Jessica Kersey, PhD, OTR/L, is Instructor, Program in Occupational Therapy, Washington University in St. Louis, St. Louis, MO;
Elizabeth Skidmore, PhD, OTR/L, is Professor, Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA.
Am J Occup Ther. 2023 Nov 1;77(6). doi: 10.5014/ajot.2023.050255.
Little is known about the severity of participation restrictions among people living in the community with chronic stroke. Even less is known about the association between participation and health in this population.
To describe participation among people with chronic stroke and examine the association between participation and physical and mental health.
Secondary analysis of baseline data from an intervention study.
The parent multisite intervention study was conducted in the community, and assessments were administered in participants' homes.
Thirty-one community-dwelling adults with chronic stroke.
Participation was measured with the Activity Card Sort (percentage of prestroke activities retained) and the Enfranchisement Scale of the Community Participation Indicators. Health was measured with the PROMIS®-29 Physical Health and Mental Health subscales. We calculated descriptive statistics for participation measures and Spearman's ρ correlations between participation and health outcomes.
Participation scores were poor on all measures of participation. Most striking, 94.9% of participants retained less than 80% of their prestroke activities. All measures of participation were modestly correlated with physical health (ρ = .28-.46) and were moderately correlated with mental health (ρ = .42-.63).
Participation restrictions are prevalent among adults with chronic stroke, with potential implications for mental health. Stronger community-based rehabilitation and support services to enhance participation of this high-risk population are warranted. What This Article Adds: This report highlights the severity of participation restrictions among people with chronic stroke. Moreover, this report shows that people with stroke feel a lack of inclusion in the community and that participation is associated with mental and physical health.
对于生活在社区中的慢性中风患者的参与限制的严重程度知之甚少。对于该人群的参与与健康之间的关系，了解得就更少了。
描述慢性中风患者的参与情况，并研究参与与身心健康之间的关系。
干预研究的基线数据的二次分析。
该家长多站点干预研究在社区中进行，评估在参与者的家中进行。
31 名居住在社区中的慢性中风成人。
参与度使用活动分类卡（保留的发病前活动的百分比）和社区参与指标的赋权量表进行测量。健康使用 PROMIS®-29 身体健康和心理健康子量表进行测量。我们计算了参与度指标的描述性统计数据，并计算了参与度与健康结果之间的斯皮尔曼 ρ 相关。
所有参与度指标的参与度得分都很差。最引人注目的是，94.9%的参与者保留的发病前活动不到 80%。所有参与度指标都与身体健康（ρ=.28-.46）中度相关，与心理健康（ρ=.42-.63）中度相关。
慢性中风患者的参与限制普遍存在，这可能对心理健康产生影响。需要更强的基于社区的康复和支持服务，以增强这一高风险人群的参与度。本文的重要性：本报告强调了慢性中风患者参与限制的严重程度。此外，本报告表明，中风患者感到自己在社区中被排斥，参与度与身心健康有关。
