Perceived Participation and Its Correlates Among First-Stroke Survivors at Six Months After Discharge From a Tertiary Hospital in China

Abstract

ObjectivesTo describe perceived participation of first-stroke survivors in mainland China, and to determine variables that may correlate with perceived participation 6 months after discharge. DesignCross-sectional survey. SettingNeurology department of a tertiary hospital, with subsequent follow-up of patients in their homes. ParticipantsFirst-stroke survivors (N=236) who had been treated in the neurology department and discharged 6 months before their participation in our study. InterventionsNot applicable. Main Outcome MeasuresParticipation was assessed using the Chinese version of the self-report Impact on Participation and Autonomy Questionnaire. Performance on activities of daily living was measured using the Barthel Index, and physical function was measured with the Chinese Stroke Scale. The Hospital Anxiety and Depression Scale and the Social Support Rating Scale were also used. ResultsThe mean score of perceived participation was 40.39±15.29, and 52.1%, 38.1%, 33.1%, and 5.5% of the participants reported insufficient participation in the domains of autonomy outdoors, family role, social relations, and autonomy indoors, respectively. Physical function served as the strongest correlate for the domains of family role and autonomy outdoors (standardized coefficients =.426 and .336, respectively), while depression was the strongest correlate for the domain of social relations (standardized coefficient =.315). ConclusionsPhysical function and activities of daily living were significantly associated with perceived participation in almost all domains. Depression was an important correlater of participation in the social relations domain. Perceived participation may be influenced by multiple factors, and tailored strategies should be implemented early in the rehabilitation phase poststroke to promote participation in all domains of daily living.