Abstract
Objective
To investigate changes in the frequency of participation 6 months poststroke compared
with prestroke; and to establish whether the change is associated with participation
restrictions and satisfaction with participation 6 months poststroke.
Design
Inception cohort study. Prestroke frequency of participation was measured retrospectively
in the first week poststroke. Frequency, participation restrictions, and satisfaction
with participation were assessed 6 months poststroke.
Setting
General hospitals and home residences.
Participants
Patients with stroke (N=325; 65.5% men; mean age, 66.9±12.2y) admitted to 1 of 6 participating
general hospitals.
Interventions
Not applicable.
Main Outcome Measure
Utrecht Scale for Evaluation of Rehabilitation-Participation (0–100), which consists
of 3 scales: frequency, restrictions, and satisfaction. The frequency scale consists
of 2 parts: vocational activities (work, volunteer work, education, household activities)
and leisure and social activities.
Results
Vocational activities showed a large decrease (effect size: 0.6) poststroke; leisure
and social activities showed a small decrease (effect size: 0.13) poststroke. In multiple
regression analyses, both the frequency of participation in vocational activities
6 months poststroke and the decrease in vocational activities compared with before
the stroke were significantly associated with the participation restrictions experienced
and satisfaction with participation after controlling for age, sex, level of education,
dependency in activities of daily living, cognitive functioning, and presence of depressive
symptoms. The presence of depressive symptoms showed the strongest association with
the subjective experience of participation.
Conclusions
The frequency of participation decreased after a stroke, and this decrease was associated
with participation restrictions experienced and satisfaction with participation. Resuming
vocational activities and screening and, if applicable, treatment of depressive symptoms
should be priorities in stroke rehabilitation.
Keywords
List of abbreviations:
ADL (activities of daily living), BI (Barthel Index), ICF (International Classification of Functioning, Disability and Health), USER-Participation (Utrecht Scale for Evaluation of Rehabilitation-Participation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 25, 2014
Footnotes
Supported by VSB fund (grant no. 60-61300-98-022).
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
