The results offer important insights into the Icariside-I factors affecting the likelihood of speaking up and, after being confirmed in further research, could be used to design trainings for oncology staff. Tenacissoside-I quality of life has been reported to be influenced by many factors with rather complex interactions. Therefore, a conceptual model might be beneficial in explaining the relationships among such factors. Wilson and Cleary have already suggested a 5-level model, including biological, physical and mental symptoms, functions, health satisfaction, age and environmental conditions, trying to classify and clarify the relationships between these variables. By this model, demonstrated that QoL can be predicted by factors such as health satisfaction directly, and by environmental conditions through health satisfaction and depressive symptoms indirectly. Therefore, health-related quality of life seems to play an important role in influencing the QoL in people with cardiovascular disease and stroke. Health-related quality of life in patients with cardiovascular disease, stroke, and other chronic diseases has been studied extensively using different methods in recent years. The results of these studies have suggested that the HRQoL might be associated with lifestyle, comorbidity and mental health. Some studies disclosed that although chronic diseases usually exert a negative impact on quality of physical health, the status of mental health might be relatively unaffected. Other studies also suggested that the major contribution of the chronic disease to the negative impact on HRQoL could be the symptoms and disabilities of the disease rather than the disease itself. Besides, Spitzer et al. already proposed that both physical and mental disorders might have different effects on the components of HRQoL. These seemingly controversial results raised the question that, even with similar outcomes, the underlying pathways for these disease to influence the HRQoL might be different, just as that proposed by Mayo et al., who used the Wilson and Cleary model to evaluate the HRQoL in people recovering from stroke.