Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA.
Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
Top Stroke Rehabil. 2023 Sep;30(6):568-577. doi: 10.1080/10749357.2022.2110192. Epub 2022 Sep 8.
Participation restrictions continue to be prevalent for community-dwelling stroke survivors. Research is needed to understand the associated post-stroke factors that limit or facilitate optimal participation and quality of life.
To investigate emotional health, executive functioning (EF), and social support as predictors of participation restrictions post-stroke.
Cross-sectional data collected from participants ≥ 6 months after mild stroke with and without aphasia ( = 114) were analyzed using three participation outcome measures: Reintegration to Normal Living Index (RNL), Activity Card Sort (ACS), and the Stroke Impact Scale (SIS) Version 2.0 Participation/Role Function domain. Predictor variables investigated were emotional health (SIS Emotion domain scores), EF (Delis Kaplan Executive Function System Trail Making Condition 4: DKEFS), social support (Medical Outcomes Study Social Support Survey: MOS-SSS), stroke severity (National Institutes of Health Stroke Scale: NIHSS), and education level.
Using multiple regression, these predictors accounted for 26.4% to 40% of the variance for the three participation outcomes. Emotional health was a significant independent predictor across all three measures. Social support was a significant predictor of participation as measured on the RNL. Executive function was not a significant predictor of participation when controlling for the other predictor variables.
Emotional health and social support should be considered as modifiable factors that could optimize meaningful participation and quality of life.
参与限制仍然普遍存在于社区居住的中风幸存者中。需要研究了解与限制或促进最佳参与和生活质量相关的中风后因素。
调查情绪健康、执行功能 (EF) 和社会支持作为中风后参与限制的预测因素。
使用三种参与结果测量工具对轻度中风后伴有和不伴有失语症的参与者（n=114）≥6 个月收集的横断面数据进行分析：正常生活再融入指数 (RNL)、活动卡片分类 (ACS) 和中风影响量表 (SIS) 版本 2.0 参与/角色功能领域。研究的预测变量包括情绪健康（SIS 情绪领域评分）、执行功能（Delis-Kaplan 执行功能系统追踪条件 4：DKEFS）、社会支持（医疗结果研究社会支持调查：MOS-SSS）、中风严重程度（国立卫生研究院中风量表：NIHSS）和教育水平。
使用多元回归，这些预测因素可以解释三种参与结果的 26.4%到 40%的差异。情绪健康是所有三种测量方法中独立的重要预测因素。社会支持是 RNL 测量参与的重要预测因素。在控制其他预测变量的情况下，执行功能不是参与的重要预测因素。
情绪健康和社会支持应该被视为可以优化有意义的参与和生活质量的可改变因素。
