2.1 Design
The aim of this study was to investigate quality of life and mood (symptoms of anxiety and depression) in patients with ICH and to identify the factors associated with them. We used a cross-sectional design and conducted descriptive correlational analyses, including semistructured interviews and self-assessments of patients, to investigate the relationship between patient demographic characteristics, general quality of life, and mood. All the above work was completed within seven days of admission.
2.2 Participants
Participants were patients with ICH treated in the Department of Neurosurgery at the Southwestern Medical University Hospital from June 2021 to August 2022. Patient inclusion criteria: (1) patients were diagnosed with ICH based on medical history and imaging findings, (2) patients were conscious and able to complete the questionnaire, and (3) patients had complete clinical information. The exclusion criteria were as follows: (1) patients with a personal or family history of mood disorders, (2) patients who were transferred or withdrawn from the study, and (3) patients who were physically disabled or suffered from other major diseases.
2.3 Research tools
2.3.1 General characteristics of participants
Eight general characteristics of participants, namely, gender, age, marital status, exercise habits, household income, education, smoking, and alcohol consumption, were included.
2.3.2 Anxiety and depression
Depression was assessed using the 24-item Hamilton Depression Scale (HAMD). This scale is used to assess depressive symptoms in adults during the past week, with scores below 8 indicating no depression, 8-16 indicating mild depression, 17-20 indicating moderate depression, and 35 or more indicating major depression [7].
Anxiety was assessed using the Hamilton Anxiety Inventory (HAMA) [8], a 14-item questionnaire that assesses anxiety symptoms over the past week. It has two main components, physical anxiety and psychological anxiety, that assess anxiety as severe anxiety (>29); marked anxiety (21-29); anxiety (14-21); possible anxiety (7-14), and no anxiety symptoms (<7). In general, a HAMA score higher than 14 indicates clinically significant anxiety symptoms.
2.3.3 Participants' general quality of life and self-burden perception scales
The Quality of Life Scale (SF-36) developed by the Institute of Medicine is widely recognized and used worldwide to evaluate health-related quality of life. It includes 8 dimensions: physiological function (PF), role-physical (RP), body pain (BP), general health (GH), vitality (VT), social function (SF), emotional function (RE) and mental health (MH). In addition, health change (HT) items are also included. The Satisfaction with Life Scale (SWLS) was used to assess patients' life satisfaction. The Patient Self-Care Assessment Scale (Barthel) was used to assess a patient's ability to care for themselves. The SF-36, Barthel and SWLS scales were used to evaluate the quality of life of patients. The Self-Perceived Burden Scale (SPBS) was used to assess the patients’ degree of self-perceived burden.
2.4 Data analysis
All data analyses were conducted in the R Statistical Computing framework v3.4 or higher. Descriptive statistics were used to analyze participants' general characteristics, anxiety symptoms and depressive symptoms. A t test, ANOVA, was used to test for differences in anxiety symptoms and depressive symptoms across participant characteristics. Measures that followed a normal distribution were expressed as the mean ± standard deviation (mean ± standard deviation). Correlations between continuous variables were analyzed with Pearson correlations. Factors influencing participants' anxiety symptoms and depressive symptoms were analyzed by regression analysis. P<0.05 indicated that the difference was statistically significant.