The relationship of expectation and satisfaction of filial piety with stroke-related outcomes of Chinese older adults in stroke rehabilitation

UnrestrictedPrevious studies have demonstrated that social support affects older adults’ functional recovery, depression, and quality of life after stroke in rehabilitation programs. Filial piety, in term, is a special type of social support in Chinese culture that older Chinese adults need and value, particularly after they experience a stroke. Due to the scarcity of existing studies on this topic and the pivotal role filial piety may play in stroke outcome, it is important to undertake the study.; In this study, five domains of expected filial piety were first identified through qualitative analysis of semi-structured interview data: emotional, physical, economic, informational, and spiritual domain. Each domain was further subdivided into components indicating specific types of expected filial behaviors or attitudes as given by the informants.; In addition, a total of 30 items for EFP and SFP were created based on the findings described above. Both scales demonstrated sufficient reliability and appropriate content validity. However, acceptable convergent construct validity was established only for the EFP. Factor analysis was also performed on the EFP and SFP. The result indicated, when compared to original-designed factor structure, the EFP demonstrated better construct validity than the SFP.; Finally, at approximately one month post stroke, it was found that the expectation level of filial piety in the physical domain was significantly and negatively associated with overall health-related quality of life and its physical and mental dimensions. Moreover, a significantly negative association was found between filial expectation in the spiritual domain and health-related quality of life in mental dimension. No significant association was found between overall satisfaction of filial piety or any of its subscales scores and any of the outcomes. However, the interaction terms of EFP by SFP indicated that satisfaction moderated the effect of expectation on depression and on the health-related quality of life. Furthermore, a measurement flaw was discovered which suggested the need for alternative ways to evaluate satisfaction of filial piety, such as assessing filial discrepancy and frequency in the future research. The difference between SFP and EFP scores was computed as a measure of filial discrepancy. Although the findings indicated the same relationships could be detected between filial discrepancy and the outcomes as had been revealed for filial expectations and the outcomes, in this case these relationships were in the opposite direction