Poststroke activity engagement in community dwellers: Association with illness perceptions and perceived environment

Abstract

Objectives To investigate whether individuals’ poststroke activity engagement is associated with their perceptions of stroke, as well as their perceptions of physical and social environment. Design Cross-sectional study. Setting Participants were recruited from eight rehabilitation settings in Beijing, China. Participants A total of 202 dyads of community dwellers with stroke and their primary caregivers. Main Measures Activity engagement measured by the Assessment of Life Habits; stroke individuals’ and caregivers’ illness perceptions measured by the Stroke-Specific Illness Perceptions Questionnaire – Revised; and stroke individuals’ perceived social and physical environment measured by the Social Support Survey and abbreviated Neighborhood Environment Walkability Scale. Results A total of 202 dyads of individuals with stroke and their caregivers participated in the study with mean ages of 61.3 (8.3) and 52.6 (11.6), respectively. On average, stroke individuals scored 7.61 (1.42) on the daily activities subscale, indicating that they completed personal level activities without assistance but with some difficulty. They scored 6.21 (2.21) on the social roles subscale, suggesting that individuals completed societal level activities with assistive devices and with some difficulty. Illness perceptions correlated significantly with personal level activity engagement (change in R-squared = 0.029; p = 0.049), and perceived accessibility and heterogeneity correlated significantly with societal level activity engagement (change in R-squared = 0.025; p = 0.011). Conclusions Poststroke activity engagement is associated not only with stroke individuals’ performance skills but also with their perceptions of stroke, and how they perceive their physical environment. The findings may assist clinicians’ decision making when developing comprehensive, targeted interventions for improving activity engagement and maximizing recovery after stroke.