School of Nursing, Southern Medical University, Guangzhou, China.
Disabil Rehabil. 2021 Mar;43(5):648-656. doi: 10.1080/09638288.2019.1636314. Epub 2019 Aug 22.
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.
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.
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.
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 rehabilitationAlthough 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.
描述中青年脑卒中患者在急性治疗后一个月出院后的参与感，并评估其决定因素。
从两家三级医院连续招募了 223 名患者，在出院后 1 个月通过参与和自主影响问卷（IPA）在门诊或社区进行随访，以评估其参与度，其中 23 名患者失访。参与度的决定因素（即社会人口统计学、疾病相关、身体、心理和社会因素）在四个领域确定：室内自主；户外自主；家庭角色；和社会生活。
我们的受访者的整体参与感良好到一般。46 名（23.0%）、32 名（16.0%）、13 名（6.5%）和 19 名（9.5%）分别在室内自主、家庭角色、户外自主和社会生活领域中认为自己的参与度为“非常好”。卒中严重程度、抑郁症状和社会支持是所有领域参与的共同决定因素，而卒中严重程度是最强的相关性因素。日常生活活动能力与室内自主、家庭角色和户外自主相关，但与社会生活无关。
我们的受访者的感知参与度相对乐观。身体健康以及心理和社会状况会影响参与度。应该在康复阶段早期实施有针对性的策略，以促进脑卒中幸存者在所有领域的参与度。
尽管中青年脑卒中患者的整体感知参与度良好，但应注意他们的家庭角色。主要策略应侧重于减轻卒中严重程度，以提高患者的参与度。改善患者的抑郁症状和社会支持也有助于提高他们的参与度。
