The influence of the quality and quantity of social support in the promotion of community participation following stroke

Abstract

Background: Community participation for a client who has sustained a stroke often requires the client to make adjustments, adaptations, and compensations for residual impairments or disability following stroke rehabilitation. The ability to make these needed adjustments, adaptations, and compensations often require a client‐centred assistance from an occupational therapist ( Rogers, 2006 ). Assessment of environmental factors, such as social support, is one avenue an occupational therapist may consider in the provision of client‐centred assistance. As such, the purpose of this study was to examine the impact of social support on community participation after stroke. Methods: Ninety‐five stroke survivors were interviewed at home 3 to 6 months postdischarge from a rehabilitation hospital. Multivariate analysis was used to determine the effects of social support on community participation, as measured by the Reintegration to Normal Living Index, following stroke rehabilitation. Quality and quantity of social support were measured using the Social Support Inventory for People with Acquired Disabilities. Results: The quality of social support did not have a greater relationship to community participation than the quantity of social support, as hypothesised. As main effects, both quality (P = 0.03) and quantity (P = 0.004) of social support were found to be significant. Quality and quantity of social support explained 31% and 35% of the variance, respectively, with regard to community participation, indicating moderately strong relationships to the dependent variable. However, the results of bivariate analyses indicate that for people who had sustained a stroke, community participation was more related to their functional limitation (P = 0.001), rather than to the support that was available to them.Conclusions: Assessment and development of social support as a component of occupational therapy intervention may improve the degree of community participation for people with stroke.