冷漠、认知障碍和社会支持影响中风后参与认知要求较高活动的程度。
Apathy, Cognitive Impairment, and Social Support Contribute to Participation in Cognitively Demanding Activities Poststroke.
作者信息
Ho Amy, Nicholas Marjorie L, Dagli Chaitali, Connor Lisa Tabor
机构信息
Department of Occupational Therapy, MGH Institute of Health Professions, Boston MA, USA.
Department of Communication Sciences & Disorders, MGH Institute of Health Professions, Boston MA, USA.
出版信息
Behav Neurol. 2021 Mar 26;2021:8810632. doi: 10.1155/2021/8810632. eCollection 2021.
OBJECTIVE
To understand the extent to which apathy, cognition, and social support predict participation in activities with cognitive demands.
DESIGN
Prospective, quantitative correlational, cross-sectional study. . Outpatient treatment centers and community stroke support groups located in St. Louis, MO, and Boston, MA. . 81 community-dwelling individuals ≥ 6-month poststroke with and without aphasia. . Participants completed the Activity Card Sort (ACS), Apathy Evaluation Scale (AES), Medical Outcomes Study Social Support Survey (MOS-SSS), and Delis-Kaplan Executive Function System (DKEFS) Design Fluency and Trail-Making subtests.
RESULTS
Cognitive deficits limit participation in activities with high cognitive demands. Apathy and positive social interaction influence participation, regardless of high or low cognitive demands. Poststroke aphasia did not impact return to participation in activities with high and low cognitive demands. . Cognitive deficits seen poststroke contribute to participation only for activities with high cognitive demands. Apathy has a significant and negative influence on participation overall. Social support is a modifiable contextual factor that can facilitate participation. Poststroke apathy can be detrimental to participation but is not well recognized. The availability of companionship from others to enjoy time with can facilitate participation.
目的
了解冷漠、认知和社会支持在多大程度上能够预测参与有认知要求的活动。
设计
前瞻性、定量相关性横断面研究。地点为位于密苏里州圣路易斯市和马萨诸塞州波士顿市的门诊治疗中心和社区中风支持小组。研究对象为81名中风后6个月及以上的社区居住个体，有失语症和无失语症。参与者完成了活动卡片分类测试（ACS）、冷漠评估量表（AES）、医学结局研究社会支持调查（MOS - SSS）以及德利 - 卡普兰执行功能系统（DKEFS）的设计流畅性和连线测验子测试。
结果
认知缺陷限制了对有高认知要求活动的参与。冷漠和积极的社会互动会影响参与，无论认知要求高低。中风后失语症并不影响恢复参与有高认知要求和低认知要求的活动。中风后出现的认知缺陷仅对有高认知要求的活动参与有影响。冷漠对总体参与有显著负面影响。社会支持是一个可改变的情境因素，能够促进参与。中风后的冷漠可能对参与不利，但尚未得到充分认识。有他人陪伴共度时光有助于促进参与。
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