Perceived participation and its determinants among young and middle-aged stroke survivors following acute care one month after discharge

Abstract

Purpose To describe the perceived participation and assess its determinants among young and middle-aged stroke patients following acute care one month after discharge in mainland China. Methods Two hundred and twenty-three patients were consecutively recruited from two tertiary hospitals and were followed up 1 month after discharge in the outpatient department or their communities to assess their participation by using the Impact on Participation and Autonomy Questionnaire, with 23 patients lost to follow-up. Determinants (i.e., sociodemographic, diseased-related, physical, psychological, and social factors) of participation were identified in four domains: indoor autonomy; outdoor autonomy; family role; and social life. Results The overall perceived participation of our respondents was good to fair. Forty-six (23.0%), 32 (16.0%), 13 (6.5%), and 19 (9.5%) perceived their participation as “very good” in the domains of indoor autonomy, family role, outdoor autonomy and social life, respectively. Stroke severity, depressive symptoms, and social support were the common determinants of participation for all the domains, with stroke severity being the strongest correlate. Activities of daily living was associated with indoor autonomy, family role, and outdoor autonomy, but not associated with social life. Conclusions The perceived participation of our respondents is relatively optimistic. Physical health along with mental and social status can affect participation. Tailored strategies should be implemented early in the rehabilitation phase to promote stoke survivors’ participation in all the domains. Implications for rehabilitation Although the overall perceived participation of young and middle-aged stroke patients was fair to good, attention should be paid to their family roles. The strategies should be mainly focused on reducing the stroke severity to improve patients’ participation. Improving patients’ depressive symptom and social support can also be helpful for improving their participation.