Associations between participation and personal factors in community-dwelling adults post-stroke

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Published 27th January 2023

Participation in everyday life is often disrupted, restricted and more challenging for people who have suffered from stroke. Returning to pre-stroke activities can be physically demanding, sometimes leading to less participation in community-based activities and a preference for home-based and sedentary activities. This project led by The University of Queensland and involving Hopkins researchers Prof. Louise Gustafsson and Prof. Tamara Ownsworth investigated the associations between post-stroke participation and personal factors, including demographic characteristics, self- and threat appraisals, personality variables and participation outcomes. The results highlight the inter-relatedness of self-concept change, perceived recovery and post-stroke participation.

Purpose:

To examine associations between post-stroke participation and personal factors, including demographic characteristics, self- and threat appraisals, and personality variables.

Methods:

An exploratory cross-sectional study with purpose-designed survey was completed online or via mail. The survey was comprised of demographic and health-related questions and multiple questionnaires, including the Stroke Impact Scale Version 3.0 (SISv3) (participation/perceived recovery), Community Integration Questionnaire (CIQ) (participation), Head Injury Semantic Differential III (pre- vs post-stroke self-concept/self-discrepancy), Appraisal of Threat and Avoidance Questionnaire (threat appraisal), Life Orientation Test – Revised (optimism) and Relationships Questionnaire (adult attachment style) that measured variables of interest. Sixty-two participants, aged 24–96 years who had experienced a stroke (one or multiple events) and had returned to community living, completed the survey. Associations were examined using correlations, and univariate and multiple linear regression analyses.

Results:

Regression analysis showed that greater participation, measured using the CIQ, was associated with younger age, female gender, lower self-discrepancy and higher perceived recovery, explaining 69% of the variability in CIQ participation. Further, greater participation on the SISv3 was associated with lower self-discrepancy and higher perceived recovery, explaining 64% of the variability in SISv3 participation.

Conclusions:

Results indicate that personal factors, particularly self-appraisals like self-concept/self-discrepancy, in combination with perceived recovery may be important in explaining a large portion of variance in post-stroke participation. Specifically, findings highlight the interrelatedness of self-concept change, perceived recovery and post-stroke participation. Further longitudinal research is needed to clarify the directionality of these associations throughout the hospital-to-home transition.

Authors

Tamara Ownsworth

Professor

Louise Gustafsson

Professor