Unraveling the quality-of-life network: how activities of daily living are embedded in the multidimensional quality of life after stroke.
6 affiliations
- 1Department of Nursing, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.
- 2NingCi Rehabilitation Hospital, Ningbo, Zhejiang, China.
- 3Department of Rehabilitation, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.
- 4Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China.
- 5Department of Nursing, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China. [email protected].
- 6NingCi Rehabilitation Hospital, Ningbo, Zhejiang, China. [email protected].
Abstract
Background
Quality of Life (QoL) after stroke is a multidimensional construct, yet its internal interactive architecture and how objective functional capacity, specifically Activities of Daily Living (ADL), embeds within this subjective network remain poorly understood.Objective
This study aimed to delineate the interdependent network structure of post-stroke quality of life domains and to investigate the specific role of ADL within this system.Methods
In this cross-sectional study, a sample of 451 stroke survivors was recruited. Psychometric network analysis was conducted on the 12 domains of the Stroke-Specific Quality of Life (SS-QOL) scale to estimate the core QoL network. Subsequently, ADL was integrated as an external node to examine its precise connections. Centrality indices and bridge centrality were calculated to identify hubs and bridges. Edge-weight accuracy and centrality stability were assessed via bootstrap analysis.Results
The core 12-domain QoL network was stable and interpretable. Self-Care and Thinking emerged as the most central hubs (strength centrality: 1.24 and 1.16). Social Roles acted as a key bridge (highest betweenness centrality: 26). Crucially, ADL showed its strong direct association with Self-Care (edge weight = 0.169) and Mobility (edge weight = 0.207). This pattern shows that ADL is directly associated with these core functional domains, without being directly linked to more subjective domains like Mood or Social Roles.Conclusions
This study provides a cross-sectional map of interdependencies within the post-stroke QoL system. Within this observed network, Self-Care emerged as a central and interconnected domain, thereby suggesting it as a candidate for future intervention research. The peripheral yet specialized connectivity of ADL suggests its effect on broader QoL is likely system-mediated. These hypotheses regarding directional influences and intervention efficacy require explicit testing in longitudinal or experimental studies.
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BibTeX
@article{yu2026unraveling,
title = {{Unraveling the quality-of-life network: how activities of daily living are embedded in the multidimensional quality of life after stroke.}},
author = {Weifei Yu and Yiqing Zhang and Lu Shi and Lulu Tong and Jingjing Ma},
journal = {BMC neurology},
year = {2026},
month = jul,
doi = {10.1186/s12883-026-05191-y},
url = {https://europepmc.org/article/MED/42902246},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Unraveling the quality-of-life network: how activities of daily living are embedded in the multidimensional quality of life after stroke.
AU - Weifei Yu
AU - Yiqing Zhang
AU - Lu Shi
AU - Lulu Tong
AU - Jingjing Ma
PY - 2026
DA - 2026/07/01
JO - BMC neurology
DO - 10.1186/s12883-026-05191-y
UR - https://europepmc.org/article/MED/42902246
AB - Background Quality of Life (QoL) after stroke is a multidimensional construct, yet its internal interactive architecture and how objective functional capacity, specifically Activities of Daily Living (ADL), embeds within this subjective network remain poorly understood.Objective This study aimed to delineate the interdependent network structure of post-stroke quality of life domains and to investigate the specific role of ADL within this system.Methods In this cross-sectional study, a sample of 451 stroke survivors was recruited. Psychometric network analysis was conducted on the 12 domains of the Stroke-Specific Quality of Life (SS-QOL) scale to estimate the core QoL network. Subsequently, ADL was integrated as an external node to examine its precise connections. Centrality indices and bridge centrality were calculated to identify hubs and bridges. Edge-weight accuracy and centrality stability were assessed via bootstrap analysis.Results The core 12-domain QoL network was stable and interpretable. Self-Care and Thinking emerged as the most central hubs (strength centrality: 1.24 and 1.16). Social Roles acted as a key bridge (highest betweenness centrality: 26). Crucially, ADL showed its strong direct association with Self-Care (edge weight = 0.169) and Mobility (edge weight = 0.207). This pattern shows that ADL is directly associated with these core functional domains, without being directly linked to more subjective domains like Mood or Social Roles.Conclusions This study provides a cross-sectional map of interdependencies within the post-stroke QoL system. Within this observed network, Self-Care emerged as a central and interconnected domain, thereby suggesting it as a candidate for future intervention research. The peripheral yet specialized connectivity of ADL suggests its effect on broader QoL is likely system-mediated. These hypotheses regarding directional influences and intervention efficacy require explicit testing in longitudinal or experimental studies.
SN - 1471-2377
ER -