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Perceived Participation and Its Correlates Among First-Stroke Survivors at Six Months After Discharge From a Tertiary Hospital in China

  • Author Footnotes
    ∗ Chen, He, and Zhou contributed equally to this work.
    Xuemei Chen
    Footnotes
    ∗ Chen, He, and Zhou contributed equally to this work.
    Affiliations
    Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China

    School of Nursing, University of Pittsburgh, Pittsburgh, PA
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  • Author Footnotes
    ∗ Chen, He, and Zhou contributed equally to this work.
    Yanan He
    Footnotes
    ∗ Chen, He, and Zhou contributed equally to this work.
    Affiliations
    Department of Neurology, East Hospital, School of Medicine, Tongji University, Shanghai, China
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  • Xianmei Meng
    Affiliations
    Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China

    School of Health Sciences, Wuhan University, Wuhan, Hubei, China
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  • Chenchen Gao
    Affiliations
    Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
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  • Zhihui Liu
    Affiliations
    Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
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  • Author Footnotes
    ∗ Chen, He, and Zhou contributed equally to this work.
    Lanshu Zhou
    Correspondence
    Corresponding author Lanshu Zhou, PhD, Clinical Nursing Department, Nursing School, Second Military Medical University, No.800 Xiangyin Rd, Yangpu District, Shanghai 200433, China.
    Footnotes
    ∗ Chen, He, and Zhou contributed equally to this work.
    Affiliations
    Clinical Nursing Department, School of Nursing, Second Military Medical University, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    ∗ Chen, He, and Zhou contributed equally to this work.
Published:October 26, 2017DOI:https://doi.org/10.1016/j.apmr.2017.09.120

      Highlights

      • Perceived participation was evaluated in 236 stroke survivors 6 months poststroke.
      • Physical function was the strongest predictor of participation.
      • Social participation was significantly influenced by depression status.
      • Participation factors should be individually assessed for tailored early intervention.
      • Physical function should be emphasized early poststroke.

      Abstract

      Objectives

      To describe perceived participation of first-stroke survivors in mainland China, and to determine variables that may correlate with perceived participation 6 months after discharge.

      Design

      Cross-sectional survey.

      Setting

      Neurology department of a tertiary hospital, with subsequent follow-up of patients in their homes.

      Participants

      First-stroke survivors (N=236) who had been treated in the neurology department and discharged 6 months before their participation in our study.

      Interventions

      Not applicable.

      Main Outcome Measures

      Participation was assessed using the Chinese version of the self-report Impact on Participation and Autonomy Questionnaire. Performance on activities of daily living was measured using the Barthel Index, and physical function was measured with the Chinese Stroke Scale. The Hospital Anxiety and Depression Scale and the Social Support Rating Scale were also used.

      Results

      The mean score of perceived participation was 40.39±15.29, and 52.1%, 38.1%, 33.1%, and 5.5% of the participants reported insufficient participation in the domains of autonomy outdoors, family role, social relations, and autonomy indoors, respectively. Physical function served as the strongest correlate for the domains of family role and autonomy outdoors (standardized coefficients =.426 and .336, respectively), while depression was the strongest correlate for the domain of social relations (standardized coefficient =.315).

      Conclusions

      Physical function and activities of daily living were significantly associated with perceived participation in almost all domains. Depression was an important correlater of participation in the social relations domain. Perceived participation may be influenced by multiple factors, and tailored strategies should be implemented early in the rehabilitation phase poststroke to promote participation in all domains of daily living.

      Keywords

      List of abbreviations:

      IPA (Impact on Participation and Autonomy Questionnaire), IPA-C (Chinese version of the Impact on Participation and Autonomy Questionnaire)
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