Dissertations & Theses (Open Access)

Date of Award

Spring 5-2019

Degree Name

Doctor of Philosophy in Nursing (PhD)


Rebecca L. Casarez, PhD

Second Advisor

Geri LoBiondo-Wood, PhD

Third Advisor

Louise D. McCullough, M.D.


Objective: Post-stroke inflammation is detrimental to the brain and results in an unfavorable recovery. Optimism has been associated with lower inflammation and better health outcomes among people with medical conditions, but no studies have assessed this association in the stroke population. The overall goals were to examine the relationships among optimism, stroke severity, physical disability, and inflammation during hospitalization and evaluate the relationships among optimism, inflammation, and stroke recovery over the three-month post-stroke period.

Methods: This study was a secondary analysis of data collected from the BioRepository of Neurological Diseases biobank. Outcomes included optimism, stroke severity, physical recovery, and inflammatory markers (IL-6, TNF-α, and CRP). Spearman’s correlation, Wilcoxon signed-rank test, multiple linear regression, and mixed-effect regression model were used to determine the relationships among the variables.

Results:The sample consisted of 49 subjects at baseline and 13 subjects at 3-month follow-up. The results indicated that subjects with higher optimism showed less stroke severity (p=.001), less physical disability (p=.03), and lower level of CRP (p=.02) at baseline compared to those with lower optimism. Additionally, optimism was associated with less stroke severity (p

Conclusion: Optimistic stroke survivors showed lower inflammation and better stroke recovery. By understanding this relationship may provide a scientific framework whereby new strategies for stroke recovery can be developed in the future.


optimism, inflammation, stroke recovery

Included in

Nursing Commons



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