Influence of Environmental Factors on Social Participation Post-Stroke

Carolyn M Baum,Lisa Tabor Connor,Marjorie L Nicholas,Erin L Foley

doi:10.1155/2019/2606039

Carolyn M Baum, Lisa Tabor Connor + Show 2 more

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https://doi.org/10.1155/2019/2606039

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Abstract

Objectives For rehabilitation professionals to adequately address meaningful participation in social activities with their patients after a stroke, there must be a better understanding of neurobehavior, that is, how neurological impairment and its sequelae and environmental factors support or limit social participation. The current study examines how stroke severity (NIH Stroke Scale), its impact on perceived mobility (Stroke Impact Scale mobility domain), and the environment (MOS Social Support–Positive Social Interactions scale and Measure of Stroke Environment receptivity and built environment domains) influence social participation (Activity Card Sort: ACS). Methods A correlational, cross-sectional design examined the relationships among neurological impairment, perceived limitations in activity, environmental factors, and social participation. Participants included 48 individuals who were at least 6 months post-stroke both with aphasia (N = 22) and without aphasia (N = 26) living in the community for whom all measures were available for analysis. Results No differences in social participation were found between those with and without aphasia, though both groups reported a large (25-30%) decline in participating in their prestroke social activities. For the ACS Social Domain activities and ACS Partner to Do With activities (percent retained), 37% and 35% of the variance, respectively, was accounted for by the predictor variables, with only MOS Social Support making an independent contribution to social participation. In this sample, neurological impairment was not a significant correlate of social participation. Additionally, perceived mobility and the built environment were not found to independently predict participation in social activities. Conclusions Perceived social support was found to predict social participation in individuals living in the community 6 months or greater post-stroke. Focusing on social support during post-stroke rehabilitation may provide an avenue for increased social participation and more successful community reintegration.

Highlights

In the United States, someone has a stroke every 40 seconds, which equates to approximately 800,000 people per year [1]
Both persons with aphasia (PWA) and persons without aphasia (PWOA) had resumed some of their prestroke social activities, but still experienced a notable reduction in social participation in both measures investigated
The Medical Outcomes Study (MOS) Social Support-Positive Social Interactions scale, Stroke Impact Scale (SIS) mobility, and the Measure of Stroke Environment (MOSE) receptivity and built domains were found to be significantly correlated with the ACS Social Domain percent retained

Summary

Introduction

In the United States, someone has a stroke every 40 seconds, which equates to approximately 800,000 people per year [1]. Stroke is the leading preventable cause of disability with significant societal cost [1]. Due to the prevalence of stroke and the concomitant societal cost, much research has been done on the prevention and rehabilitation of this condition. Less is known about the extent to which individuals who have experienced a stroke successfully reintegrate into the community and the factors that have an impact on the ability to participate in everyday activities after return home, for people with mild stroke. Full participation is individually defined and relies upon self-report. For many individuals with disabilities, meaningful engagement means that they have access to a full range of opportunities for participation unrestricted by Behavioural Neurology their physical, cognitive, or mental health challenges or physical, social, or political environments [2]

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