Social functioning assessment in stroke patients.

The influence of depression, intellectual function, and physical impairment on patient reports of social functioning was assessed by comparing responses obtained from 30 stroke patients with those obtained from an outside informant who knew the patient well. There was relatively good agreement between patient and other for both the overall score on the Social Functioning Examination (SFE) and individual items related to specific aspects of social functioning. Differences between scores obtained from a patient and outside informant were not significantly related to either depression, moderate degrees of intellectual impairment, relative closeness of patient and informant or to degree of physical impairment. These data suggest that valid SF assessments can be made either by a stroke patient who is capable of being interviewed or by a familiar outside informant. In addition, the prognostic utility of the SFE was examined by interviewing 50 patients during the acute stroke period and following them over six months. Social functioning in-hospital scores were not found significantly related to 6-month scores for either depression, intellectual impairment, or physical impairment, but depression and in-hospital impairment significantly predicted social functioning at 6-month follow-up. These data suggest that the most impaired stroke patients are the most likely to undergo social deterioration during the post-stroke period and may require the greatest amount of social intervention. Whether treatment of these variables significantly affects 6-month outcome remains an intriguing question for further study.