Results: Findings showed that stroke survivors' daily sleep time significantly varied by sex (P < 0.001), education (P = 0.006) and body mass index (P = 0.012). The EuroQOL-5 Dimension index (P < 0.001), and its dimensions of mobility (P = 0.011), usual activities (P < 0.001) and pain/discomfort (P = 0.005) showed significant differences among people with different sleep times. In the final model, after adjusting for covariates, respondents who slept ≤5 h had odds ratios of 1.82 (95% confidence interval 1.05-3.16) for usual activities and 1.95 (95% confidence interval 1.16-3.27) for pain/discomfort compared with respondents who slept 6-8 h. Respondents who slept ≥9 h had an odds ratio of 3.03 (95% confidence interval 1.43-6.43) for usual activities compared with those who slept 6-8 h. Adjusted means for the EuroQOL-5 Dimension index showed significant differences: 0.76 for ≤5 h, 0.85 for 6-8 h and 0.75 for ≥9 h (P = 0.001). Conclusions: Our findings show an association between quality of life and sleep time among adult stroke survivors. Sleep time should be considered in efforts to improve stroke survivors' quality of life, including education and interventions that encourage 6-8 h of sleep.

Handgrip strength is used as an important indicator of health in older adults. We aimed to explore the association between stress, depression, and suicidal ideation and handgrip strength among older adults. We conducted this cross-sectional study involving 1254 individuals (aged ≥65 years), using data from the 2015 Korean National Health and Nutrition Examination Survey VI. We used logistic regression analysis to examine associations between handgrip strength and mental health. Among mental health factors, a significant difference was noted between stress and handgrip strength among the older adults. After adjusting for confounding factors, the odd ratio (OR) of stress among older adults with low handgrip strength was statistically significant in Models 1 (1.61 (95% CI: 1.01–2.57)) and 2 (1.59 (95% CI: 1.01–2.52)) but not in Model 3 (1.52 (95% CI: .96–2.43)). No significant association was found between depression or suicidal ideation and handgrip strength. The risk of stress was 1.59-1.61 times higher in older adults with low handgrip strength, compared to that in older adults with normal handgrip strength. It is necessary to develop strategies aimed at managing stress among older adults with low handgrip strength and educating them about the importance of handgrip strength and exercises that increase handgrip strength.

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The aim of this qualitative study was to examine the process of surviving child abuse in people with a mental illness in order to develop an explanatory theory. The study utilized the grounded theory approach. Seventeen community-dwelling adults with a mental illness who had experienced child abuse were interviewed. For the in-depth interview, the lifeline interview method was used. Data were collected from July 14, 2019, to February 28, 2020. The constant comparative method was used for analysis, to identify similarities and differences between different statements, and similar phenomena or theories were compared and analyzed continuously. The central phenomena were “losing oneself” and “in a precarious state.” Participants used “expressing,” “standing on one’s own feet,” and “avoiding” as coping strategies. Observed outcomes were “making life work for them” and “living with others.” The core category was “losing myself, embracing myself as someone in a precarious state, and being reborn as the master of my life.” Positive religious coping, having a supportive network, and emotional or physical distance from difficult situations played a major role in surviving participants’ experiences of child abuse and being victimized because of their mental illness. Our findings provide a theoretical basis for understanding people with mental illness who have survived child abuse, and suggest that opportunities for sharing their stories, facilitating self-reliance, and avoiding the causes of their difficulties all play a role in their healing process. Based on this study, it is expected that clinical experts and policy developers will be able to formulate evidence-based interventions and policies.

Purpose: This study investigated the association of sleep duration with healthrelated quality of life (HRQoL) and mental health in cancer survivors.Design and Methods: This cross-sectional study included 846 cancer survivors aged 19 years and older from Korea. Associations between sleep duration, HRQoL, and mental health were analyzed using analysis of covariance and logistic regression.Findings: Survivors who slept 5 h or less had lower HRQoL and higher risk of suicidal ideation than survivors who slept 6-8 h.Practice Implications: Sleep improvement programs should be developed as sleep disorders may be a central concern among cancer survivors.