level of social support [ 22 ]. These differences are thought to arise from socio-cultural variances and social bonds. On the other hand, occupation can be associated with such factors as economic status and the improvement of coping mechanisms. For patients with chronic diseases, it can be associated with the fact that their previously initiated social support process is continued during the CVD process as well. In addition, it is thought that individuals receiving help from their spouse or daughter/son are raised in an extended family culture where providing and receiving help is considered a normal action in this process and they may perceive social support as a natural outcome of familial ties. Among the socio-demographic characteristics of patients who have undergone CVD, the factors affecting anxiety levels were found to include age (39–49 years), being a high school graduate, having a chronic disease, having a hypertension diagnosis, having a heart failure + diabetes diagnosis, and having a cerebral infarction diagnosis (Table 3 ). When the literature was reviewed, it was seen that Karahan and Kardok found higher anxiety levels in patients whose left hemispheres were affected [ 7 ], which is similar to our study. No study has been found to examine the effects of CVD anxiety levels on socio-demographic characteristics in the literature. CVD is a condition with a long treatment and rehabilitation process, which has a negative effect on the individual’s quality of life. In addition, various chronic diseases such as hypertension, diabetes and heart failure, which were already present before CVD, could lead to an increase in physical, mental and social burdens. The increase in individuals’ anxiety levels after CVD is considered to be associated with this fact. Among the socio-demographic characteristics of CVD patients, the factors affecting their spiritual well-being levels were determined to include age, being a high school graduate, self-employed, having a chronic disease, and receiving help from their daughter/son (Table 3 ). Bozoğlan examined spiritual well-being in stroke patients and found that patients aged over 76, married individuals, individuals who had an education level of high school or higher, individuals receiving help from their daughter/son and spouse had higher levels of spiritual well-being [ 13 ]. Similarly, a study conducted in China found that religious belief, education level and social support received from family affected spiritual well-being [ 3 ]. In the literature review, studies examining spiritual well-being in various chronic diseases other than CVD reported were seen to report that patients with had a diagnosis of hypertension, aged under 65, those who were unmarried, had no chronic disease and higher education levels had higher levels of spiritual well-being [ 27 ]. In the study conducted by Yılmaz and Kara examining spiritual well-being in individuals with a chronic disease, spiritual well-being was found to be higher among those aged 64 and under, male patients, married individuals, and individuals with high education and income level [ 28 ]. The positive correlation between age and spiritual well-being in CVD patients is considered to result from the socio-cultural structure and the extended family culture. The relationship between occupation and spiritual well-being in CVD patients, on the other hand, is thought to be related to economic factors. The present study determined a positive relationship between the patients’ perceived social support and spiritual well-being levels (Table 4 ). No study has been found to examine the relationship between social support and spiritual well-being in the literature. However, Wang and colleagues carried out a study with stroke patients and reported that the level of social support affected spiritual well-being positively [ 3 ]. CVD is a condition that brings along mental, emotional and economic burdens to patients. The social support received by the patient during the treatment, care and rehabilitation processes of the disease helps the patient to cope with and adapt to the disease. Therefore, good states of spiritual well-being in individuals who receive support is an expected outcome. No significant correlation was found between the perceived social support and anxiety levels of patients who have experienced CVD (Table 4 ). The literature includes studies reporting that the level of perceived social support could reduce anxiety, which is different from our study [ 6 ], [ 10 ], [ 11 ]. Social support helps the patient to cope with their disease. Therefore, it is an expected condition that anxiety levels decrease as social support increases. On the other hand, the finding that social support had no effect on anxiety levels in the present study is considered to result from the fact that a majority of the patients were housewives and retired, which make them economically dependent. No significant relationship was found between CVD patients’ anxiety levels and spiritual well-being levels, as well (Table 4 ). In the literature review, no study could be found to examine the relationship between anxiety levels and spiritual well-being levels. It is believed that there is no significant relationship due to the additional physical, mental and social burdens brought about by the treatment process associated with the presence of CVD, the negative effects on the individual’s body image and the patients’ inability to meet their spiritual needs. Strengths and Limitations The primary strength of the study is the sample size consisting of 231 patients who had experienced CVD. Additionally, no other study could be found to examine the level of social support, anxiety and spiritual well-being together after CVD as well as the correlations among them. The study is expected to contribute to the literature in this respect. The limitations of the study, on the other hand, include being conducted in a single hospital and being limited to the individuals who were hospitalized. Conclusion In the present study, it was found that the patients’ perceived social support level was moderate, anxiety level was high and spiritual well-being level was moderate. A positive relationship was found between perceived social support and spiritual well-being levels of the patients. No significant correlation was found between the social support the patients received and their anxiety levels. Similarly, patients’ anxiety levels and spiritual well-being levels were not significantly correlated with each other. A positive relationship was determined between the patients’ age and spiritual well-being levels. The factors affecting the patients’ perceived social support levels include being a civil servant, having a chronic disease, being diagnosed with hypertension + diabetes, receiving help from their daughter/son, receiving help from their spouse, and having their left hemisphere affected in the brain. The factors affecting the patients’ anxiety levels include age (39–49 years), being a high school graduate, being a civil servant, having a chronic disease, having a hypertension diagnosis, having a heart failure + diabetes diagnosis, and having a cerebral infarction diagnosis. The factors affecting the patients’ spiritual well-being levels are age, being a high school graduate, occupation, having a chronic disease, and receiving help from their daughter/son. Declarations Ethical Considerations Approval was received from the Ethical Committee (Number: 2023/04–10 and Date: 13.06.2023) before starting the study. Written permission was obtained from the patients through the “Informed Consent Form”. Consent for publication Not applicable. Competing interest The authors declare no competing interests. Funding disclosures Author Contribution Uğur ÖNER(Formal analysis), (Investigation), (Data collection), (Visualization), (Validation), (Writing - original draft), (Writing - review and editing), (Methodology)Ahmet EROL (Formal analysis), (Investigation), (Validation), (Visualization) (Writing - original draft), (Writing - review and editing)Hediye UTLİ(Formal analysis), (Investigation), (Validation), (Visualization) Mahmut DİNÇ(Formal analysis), (Investigation), (Validation), (Writing - review and editing) Acknowledgments We thank all the participants who voluntarily contributed to this study. Data availability statement The data supporting this study’s findings are available from the corresponding author, [UÖ], upon reasonable request. References Ordu Y, Caliskan N. Evaluation of care according to the nursing model based on life activities within a cerebrovascular disease. J Nursology. 2022;25(3):189–200. 10.5152/JANHS.2022.710595 . Kumar A, McCullough L. Cerebrovascular disease in women. Ther Adv Neurol Disord. 2021;14:1–22. 10.1177/1756286420985237 . Wang Z, et al. Needs for nurses to provide spiritual care and their associated influencing factors among elderly inpatients with stroke in China: A cross-sectional quantitative study. Palliat Support Care. 2022;20(3):407–16. 10.1017/S1478951522000426 . TUİK. 2022. Atsu FS, et al. Care for the cerebrovascular accident survivors: experiences of family caregivers. BMC Palliat Care. 2024;23(138):1–9. 10.1186/s12904-024-01468-6 . Schottke H, Giabbiconi CM. Post-stroke depression and post-stroke anxiety: Prevalence and predictors. Int Psychogeriatr. 2015;27(11):1805–12. 10.1017/S1041610215000988 . Karahan AY, Kaydok E. Depression and anxiety levels in geriatric patients with hemiplegia. Med Bull Sisli Hosp. no. 2013;3:130–7. 10.5350/semb2013470306 . Dogru Huzmeli E, Sarac ET. Examination of Sleep Quality, Anxiety and Depression in Stroke Patients. Turkish J Cerebrovasc Dis, 2017. Uçgun T, Öksüz E. The relationship between biological rhythm and perceived social support, coping styles and medication adherence in patients with bipolar disorder in Türkiye, Arch. Psychiatr. Nurs. , vol. 48, no. January, pp. 68–73, 2024, 10.1016/j.apnu.2024.01.013 Zhao Y, Hu B, Liu Q, Wang Y, Zhao Y, Zhu X. Social support and sleep quality in patients with stroke: The mediating roles of depression and anxiety symptoms. Int J Nurs Pract. 2022;28(3):e12939. 10.1111/ijn.12939 . Henry A et al. August., Anxiety and depression in patients with multiple sclerosis: The mediating effects of perceived social support, Mult. Scler. Relat. Disord. , vol. 27, no. 2018, pp. 46–51, 2019, 10.1016/j.msard.2018.09.039 de Lima RJ, da Silva CRR, da Costa TF, de Madruga KM, Pimenta CJL, de Costa KN. Resilience, functional capacity and social support of people with stroke sequelae. Rev Eletrônica Enferm. 2020;22:59542. 10.5216/ree.v22.59542 . Bozoglan S. Determınatıon of spırıtualıty and comfort levels of patıents wıth stroke. Ege Üniversitesi Sağlık Bilimleri Enstitüsü; 2022. Eker D, Arkar H, Yaldiz H. Factorial structure, validity, and reliability of revised form of the multidimensional scale of perceived social support. Turkish J Psychiatry. 2001;12(1):17–25. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56(6):893–7. 10.1037/0022-006X.56.6.893 . Ulusoy M, Sahin NH, Erkmen H. Turkish version of the beck anxiety inventory: Psychometric properties. J Cogn Psychother Int Q. 1998;12(2):163–72. Daaleman TP. The spirituality index of well-being: A new instrument for health-related quality-of-life research, Ann. Fam. Med. , vol. 2, no. 5, pp. 499–503, Sep. 2004, 10.1370/afm.89 Serbest E, Akgun Sahin Z. Turkish validity and reliability study of spirituality index of well-being. Turkish J Fam Med Prim Care. 2021;15(4):872–8. 10.21763/tjfmpc.1002394 . WSO. 2022. https://www.world-stroke.org/ Apaydin Kaya C, Mercan E, Cifcili S. Health and care needs of patients with stroke applied to home health service. J Turkish Fam Physician. 2018;9(3):69–77. 10.15511/tjtfp.18.00369 . Gunal A, Uyanık M. Social problem solving approach, caregiving role, depression and quality of life in stroke caregivers. Caregivers J Hum Rhythm. 2019;5(2):86–103. Erdem O. The relatıonshıp between perceıved socıal support and functıonal status, qualıty of lıfe and depressıon ın stroke patıents. TC Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi; 2019. Wondimagegnehu A, Abebe W, Abraha A, Teferra S. Depression and social support among breast cancer patients in Addis Ababa, Ethiopia. BMC Cancer. 2019;19(1):836. 10.1186/s12885-019-6007-4 . Duzen O, Goktas S. The determination of quality of life and social support levels of patients undergoing lung cancer surgery and adjuvant chemotherapy. Heal Soc. 2021;31(3):153–62. Canpolat M, Cıtlık Sarıtas S. Determining the relationship between perceived social support and quality of life in patients peveloping diabetic foot, Van Heal. Sci. J. , vol. 15, no. 3, pp. 275–283, Dec. 2022, 10.52976/vansaglik.1158975 Yu F, Li H, Tai C, Guo T, Pang D. Effect of family education program on cognitive impairment, anxiety, and depression in persons who have had a stroke: A randomized, controlled study. Nurs Heal Sci. 2019;21(1):44–53. 10.1111/nhs.12548 . Asiret GD, Okatan C. Determination of the relationship between drug compliance levels and spiritual Well- being of hypertension patients. J Cardiovasc Nurs. 2019;10(23):122–8. 10.5543/khd.2019.66376 . Kutmec Yilmaz C, Kara FS. The effect of spiritual well-being on adaptation to chronic illness among people with chronic illnesses. Perspect Psychiatr Care. 2021;57(1):318–25. 10.1111/ppc.12566 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5319125","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":370446386,"identity":"54f0a321-43d2-4c4b-989d-8ca9d1d7dec5","order_by":0,"name":"Ugur Oner","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA40lEQVRIiWNgGAWjYBADHn725mNgFhs7IaVQWkay51gaA0MCUAszkVpsDG74mIG1MBDSYi+Re/DDzzag1hs83x58/LFNno+ZgfHDxxw8tkjkJUv2ArUwzu7dbjgj4bZhGzMDs+TMbfi05Jgx8AK1MMuc3SbNk3CbEaiFjZmXgBbGv0AtbBI5z0Ba7InSwgyyBchgA2lJJKzlzBtjaZlzQK08x8wkZ6TdTm5jZmzG6xf29hzDj2/KGOztjzc/k/hgc9t2fnvzwQ8f8WgBA0a2/yjcBgLqQeAPEWpGwSgYBaNg5AIA2UJErDkEHTYAAAAASUVORK5CYII=","orcid":"","institution":"Batman University","correspondingAuthor":true,"prefix":"","firstName":"Ugur","middleName":"","lastName":"Oner","suffix":""},{"id":370446387,"identity":"3941a369-2a51-4893-8e1b-5a5866fcac9f","order_by":1,"name":"Ahmet Erol","email":"","orcid":"","institution":"Batman University","correspondingAuthor":false,"prefix":"","firstName":"Ahmet","middleName":"","lastName":"Erol","suffix":""},{"id":370446388,"identity":"322997a2-3b42-43c6-a869-d302ad6512fd","order_by":2,"name":"Hediye Utli","email":"","orcid":"","institution":"Mardin Artuklu University","correspondingAuthor":false,"prefix":"","firstName":"Hediye","middleName":"","lastName":"Utli","suffix":""},{"id":370446389,"identity":"615dca60-a1de-4a60-a07b-69f03c418992","order_by":3,"name":"Mahmut Dinc","email":"","orcid":"","institution":"Batman University","correspondingAuthor":false,"prefix":"","firstName":"Mahmut","middleName":"","lastName":"Dinc","suffix":""}],"badges":[],"createdAt":"2024-10-23 13:08:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5319125/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5319125/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":75470986,"identity":"7cea6d61-ad33-4785-9bc0-91b57e9f5983","added_by":"auto","created_at":"2025-02-05 02:53:54","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1857601,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5319125/v1/d210f4b4-1aef-40cc-8780-1b73decf24cb.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Identifying Anxiety, Social Support and Spiritual Well-Being States of Patients Experiencing Cerebrovascular Event: A cross-sectional descriptive study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCerebrovascular disease (CVD) is a deficit that can develop suddenly, either focal or generalized, lasts longer than 24 hours, may result in death and cannot be explained by any cause other than vascular reasons [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The prevalence of patients who have experienced CVD is estimated to exceed 60\u0026nbsp;million around the world. Approximately 16\u0026nbsp;million people worldwide are diagnosed with CVD each year [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Today, the incidence of CVD is increasing by 8.7% annually with the increasing elderly population [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. According to the 2022 data in T\u0026uuml;rkiye, CVD is the 3rd disease causing death with a rate of 19.2% [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Additionally, CVD has become one of the most significant reasons causing patients over 65 to be hospitalized today [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCVD is not only a physical disease, but also a condition that can lead to various psychological problems. The most frequently reported ones are anxiety and depression [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. A systematic study has shown that the rate of anxiety due to CVD is 20.4% in patients [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Similarly, in the studies conducted by Karahan AY. and Kaydok E, as well as M\u0026uuml;ft\u0026uuml;oğlu and colleagues it was found that patients\u0026rsquo; anxiety levels were high following CVD [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Studies have looked into the factors affecting anxiety levels following CVD. Accordingly, gender, the severity of the disease, mental disorders, the presence of chronic diseases and smoking were reported to increase patients\u0026rsquo; anxiety levels [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePatients may develop various chronic problems such as stroke after CVD, which could lead patients to become dependent on care [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Social support plays a key role in patients\u0026rsquo; ability to cope with and adapt to their disease. Evidence shows that patients who receive social support report lower anxiety symptoms [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Social support is known as a multidimensional structure. Social support is defined as the material and spiritual assistance provided by the people (spouse, family, and friends) around an individual who is under pressure or in difficulty. Social support is increasingly more associated with the overall health condition, and the course and rehabilitation of diseases. Social support is considered to affect the patient\u0026rsquo;s physical and psychosocial well-being, the quality of patient care and the result of the disease among patients who experience CVD [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eProfessional nurses should ensure the patient\u0026rsquo;s comfort and meet their spiritual needs during the treatment, care and rehabilitation process of patients diagnosed with CVD. Given that CVD is condition that considerably changes and threatens the quality of life, it is important to meet the patient\u0026rsquo;s spiritual needs. Indeed, spiritual care is known to have a positive effect on patients [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The spiritual care provided by a professional nurse helps the patient to cope with problems such as depression and anxiety experienced following CVD. In addition, it facilitates patients\u0026rsquo; recovery and adaptation processes. Considering the potential benefits of spiritual support and spiritual care following CVD for the patient, it is essential that nurses incorporate spiritual care and social support needs into the treatment, care and rehabilitation process. As a matter of fact, one study has reported that patients receiving social support have better psychological health, quality of life, cognition, daily life activities, social participation and spiritual well-being [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhen the related literature was reviewed, no study could be found to examine CVD patients\u0026rsquo; anxiety, social support and spiritual well-being states together. In this regard, our study is expected to contribute to the literature in terms of evaluating the anxiety, social support and spiritual well-being of patients who experience CVD as well as the correlations among them. The present study was conducted with the aim of determining the anxiety, social support and spiritual well-being of patients who have experienced CVD.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eDesign\u003c/h2\u003e \u003cp\u003eThe study a descriptive and cross-sectional in nature. The population of the study consisted of patients (n\u0026thinsp;=\u0026thinsp;540) hospitalized in the Neurology, Brain Surgery and Stroke Units of a Training and Research Hospital in XXX. The sample size was calculated as 225 patients with a 95% confidence interval, 5% margin of error and 95% power analysis. The study was completed with 231 patients who met the inclusion criteria and agreed to participate. The data were collected between June and December 2023.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eInclusion Criteria\u003c/h3\u003e\n\u003cp\u003ePatients who were hospitalized with a CVD diagnosis in the Neurology, Brain Surgery and Stroke Units of a Training and Research Hospital in XXX, aged 18 and over, conscious and open to communication and cooperation were included.\u003c/p\u003e\n\u003ch3\u003eData Collection Instruments\u003c/h3\u003e\n\u003cp\u003eThe data were collected using the Patient Information Form, \u0026ldquo;Multidimensional Scale of Perceived Social Support\u0026rdquo; (MSPSS), \u0026ldquo;Beck Anxiety Inventory\u0026rdquo; (BAI) and \u0026ldquo;Spiritual Well-Being Scale\u0026rdquo; (SWBS).\u003c/p\u003e\n\u003ch3\u003ePatient Information Form\u003c/h3\u003e\n\u003cp\u003eDeveloped by the researchers, the form consists of 12 questions asking about the patients\u0026rsquo; age, gender, marital status, education level, occupation, social security, smoking habits, alcohol consumption habits, presence of chronic diseases, state of assistance, type of CVD and the affected hemisphere of the brain.\u003c/p\u003e\n\u003ch3\u003eMultidimensional Scale of Perceived Social Support\u003c/h3\u003e\n\u003cp\u003eThe MSPSS was developed by Zimet and colleagues in the United States of America and its Turkish validity and reliability was established by Eker and colleagues in 2001 [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The MSPSS is a 7-point Likert type scale consisting of 12 items to measure the sufficiency of the social support received from three different sources (family, friends and a significant other). The minimum possible score to be obtained from the scale is 12 and the maximum score is 84. A high score indicates a high level of perceived social support. While the Cronbach\u0026rsquo;s Alpha coefficient of the original scale was 0.89 [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], it was found as 0.87 in the present study.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eBeck Anxiety Inventory\u003c/h2\u003e \u003cp\u003eThe BAI was developed by Beck and colleagues to measure the frequency of individuals\u0026rsquo; anxiety symptoms [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Its Turkish validity and reliability study was conducted by Ulusoy and colleagues (1998) [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. It is a 7-point Likert type scale consisting of 21 items. The minimum score to be obtained on the scale is 0, while the maximum score is 63. Higher total scores indicate increased anxiety experienced by the individual. The Cronbach\u0026rsquo;s Alpha coefficient of the original scale was 0.93 [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] whereas it was found to be 0.89 in the present study.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSpiritual Well-Being Scale\u003c/h3\u003e\n\u003cp\u003eThe SWBS was developed by Daaleman and Frey in 2004 to measure spiritual well-being among individuals [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Serbest and Akg\u0026uuml;n conducted the Turkish validity and reliability study of the scale [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The 5-point-Likert type scale consists of 2 subscales (life plan and self-efficacy) and 12 items. The minimum and maximum possible scores on the scale are 12 and 60, respectively. Higher scores indicate that individuals have high levels of spiritual well-being. While the Cronbach\u0026rsquo;s Alpha coefficient of the original scale was 0.95 [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], it was found as 0.87 in the present study.\u003c/p\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eThe data were collected through face-to-face interviews. The aim of the study was explained to the patients and they were informed that the data would be kept confidential and that they could leave the study aby time they wanted. Written consent was received from the patients who agreed to participate. The researchers waited in the patient\u0026rsquo;s room until the questionnaires were completed to prevent influence from accompanying individuals around them. It took approximately 20\u0026ndash;25 minutes to fill in the questionnaires. The forms were checked for missing data while collecting the forms.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThe data obtained were analysed on the SPSS 25.0 software. Numbers, percentages, means, standard deviation, minimum and maximum values were used for the descriptive statistics of the data. Normality was tested using Kolmogorov Simirnov and graphic methods. Mann-Whitney U test, Kruskal-Wallis test, Bonferroni and Spearman correlation analysis were conducted to analyse the data that were not normally distributed. Cronbach\u0026rsquo;s Alfa reliability coefficients were evaluated to determine the internal consistencies of the scales and subscales. The level of significance was accepted as p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 for the statistical analyses.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe mean age of the patients who participated in the study is 60.62\u0026thinsp;\u0026plusmn;\u0026thinsp;10.44, with 35.5% of them being in the 50\u0026ndash;60 age group. Of the patients, 52.4% are female, 81.4% are married, and a majority (54.5%) completed primary education and 42.4% are housewives. It was seen that 80.1% of these patients had social security, 54.1% had smoking history and 94.4% did not consume alcohol. It was also determined that 73.1% of the patients had a chronic disease and 19.9% were diagnosed with Hypertension\u0026thinsp;+\u0026thinsp;Diabetes. It was found that 43.7% of the patients received help from their daughter or son, 68% had had cerebral infarction and 53.2% had their left hemisphere affected (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive Characteristics of Patients (n\u0026thinsp;=\u0026thinsp;231)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/b\u003e60.62\u0026thinsp;\u0026plusmn;\u0026thinsp;10.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37 (%16.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50\u0026ndash;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82 (%35.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61\u0026ndash;71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79 (%34.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThose aged over 72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (%14.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121 (%52.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e110 (%47.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e188 (%81.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43 (%18.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eEducation level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eİlliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69 (29.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e126 (%54.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (%11.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (%3.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e98 (%42.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66 (%28.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (%15.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCivil servant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (%11.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWorker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (%2.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eSocial security\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e185 (%80.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46 (%19.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eSmoking habits\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e98 (%42.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e106 (%45.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCessation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (%11.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eAlcohol consumption habits\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (%2.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e218 (%94.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCessation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (%3.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003ePresence of chronic diseases\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e169 (%73.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e62 (%26.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003e\u003cb\u003eVarious chronic diseases *\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHypertension\u0026thinsp;+\u0026thinsp;Diabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46 (%19.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39 (%16.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23 (%10.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHeart failure + Diabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17 (%7.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHeart failure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 (%9.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHeart failure\u0026thinsp;+\u0026thinsp;Hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (%6.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCoronary artery disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (%3.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKidney failure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (%2.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eThe person providing care for the patient\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDaughter/son\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e101 (%43.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54 (%23.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpouse + daughter + son\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54 (23.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDaughter-in-law\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (%3.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCaregiver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (%2.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (3.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eType of CVD\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCerebral infarction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e157 (%68.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCerebral haemorrhage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74 (%32.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eThe affected hemisphere of the brain\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRight hemisphere\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e108 (%46.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLeft hemisphere\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e123 (%53.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe total mean score on the MSPSS was found as 63.09\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;12.45 in the present study, indicating a moderate level of perceived social support. The highest mean score among the subscales belonged to \u0026ldquo;family\u0026rdquo; (22.11\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;4.31), the second highest mean score was on \u0026ldquo;friends\u0026rdquo; (21.30\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;4.68), while the lowest mean was found to belong to \u0026ldquo;a significant other\u0026rdquo; (19.67\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;5.24) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The total mean score of the participants on the BAI was found as 53.59\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;11.50, which showed that the patients experiences a high level of anxiety (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The patients\u0026rsquo; total mean score was calculated as 43.62\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;8.65 on the SWBS and it was concluded that they had a moderate level of spiritual well-being. The mean score on the self-efficacy subscale on this scale was 24.75\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;5.30, indicating a moderate level of self-efficacy for life, while it was 18.87\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;4.20 on the life plan subscale, which revealed that the participants had a moderate level of perception of making sense of their lives (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of MSPSS, BAI and SWBS Total and Subscale Scores\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eScale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD*\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMedian (Min-Max) **\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCronbach Alfa\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMSPSS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e63.09\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;12.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e63.00 (21.00\u0026ndash;83.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.873\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e22.11\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;4.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23.00 (6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.718\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFriends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e21.30\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;4.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.00 (6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.686\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSignificant other\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e19.67\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;5.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20.50 (6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.764\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBAI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e53.59\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;11.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49.00 (29.00\u0026ndash;74.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.896\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSWBS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e43.62\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;8.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40.00 (18.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.872\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-efficacy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e24.75\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;5.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23.00 (11.00\u0026ndash;35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.818\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLife plan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e18.87\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;4.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.00 (7.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.773\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cb\u003e*\u003c/b\u003eSD: Standard Deviation, **Scale total min-max point\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e displays the comparisons of the patients\u0026rsquo; socio-demographic characteristics and their total and subscale mean scores on the MSPSS, BAI and SWBS. It was found that patients aged between 61 and 71 had higher mean scores on the family and self-efficacy subscales compared to those aged over 72 (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.020; p\u0026thinsp;=\u0026thinsp;0.003\u003c/b\u003e). Patients in the 39\u0026ndash;49 years age group had higher mean scores on BAI total as well as the friends and self-efficacy subscales than those aged over 72 (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.011\u003c/b\u003e; \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.022; p\u0026thinsp;=\u0026thinsp;0.008\u003c/b\u003e). The total BAI mean score for patients aged 39\u0026ndash;49 was higher than that of patients in the age groups 50\u0026ndash;60 and 61\u0026ndash;71 (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.000\u003c/b\u003e). The total mean scores on the self-efficacy subscale were higher among the patients aged 50\u0026ndash;60 compared to those aged over 72 and among male patients compared to female patients (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.012\u003c/b\u003e). Patients who were high school graduates had significantly higher mean scores on total BAI and friends subscale than the patients who were illiterate (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.000\u003c/b\u003e; \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.012; p\u0026thinsp;=\u0026thinsp;0.006\u003c/b\u003e). Total BAI and SWBS mean scores of high school graduates were found to be significantly higher than those of patients who completed primary education (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.036; p\u0026thinsp;=\u0026thinsp;0.046; p\u0026thinsp;=\u0026thinsp;0.027\u003c/b\u003e). Patients with an occupation as civil servants had a higher total mean score on the MSPSS compared to those who were workers (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.049\u003c/b\u003e). Patients with an occupation as civil servants had a higher total mean score on the BAI than those who were retired (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.004\u003c/b\u003e). Patients who were housewives had a higher mean score on the life plan subscale than workers (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.048\u003c/b\u003e). The total SWBSS mean score of self-employed was higher compared to the patients who were workers (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.010\u003c/b\u003e). Patients who had a chronic disease were found to have higher mean scores on the total MSPSS, total BAI, total SWBS, as well as the subscales of family, friends and self-efficacy compared to those who did not have a chronic disease. The total MSPSS mean scores and family subscale mean scores of the patients diagnosed with hypertension\u0026thinsp;+\u0026thinsp;diabetes were higher than those diagnosed with diabetes alone (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.045; p\u0026thinsp;=\u0026thinsp;0.046\u003c/b\u003e). The mean score on the \u0026ldquo;significant other\u0026rdquo; subscale was found to be higher among the patients diagnosed with hypertension\u0026thinsp;+\u0026thinsp;diabetes than those diagnosed with heart failure\u0026thinsp;+\u0026thinsp;diabetes (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.006\u003c/b\u003e). Patients diagnosed with hypertension and heart failure\u0026thinsp;+\u0026thinsp;diabetes were found to have a higher total mean score on the BAI compared to those diagnosed with diabetes alone (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.039\u003c/b\u003e). Patients who received help from their daughter/son were seen to have higher scores on the total MSPSS, total SWBS, as well as the family, friends, self-efficacy and life plan subscales compared to those who received help from a caregiver (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.016; p\u0026thinsp;=\u0026thinsp;0.012; p\u0026thinsp;=\u0026thinsp;0.008; p\u0026thinsp;=\u0026thinsp;0.029; p\u0026thinsp;=\u0026thinsp;0.020; p\u0026thinsp;=\u0026thinsp;0.048\u003c/b\u003e). Patients who received help from their spouse were found to have higher mean scores on the family and life plan subscales compared to those receiving help from their daughter-in-law (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.031; p\u0026thinsp;=\u0026thinsp;0.029\u003c/b\u003e). Patients who received help from their spouse were determined to have higher mean scores on the total MSPSS, as well as the family, friends and life plan subscales than patients receiving help from a caregiver (\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.029; p\u0026thinsp;=\u0026thinsp;0.001; p\u0026thinsp;=\u0026thinsp;0.026; p\u0026thinsp;=\u0026thinsp;0.043\u003c/b\u003e). It was found that the total BAI mean score of cerebral haemorrhage patients was higher than that of patients with cerebral infarction. Patients with left hemisphere brain damage had higher mean scores on the total MSPSS, family, friends and life plan subscales than those who had their right hemisphere affected.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparisons of the Patients\u0026rsquo; Socio-Demographic Characteristics and Their Total and Subscale Mean Scores on The MSPSS, BAI and SWBS\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFamily\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFriends\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSignificant other\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMSPSS Total\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eBAI Total\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSelf-efficacy\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eLife Plan\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSWBS Total\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003cp\u003e(Min-Max)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003cp\u003e(Min-Max)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003cp\u003e(Min-Max)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003cp\u003e(Min-Max)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003cp\u003e(Min-Max)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003cp\u003e(Min-Max)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003cp\u003e(Min-Max)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003cp\u003e(Min-Max)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e39\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(17.00\u0026ndash;26.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.50\u003c/p\u003e \u003cp\u003e(15.00\u0026ndash;26.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(13.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e68.50\u003c/p\u003e \u003cp\u003e(45.00\u0026ndash;77.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e63.00\u003c/p\u003e \u003cp\u003e(41.00\u0026ndash;68.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.50\u003c/p\u003e \u003cp\u003e(19.00\u0026ndash;31.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e15.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;23.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e36.50\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;54.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.50\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.50\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e61.00\u003c/p\u003e \u003cp\u003e(21.00\u0026ndash;82.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e46.00\u003c/p\u003e \u003cp\u003e(32.00\u0026ndash;69.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24.50\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;34.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e19.50\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e46.50\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;57.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e61\u0026ndash;71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(9.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66.00\u003c/p\u003e \u003cp\u003e(27.00\u0026ndash;83.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e48.00\u003c/p\u003e \u003cp\u003e(33.00\u0026ndash;69.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e19.00\u003c/p\u003e \u003cp\u003e(13.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e45.00\u003c/p\u003e \u003cp\u003e(26.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThose aged over 72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.50\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.00\u003c/p\u003e \u003cp\u003e(21.00\u0026ndash;83.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e49.00\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;74.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e40.00\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMann-Whitney /KW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKW:10.729,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.013**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKW:10.259, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.016**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eKW:0.226,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.973**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eKW:4.635,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.218**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eKW:25.529, \u003cb\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eKW:14.149,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.003**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eKW:4.311,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.230**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eKW:10.754,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.013**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.00(6.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.00(8.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.00\u003c/p\u003e \u003cp\u003e(23.00\u0026ndash;82.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50.00(34.00\u0026ndash;74.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;34.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00(7.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e40.00\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;56.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.00(7.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.00(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.00\u003c/p\u003e \u003cp\u003e(21.00\u0026ndash;83.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e47.00(29.00\u0026ndash;68.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00(11.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e41.00\u003c/p\u003e \u003cp\u003e(25.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMann-Whitney /KW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ez=-1.041,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.298*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ez=-0.508,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.612*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ez=-0.294,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.769*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ez=-0.678,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.498*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ez=-0.857,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.391*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003ez=-2.159,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.031*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ez=-0.112,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.911*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003ez=-1.055,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.291*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eİlliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.50\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.50\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e61.50\u003c/p\u003e \u003cp\u003e(23.00\u0026ndash;83.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e48.50\u003c/p\u003e \u003cp\u003e(32.00\u0026ndash;66.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;34.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e40.00\u003c/p\u003e \u003cp\u003e(26.00\u0026ndash;57.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.00\u003c/p\u003e \u003cp\u003e(21.00\u0026ndash;82.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e48.00\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;74.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e38.00\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;54.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003cp\u003e(17.00\u0026ndash;26.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(17.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.00\u003c/p\u003e \u003cp\u003e(13.00\u0026ndash;23.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.00\u003c/p\u003e \u003cp\u003e(50.00\u0026ndash;76.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59.00\u003c/p\u003e \u003cp\u003e(46.00\u0026ndash;66.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(19.00\u0026ndash;31.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;23.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e40.00\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUndergraduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.50\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.00\u003c/p\u003e \u003cp\u003e(21.00\u0026ndash;83.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e49.00\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;74.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e40.00\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMann-Whitney /KW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKW:7.419,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.060**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKW:10.912,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.012**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eKW:2.037,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.565**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eKW:7.826,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.084**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eKW:26.529, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.000**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eKW:16.486,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.001**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eKW:5.345, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.148**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eKW:12.515, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.006**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.50\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.50\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e62.00\u003c/p\u003e \u003cp\u003e(23.00\u0026ndash;82.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50.50\u003c/p\u003e \u003cp\u003e(34.00\u0026ndash;74.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22.50\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;34.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e40.00\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;56.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRetired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(9.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60.00\u003c/p\u003e \u003cp\u003e(34.00\u0026ndash;83.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e42.00\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;65.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(13.00\u0026ndash;35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e46.00\u003c/p\u003e \u003cp\u003e(26.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.50\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(9.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65.50\u003c/p\u003e \u003cp\u003e(27.00\u0026ndash;80.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e51.00\u003c/p\u003e \u003cp\u003e(32.00\u0026ndash;66.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;33.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e20.00\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e44.00\u003c/p\u003e \u003cp\u003e(25.00\u0026ndash;57.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCivil servant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.00\u003c/p\u003e \u003cp\u003e(20.00\u0026ndash;26.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.00\u003c/p\u003e \u003cp\u003e(17.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(16.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e76.00\u003c/p\u003e \u003cp\u003e(53.00\u0026ndash;77.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60.00\u003c/p\u003e \u003cp\u003e(59.00\u0026ndash;68.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e25.00\u003c/p\u003e \u003cp\u003e(19.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e16.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;22.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e41.00\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;47.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWorker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.50\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.00\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53.50\u003c/p\u003e \u003cp\u003e(21.00\u0026ndash;72.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e52.50\u003c/p\u003e \u003cp\u003e(46.00\u0026ndash;65.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20.00\u003c/p\u003e \u003cp\u003e(19.00\u0026ndash;22.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e13.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;18.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e33.00\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;40.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMann-Whitney /KW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKW:7.812, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.232**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKW:8.925,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.063**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eKW:6.942,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.139**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eKW:10.178, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.038**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eKW:13.247, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.010**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eKW:6.167,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.072**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eKW:12.553, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.014**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eKW:10.079, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.039**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePresence of chronic diseases\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.50\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.50\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.00\u003c/p\u003e \u003cp\u003e(21.00\u0026ndash;82.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50.00(29.00\u0026ndash;74.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00(7.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e44.00\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;56.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;26.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.50\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57.00\u003c/p\u003e \u003cp\u003e(21.00\u0026ndash;72.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40.00\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;69.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;34.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e40.00\u003c/p\u003e \u003cp\u003e(25.00\u0026ndash;54.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMann-Whitney /KW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ez:-2.450,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ez:-3.056,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.042*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ez:-0.067,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.567*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ez:-2.639,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.026*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ez:8.033,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.018*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003ez:-2.345,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.021*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ez:-1.214,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.344*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003ez:-3.028,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.019*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVarious chronic diseases\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension\u0026thinsp;+\u0026thinsp;Diabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.00\u003c/p\u003e \u003cp\u003e(19.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(14.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.50\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69.50\u003c/p\u003e \u003cp\u003e(49.00\u0026ndash;83.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e48.00\u003c/p\u003e \u003cp\u003e(33.00\u0026ndash;64.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e26.50\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;34.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e48.00\u003c/p\u003e \u003cp\u003e(26.00\u0026ndash;57.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.50\u003c/p\u003e \u003cp\u003e(13.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(15.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(9.00\u0026ndash;26.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e68.50\u003c/p\u003e \u003cp\u003e(37.00\u0026ndash;82.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e58.50\u003c/p\u003e \u003cp\u003e(33.00\u0026ndash;69.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003cp\u003e(14.00\u0026ndash;32.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e19.50\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e41.50\u003c/p\u003e \u003cp\u003e(26.00\u0026ndash;56.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e64.00\u003c/p\u003e \u003cp\u003e(31.00\u0026ndash;80.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e44.00\u003c/p\u003e \u003cp\u003e(34.00\u0026ndash;65.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;34.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e39.00\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeart failure + Diabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;26.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;26.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.00\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53.00\u003c/p\u003e \u003cp\u003e(23.00\u0026ndash;76.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60.00\u003c/p\u003e \u003cp\u003e(36.00\u0026ndash;66.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;32.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e19.00\u003c/p\u003e \u003cp\u003e(14.00\u0026ndash;23.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e40.00\u003c/p\u003e \u003cp\u003e(35.00\u0026ndash;55.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeart failure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.00\u003c/p\u003e \u003cp\u003e(9.00\u0026ndash;26.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e61.00\u003c/p\u003e \u003cp\u003e(23.00\u0026ndash;80.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e61.00\u003c/p\u003e \u003cp\u003e(40.00\u0026ndash;66.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(17.00\u0026ndash;32.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(14.00\u0026ndash;23.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e40.00\u003c/p\u003e \u003cp\u003e(35.00\u0026ndash;53.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeart failure\u0026thinsp;+\u0026thinsp;Hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.00\u003c/p\u003e \u003cp\u003e(14.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.50\u003c/p\u003e \u003cp\u003e(9.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(16.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.50\u003c/p\u003e \u003cp\u003e(41.00\u0026ndash;72.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e65.00\u003c/p\u003e \u003cp\u003e(50.00\u0026ndash;74.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(19.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e14.00\u003c/p\u003e \u003cp\u003e(14.00\u0026ndash;20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e36.00\u003c/p\u003e \u003cp\u003e(35.00\u0026ndash;39.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCoronary artery disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;21.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(13.00\u0026ndash;18.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.00\u003c/p\u003e \u003cp\u003e(13.00\u0026ndash;18.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52.00\u003c/p\u003e \u003cp\u003e(47.00\u0026ndash;57.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e41.00\u003c/p\u003e \u003cp\u003e(39.00\u0026ndash;55.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(19.00\u0026ndash;22.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e15.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;16.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e34.00\u003c/p\u003e \u003cp\u003e(33.00\u0026ndash;38.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKidney failure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;23.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;22.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;14.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59.00\u003c/p\u003e \u003cp\u003e(31.00\u0026ndash;59.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50.00\u003c/p\u003e \u003cp\u003e(34.00\u0026ndash;50.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e29.00\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;34.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e47.00\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMann-Whitney /KW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKW:25.850, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.001**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKW:7.323, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.480**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eKW:21.335, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.006**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eKW:21.239,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.007**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eKW:19.514, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.012**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eKW:14.105,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.079**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eKW:7.699, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.154**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eKW:7.347, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.743**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe person providing care for the patient\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDaughter/son\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.50\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.50\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.50\u003c/p\u003e \u003cp\u003e(23.00\u0026ndash;82.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e48.00\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;74.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.50\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e42.50\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;56.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(9.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e61.00\u003c/p\u003e \u003cp\u003e(27.00\u0026ndash;83.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e46.00\u003c/p\u003e \u003cp\u003e(32.00\u0026ndash;68.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;32.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e40.00\u003c/p\u003e \u003cp\u003e(26.00\u0026ndash;55.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpouse + daughter + son\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003cp\u003e(20.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(13.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.50\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69.50\u003c/p\u003e \u003cp\u003e(47.00\u0026ndash;80.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e44.50\u003c/p\u003e \u003cp\u003e(33.00\u0026ndash;69.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e27.50\u003c/p\u003e \u003cp\u003e(13.00\u0026ndash;34.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.50\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e47.50\u003c/p\u003e \u003cp\u003e(25.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDaughter-in-law\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(15.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.00\u003c/p\u003e \u003cp\u003e(9.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(16.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57.00\u003c/p\u003e \u003cp\u003e(41.00\u0026ndash;72.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e51.00\u003c/p\u003e \u003cp\u003e(48.00\u0026ndash;65.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(19.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e15.00\u003c/p\u003e \u003cp\u003e(14.00\u0026ndash;20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e38.00\u003c/p\u003e \u003cp\u003e(34.00\u0026ndash;39.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;12.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;8.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.00\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;13.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(21.00\u0026ndash;31.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e57.00\u003c/p\u003e \u003cp\u003e(46.00\u0026ndash;66.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(19.00\u0026ndash;23.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e14.00\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;16.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e35.00\u003c/p\u003e \u003cp\u003e(31.00\u0026ndash;39.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.00\u003c/p\u003e \u003cp\u003e(20.00\u0026ndash;20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.00\u003c/p\u003e \u003cp\u003e(17.00\u0026ndash;17.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.00\u003c/p\u003e \u003cp\u003e(16.00\u0026ndash;16.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53.00\u003c/p\u003e \u003cp\u003e(53.00\u0026ndash;53.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e58.00\u003c/p\u003e \u003cp\u003e(58.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.00\u003c/p\u003e \u003cp\u003e(19.00\u0026ndash;19.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e10.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;10.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e29.00\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;29.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMann-Whitney /KW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKW:26.722, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.000**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKW:15.945, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.007**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eKW:6.406, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.710**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eKW:17.347, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.004**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eKW:1.255, \u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.940**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eKW:17.074, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.004**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eKW:19.624, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.001**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eKW:20.201, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.001**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eType of CVD\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCerebral infarction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.50\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e62.00\u003c/p\u003e \u003cp\u003e(21.00\u0026ndash;83.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e46.00\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;74.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.50\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e41.00\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCerebral haemorrhage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.50\u003c/p\u003e \u003cp\u003e(12.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.50\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.00\u003c/p\u003e \u003cp\u003e(8.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.00\u003c/p\u003e \u003cp\u003e(31.00\u0026ndash;82.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59.50\u003c/p\u003e \u003cp\u003e(36.00\u0026ndash;69.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21.00\u003c/p\u003e \u003cp\u003e(14.00\u0026ndash;32.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;23.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e38.00\u003c/p\u003e \u003cp\u003e(26.00\u0026ndash;55.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMann-Whitney /KW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ez:-0.2.77,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.782*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ez:-1.397,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.162*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ez:-0.193,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.847*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ez:-0.176,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.860*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ez:-3.589,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.000*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003ez:-0.277,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.782*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ez:-0.660,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.509*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003ez:-0.507,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.612*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c9\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe affected hemisphere of the brain\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRight hemisphere\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.00\u003c/p\u003e \u003cp\u003e(9.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60.00\u003c/p\u003e \u003cp\u003e(23.00\u0026ndash;83.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e47.00\u003c/p\u003e \u003cp\u003e(29.00\u0026ndash;69.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(13.00\u0026ndash;35.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17.00\u003c/p\u003e \u003cp\u003e(10.00\u0026ndash;24.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e40.00\u003c/p\u003e \u003cp\u003e(26.00\u0026ndash;57.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeft hemisphere\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;27.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003cp\u003e(6.00\u0026ndash;28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66.00\u003c/p\u003e \u003cp\u003e(21.00\u0026ndash;82.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50.00\u003c/p\u003e \u003cp\u003e(32.00\u0026ndash;74.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.00\u003c/p\u003e \u003cp\u003e(11.00\u0026ndash;34.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e19.00\u003c/p\u003e \u003cp\u003e(7.00\u0026ndash;25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e41.00\u003c/p\u003e \u003cp\u003e(18.00\u0026ndash;58.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMann-Whitney /KW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ez:-2.003,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.045*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ez:-2.804,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.005*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ez:-1.004,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.315*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ez:-2.332,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.020*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ez:-1.549,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.121*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003ez:-0.621,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.534*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ez:-2.802,\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.005*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003ez:-0.937,\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.349*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003e* z: Mann-Whitney U test, ** KW: Kruskal Wallis test.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAccording to Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, there is a moderate positive significant correlation was found between the patients\u0026rsquo; total MSPSS scores and total SWBS scores (rho:521*, \u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.000\u003c/b\u003e). No significant correlation was found between the patients\u0026rsquo; total MSPSS scores and total BAI scores in the present study (rho:0.073*, \u003cb\u003ep\u0026thinsp;\u0026gt;\u0026thinsp;0.05\u003c/b\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Relationship Between MSPSS, BAI and SWBS Total Scores\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMSPSS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eBAI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eSWBS\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003erho\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003erho\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003erho\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMSPSS (1)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e0.267\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.521\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBAI (5)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e0.267\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.443\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSWBS (6)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.521\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e0.443\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e-\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn the present section, social support, anxiety and well-being levels of CVD patients were examined; and the discussion is presented based on the findings obtained.\u003c/p\u003e \u003cp\u003eIt was concluded that 73.1% of the individuals who experienced CVD had a chronic disease, 19.9% were diagnosed with Hypertension\u0026thinsp;+\u0026thinsp;Diabetes and 10% with diabetes alone. It was found that 43.7% received help from their daughter/son and 23.4% from their spouse (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). When the risk factors for CVD are examined, it is seen that the first three risk factors are hypertension, obesity and diabetes [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], which supports our study. In addition, studies conducted in T\u0026uuml;rkiye have reported that the caregivers of patients who have experienced CVD are generally their daughter/son and spouse [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIt has been determined in the present study that social support is at a moderate level and the highest score is on the family subscale in CVD (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). In the literature review, it was seen that the number of studies examining the relationship between CVD and social support level is only limited. This proves the significance of our study. The literature reports that the level of social support is moderate, with the highest score being attributed to the family subscale among patients who have experienced CVD [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. It is also stated that social support levels are moderate and the highest score is on the family subscale in various chronic diseases such as breast cancer, lung cancer, multiple sclerosis and diabetes [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], [\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u0026ndash;[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. These findings are consistent with our study and indicate that the greatest support is received from family. This could be associated with the family structure and strong kinship ties in Turkish society. Conditions such as stroke, which majorly affect the rest of the life and cause permanent damage, could occur in patients who have undergone CVD. Thus, patients may become dependent on care following CVD. In such a state, it is vital to provide patients with social support. While individuals enjoy their life assuming various responsibilities and roles before the disease, they may become dependent on homecare with decreased relationships with their social environment resulting in limited social circles, individuals and relationships. In such a scenario, the patient\u0026rsquo;s immediate family becomes prominent in terms of social support in the treatment, care and rehabilitation process. The finding that the family subscale mean score was high in our study is considered to be related to this fact.\u003c/p\u003e \u003cp\u003eThe present study has shown that the level of anxiety is high among patients who underwent CVD (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). When the literature is reviewed, it is seen that anxiety levels of CVD patients are high [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] or moderate [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] in studies conducted both in T\u0026uuml;rkiye [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] and other countries. CVD is a progressive condition that causes functional impairment in daily social life activities, repeated hospitalization and socioeconomic burden. Ensuring adaptation to the disease is critical in terms of effective management of the problems encountered in this process. Anxiety is among the primary mood (affective) disorders that complicates patient adaptation after CVD. Therefore, it is believed that nursing interventions should be planned and implemented to determine and minimize the anxiety levels of patients who have undergone CVD.\u003c/p\u003e \u003cp\u003eIt has been determined that spiritual well-being levels of CVD patients are moderate in the present study (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The literature contains only a limited number of studies examining the spiritual well-being states of patients who have experienced CVD. Studies carried out in T\u0026uuml;rkiye report high levels of spiritual well-being [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] while a study conducted in China found it at a moderate level [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eChronic diseases like CVD cause psychological changes and spiritual distress due to the extended treatment process. Individuals\u0026rsquo; spiritual well-being, on the other hand, can vary depending on the problems caused by the diseases and the treatment process. Enhancing the individual\u0026rsquo;s spiritual well-being is reported to increase the chance of recovery by improving their hope for life and participation in treatment. In this respect, implementation of interventions to reduce anxiety and improve spiritual well-being in patients who experience CVD is critically important.\u003c/p\u003e \u003cp\u003eWhen socio-demographic characteristics of patients who have undergone CVD were examined, the factors affecting their perceived social support levels were found to include being a civil servant, having a chronic disease, being diagnosed with hypertension and diabetes, receiving help from their daughter/son, receiving help from their spouse, having their left hemisphere affected in the brain (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). One study examining the level of social support in CVD in the literature found that social support levels increase parallel with the individual\u0026rsquo;s education level. The study reported that the patient\u0026rsquo;s gender, being married-single, the person providing care for the patient and the affected side of the brain had no effect on the level of social support [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. These differences are thought to arise from socio-cultural variances and social bonds. On the other hand, occupation can be associated with such factors as economic status and the improvement of coping mechanisms. For patients with chronic diseases, it can be associated with the fact that their previously initiated social support process is continued during the CVD process as well. In addition, it is thought that individuals receiving help from their spouse or daughter/son are raised in an extended family culture where providing and receiving help is considered a normal action in this process and they may perceive social support as a natural outcome of familial ties.\u003c/p\u003e \u003cp\u003eAmong the socio-demographic characteristics of patients who have undergone CVD, the factors affecting anxiety levels were found to include age (39\u0026ndash;49 years), being a high school graduate, having a chronic disease, having a hypertension diagnosis, having a heart failure\u0026thinsp;+\u0026thinsp;diabetes diagnosis, and having a cerebral infarction diagnosis (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). When the literature was reviewed, it was seen that Karahan and Kardok found higher anxiety levels in patients whose left hemispheres were affected [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], which is similar to our study. No study has been found to examine the effects of CVD anxiety levels on socio-demographic characteristics in the literature. CVD is a condition with a long treatment and rehabilitation process, which has a negative effect on the individual\u0026rsquo;s quality of life. In addition, various chronic diseases such as hypertension, diabetes and heart failure, which were already present before CVD, could lead to an increase in physical, mental and social burdens. The increase in individuals\u0026rsquo; anxiety levels after CVD is considered to be associated with this fact.\u003c/p\u003e \u003cp\u003eAmong the socio-demographic characteristics of CVD patients, the factors affecting their spiritual well-being levels were determined to include age, being a high school graduate, self-employed, having a chronic disease, and receiving help from their daughter/son (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Bozoğlan examined spiritual well-being in stroke patients and found that patients aged over 76, married individuals, individuals who had an education level of high school or higher, individuals receiving help from their daughter/son and spouse had higher levels of spiritual well-being [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Similarly, a study conducted in China found that religious belief, education level and social support received from family affected spiritual well-being [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In the literature review, studies examining spiritual well-being in various chronic diseases other than CVD reported were seen to report that patients with had a diagnosis of hypertension, aged under 65, those who were unmarried, had no chronic disease and higher education levels had higher levels of spiritual well-being [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. In the study conducted by Yılmaz and Kara examining spiritual well-being in individuals with a chronic disease, spiritual well-being was found to be higher among those aged 64 and under, male patients, married individuals, and individuals with high education and income level [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe positive correlation between age and spiritual well-being in CVD patients is considered to result from the socio-cultural structure and the extended family culture. The relationship between occupation and spiritual well-being in CVD patients, on the other hand, is thought to be related to economic factors.\u003c/p\u003e \u003cp\u003eThe present study determined a positive relationship between the patients\u0026rsquo; perceived social support and spiritual well-being levels (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). No study has been found to examine the relationship between social support and spiritual well-being in the literature. However, Wang and colleagues carried out a study with stroke patients and reported that the level of social support affected spiritual well-being positively [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. CVD is a condition that brings along mental, emotional and economic burdens to patients. The social support received by the patient during the treatment, care and rehabilitation processes of the disease helps the patient to cope with and adapt to the disease. Therefore, good states of spiritual well-being in individuals who receive support is an expected outcome.\u003c/p\u003e \u003cp\u003eNo significant correlation was found between the perceived social support and anxiety levels of patients who have experienced CVD (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). The literature includes studies reporting that the level of perceived social support could reduce anxiety, which is different from our study [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Social support helps the patient to cope with their disease. Therefore, it is an expected condition that anxiety levels decrease as social support increases. On the other hand, the finding that social support had no effect on anxiety levels in the present study is considered to result from the fact that a majority of the patients were housewives and retired, which make them economically dependent.\u003c/p\u003e \u003cp\u003eNo significant relationship was found between CVD patients\u0026rsquo; anxiety levels and spiritual well-being levels, as well (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). In the literature review, no study could be found to examine the relationship between anxiety levels and spiritual well-being levels. It is believed that there is no significant relationship due to the additional physical, mental and social burdens brought about by the treatment process associated with the presence of CVD, the negative effects on the individual\u0026rsquo;s body image and the patients\u0026rsquo; inability to meet their spiritual needs.\u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and Limitations\u003c/h2\u003e \u003cp\u003eThe primary strength of the study is the sample size consisting of 231 patients who had experienced CVD. Additionally, no other study could be found to examine the level of social support, anxiety and spiritual well-being together after CVD as well as the correlations among them. The study is expected to contribute to the literature in this respect. The limitations of the study, on the other hand, include being conducted in a single hospital and being limited to the individuals who were hospitalized.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn the present study, it was found that the patients\u0026rsquo; perceived social support level was moderate, anxiety level was high and spiritual well-being level was moderate. A positive relationship was found between perceived social support and spiritual well-being levels of the patients. No significant correlation was found between the social support the patients received and their anxiety levels. Similarly, patients\u0026rsquo; anxiety levels and spiritual well-being levels were not significantly correlated with each other. A positive relationship was determined between the patients\u0026rsquo; age and spiritual well-being levels.\u003c/p\u003e \u003cp\u003eThe factors affecting the patients\u0026rsquo; perceived social support levels include being a civil servant, having a chronic disease, being diagnosed with hypertension\u0026thinsp;+\u0026thinsp;diabetes, receiving help from their daughter/son, receiving help from their spouse, and having their left hemisphere affected in the brain. The factors affecting the patients\u0026rsquo; anxiety levels include age (39\u0026ndash;49 years), being a high school graduate, being a civil servant, having a chronic disease, having a hypertension diagnosis, having a heart failure\u0026thinsp;+\u0026thinsp;diabetes diagnosis, and having a cerebral infarction diagnosis. The factors affecting the patients\u0026rsquo; spiritual well-being levels are age, being a high school graduate, occupation, having a chronic disease, and receiving help from their daughter/son.\u003c/p\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cb\u003eEthical Considerations\u003c/b\u003e \u003c/p\u003e \u003cp\u003eApproval was received from the Ethical Committee (Number: 2023/04\u0026ndash;10 and Date: 13.06.2023) before starting the study. Written permission was obtained from the patients through the \u0026ldquo;Informed Consent Form\u0026rdquo;.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003eNot applicable.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interest\u003c/h2\u003e \u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003edisclosures\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eUğur \u0026Ouml;NER(Formal analysis), (Investigation), (Data collection), (Visualization), (Validation), (Writing - original draft), (Writing - review and editing), (Methodology)Ahmet EROL (Formal analysis), (Investigation), (Validation), (Visualization) (Writing - original draft), (Writing - review and editing)Hediye UTLİ(Formal analysis), (Investigation), (Validation), (Visualization) Mahmut DİN\u0026Ccedil;(Formal analysis), (Investigation), (Validation), (Writing - review and editing)\u003c/p\u003e\u003ch2\u003eAcknowledgments\u003c/h2\u003e \u003cp\u003eWe thank all the participants who voluntarily contributed to this study.\u003c/p\u003e\u003ch2\u003eData availability statement\u003c/h2\u003e \u003cp\u003eThe data supporting this study\u0026rsquo;s findings are available from the corresponding author, [U\u0026Ouml;], upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOrdu Y, Caliskan N. Evaluation of care according to the nursing model based on life activities within a cerebrovascular disease. J Nursology. 2022;25(3):189\u0026ndash;200. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5152/JANHS.2022.710595\u003c/span\u003e\u003cspan address=\"10.5152/JANHS.2022.710595\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKumar A, McCullough L. Cerebrovascular disease in women. Ther Adv Neurol Disord. 2021;14:1\u0026ndash;22. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1177/1756286420985237\u003c/span\u003e\u003cspan address=\"10.1177/1756286420985237\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang Z, et al. Needs for nurses to provide spiritual care and their associated influencing factors among elderly inpatients with stroke in China: A cross-sectional quantitative study. Palliat Support Care. 2022;20(3):407\u0026ndash;16. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1017/S1478951522000426\u003c/span\u003e\u003cspan address=\"10.1017/S1478951522000426\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTUİK. 2022. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003c/span\u003e\u003cspan address=\"http://www.data.tuik.gov.tr\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAtsu FS, et al. Care for the cerebrovascular accident survivors: experiences of family caregivers. BMC Palliat Care. 2024;23(138):1\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12904-024-01468-6\u003c/span\u003e\u003cspan address=\"10.1186/s12904-024-01468-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchottke H, Giabbiconi CM. Post-stroke depression and post-stroke anxiety: Prevalence and predictors. Int Psychogeriatr. 2015;27(11):1805\u0026ndash;12. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1017/S1041610215000988\u003c/span\u003e\u003cspan address=\"10.1017/S1041610215000988\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKarahan AY, Kaydok E. Depression and anxiety levels in geriatric patients with hemiplegia. Med Bull Sisli Hosp. no. 2013;3:130\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5350/semb2013470306\u003c/span\u003e\u003cspan address=\"10.5350/semb2013470306\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDogru Huzmeli E, Sarac ET. Examination of Sleep Quality, Anxiety and Depression in Stroke Patients. Turkish J Cerebrovasc Dis, 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eU\u0026ccedil;gun T, \u0026Ouml;ks\u0026uuml;z E. The relationship between biological rhythm and perceived social support, coping styles and medication adherence in patients with bipolar disorder in T\u0026uuml;rkiye, \u003cem\u003eArch. Psychiatr. Nurs.\u003c/em\u003e, vol. 48, no. January, pp. 68\u0026ndash;73, 2024, \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.apnu.2024.01.013\u003c/span\u003e\u003cspan address=\"10.1016/j.apnu.2024.01.013\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhao Y, Hu B, Liu Q, Wang Y, Zhao Y, Zhu X. Social support and sleep quality in patients with stroke: The mediating roles of depression and anxiety symptoms. Int J Nurs Pract. 2022;28(3):e12939. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/ijn.12939\u003c/span\u003e\u003cspan address=\"10.1111/ijn.12939\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHenry A et al. August., Anxiety and depression in patients with multiple sclerosis: The mediating effects of perceived social support, \u003cem\u003eMult. Scler. Relat. Disord.\u003c/em\u003e, vol. 27, no. 2018, pp. 46\u0026ndash;51, 2019, \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.msard.2018.09.039\u003c/span\u003e\u003cspan address=\"10.1016/j.msard.2018.09.039\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ede Lima RJ, da Silva CRR, da Costa TF, de Madruga KM, Pimenta CJL, de Costa KN. Resilience, functional capacity and social support of people with stroke sequelae. Rev Eletr\u0026ocirc;nica Enferm. 2020;22:59542. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5216/ree.v22.59542\u003c/span\u003e\u003cspan address=\"10.5216/ree.v22.59542\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBozoglan S. Determınatıon of spırıtualıty and comfort levels of patıents wıth stroke. Ege \u0026Uuml;niversitesi Sağlık Bilimleri Enstit\u0026uuml;s\u0026uuml;; 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEker D, Arkar H, Yaldiz H. Factorial structure, validity, and reliability of revised form of the multidimensional scale of perceived social support. Turkish J Psychiatry. 2001;12(1):17\u0026ndash;25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBeck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56(6):893\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1037/0022-006X.56.6.893\u003c/span\u003e\u003cspan address=\"10.1037/0022-006X.56.6.893\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUlusoy M, Sahin NH, Erkmen H. Turkish version of the beck anxiety inventory: Psychometric properties. J Cogn Psychother Int Q. 1998;12(2):163\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDaaleman TP. The spirituality index of well-being: A new instrument for health-related quality-of-life research, \u003cem\u003eAnn. Fam. Med.\u003c/em\u003e, vol. 2, no. 5, pp. 499\u0026ndash;503, Sep. 2004, \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1370/afm.89\u003c/span\u003e\u003cspan address=\"10.1370/afm.89\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSerbest E, Akgun Sahin Z. Turkish validity and reliability study of spirituality index of well-being. Turkish J Fam Med Prim Care. 2021;15(4):872\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.21763/tjfmpc.1002394\u003c/span\u003e\u003cspan address=\"10.21763/tjfmpc.1002394\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWSO. 2022. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.world-stroke.org/\u003c/span\u003e\u003cspan address=\"https://www.world-stroke.org/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eApaydin Kaya C, Mercan E, Cifcili S. Health and care needs of patients with stroke applied to home health service. J Turkish Fam Physician. 2018;9(3):69\u0026ndash;77. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.15511/tjtfp.18.00369\u003c/span\u003e\u003cspan address=\"10.15511/tjtfp.18.00369\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGunal A, Uyanık M. Social problem solving approach, caregiving role, depression and quality of life in stroke caregivers. Caregivers J Hum Rhythm. 2019;5(2):86\u0026ndash;103.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eErdem O. The relatıonshıp between perceıved socıal support and functıonal status, qualıty of lıfe and depressıon ın stroke patıents. TC Recep Tayyip Erdoğan \u0026Uuml;niversitesi Tıp Fak\u0026uuml;ltesi; 2019.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWondimagegnehu A, Abebe W, Abraha A, Teferra S. Depression and social support among breast cancer patients in Addis Ababa, Ethiopia. BMC Cancer. 2019;19(1):836. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12885-019-6007-4\u003c/span\u003e\u003cspan address=\"10.1186/s12885-019-6007-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDuzen O, Goktas S. The determination of quality of life and social support levels of patients undergoing lung cancer surgery and adjuvant chemotherapy. Heal Soc. 2021;31(3):153\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCanpolat M, Cıtlık Sarıtas S. Determining the relationship between perceived social support and quality of life in patients peveloping diabetic foot, \u003cem\u003eVan Heal. Sci. J.\u003c/em\u003e, vol. 15, no. 3, pp. 275\u0026ndash;283, Dec. 2022, \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.52976/vansaglik.1158975\u003c/span\u003e\u003cspan address=\"10.52976/vansaglik.1158975\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYu F, Li H, Tai C, Guo T, Pang D. Effect of family education program on cognitive impairment, anxiety, and depression in persons who have had a stroke: A randomized, controlled study. Nurs Heal Sci. 2019;21(1):44\u0026ndash;53. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/nhs.12548\u003c/span\u003e\u003cspan address=\"10.1111/nhs.12548\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAsiret GD, Okatan C. Determination of the relationship between drug compliance levels and spiritual Well- being of hypertension patients. J Cardiovasc Nurs. 2019;10(23):122\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5543/khd.2019.66376\u003c/span\u003e\u003cspan address=\"10.5543/khd.2019.66376\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKutmec Yilmaz C, Kara FS. The effect of spiritual well-being on adaptation to chronic illness among people with chronic illnesses. Perspect Psychiatr Care. 2021;57(1):318\u0026ndash;25. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/ppc.12566\u003c/span\u003e\u003cspan address=\"10.1111/ppc.12566\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Anxiety, patient, cerebrovascular event, social support, spiritual well-being","lastPublishedDoi":"10.21203/rs.3.rs-5319125/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5319125/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eIt has been observed to play an important role in providing holistic care by considering anxiety, social support and spiritual well-being in the care of patients. The present study aimed to determine the anxiety, social support and spiritual well-being states of patients who experience a cerebrovascular event.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e The descriptive and cross-sectional study was completed with 231 cerebrovascular patients. The data were collected using the “Patient Information Form”, “Multidimensional Scale of Perceived Social Support”, “Beck Anxiety Inventory” and “Spiritual Well-Being Scale”.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe mean age of the patients participating in the study was 60.62±10.44, with 52.4% being female. The patients were seen to obtain 63.09\u003cstrong\u003e±\u003c/strong\u003e12.45 points over the Multidimensional Scale of Perceived Social Support, indicating a moderate level of perceived social support.\u003c/p\u003e\n\u003cp\u003eIt was found that the total score of the patients was 53.59\u003cstrong\u003e±\u003c/strong\u003e11.50 points on the Beck Anxiety Inventory, which showed high levels of anxiety. The patients scores an average of 43.62\u003cstrong\u003e±\u003c/strong\u003e8.65 points on the Spiritual Well-Being Scale, indicating a moderate level of spiritual well-being. A positive significant correlation was found between the perceived social support and spiritual well-being levels of the patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e As a result of the present study, it was found that the patients had a moderate level of perceived social support, high level of anxiety and moderate level of spiritual well-being. A positive relationship was found between the patients’ perceived social support and anxiety levels. A positive relationship was determined between the patients’ age and spiritual well-being levels.\u003c/p\u003e","manuscriptTitle":"Identifying Anxiety, Social Support and Spiritual Well-Being States of Patients Experiencing Cerebrovascular Event: A cross-sectional descriptive study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-05 10:20:37","doi":"10.21203/rs.3.rs-5319125/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"afd3b319-fefb-4d43-9642-93f1a7c88569","owner":[],"postedDate":"November 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-02-05T02:53:17+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-05 10:20:37","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5319125","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5319125","identity":"rs-5319125","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}