The Relationship of Physical Function to Social Integration After Stroke

Abstract

Stroke is a leading cause of death and a serious long-term disability in this country. Much of the research on stroke rehabilitation has focused on physical/functional recovery as the predominant measure of outcome. There is a gap in knowledge of social issues and integration into societal, family, and community roles after stroke. A descriptive, correlational survey design was used to examine the relationships of functional status, depression, and overall stroke recovery to social integration in a convenience sample of ischemic stroke survivors. The survey response rate was 21.4%. Results showed that functional status, overall stroke recovery, and depression are highly significant predictors of social integration, explaining 62% of the variance (adjusted R 2 ). Comorbid depression was negatively (j.74) and significantly (.01, two-tailed) correlated to social integration, such that higher levels of depression are associated with lower levels of social integration. Finally, employment status after stroke dropped from 48% to 4.2%, and poststroke employment status was correlated to social integration (significance = .03). Care for patients with chronic conditions like stroke should address all domains of the individualVphysical, psychosocial, and environmental. Factors including depression and perceptions of overall stroke recovery are significant and should be addressed in the rehabilitation process to better promote social integration. Social integration is an important and understudied aspect of stroke recovery that warrants further research.

Living with companion animals after stroke: experiences of older people in community and primary care nursing

“…The study found that physical as well as psychosocial factors were important in recovery after stroke, an observation that has been confirmed in other studies (Jönsson et al, 2005;Baseman et al, 2010). This indicates that more longitudinal studies are required investigating the possibility that interacting with animals positively influences recovery after stroke.…”

Community reintegration and related factors in a Nigerian stroke sample

“…The present study found significant influence of both pre-and post-stroke occupational engagements on the participants' level of satisfaction with community reintegration. Baseman et al 32 had similarly found social integration among stroke survivors to be related to post-stroke employment status. It is understandable that participants who are able to sustain their employment post-stroke may find satisfaction and contentment in their being able to function at an economically productive level.…”

“…Other studies have reported return rate to work among previously working survivors to range between 8.8% and <50% post-stroke 32,33 . The present study found significant influence of both pre-and post-stroke occupational engagements on the participants' level of satisfaction with community reintegration.…”

“…Though the predominant co-morbidity among participants was hypertension, diabetes mellitus was the condition that significantly and adversely influenced their level of satisfaction with community reintegration. Baseman et al 32 had reported the presence of a co-morbidity to negatively influence the reintegration of stroke survivors. Our finding of a significant relationship between the level of support from the community and satisfaction with community reintegration seems to suggest that survivors perceive support from their communities as a requirement for re-integration back to these same communities.…”

Restricted Participation in Stroke Caregivers: Who Is at Risk?

“…26,27 Research in survivors has also shown that survivors' participation restriction is associated with older age, being a woman, greater stroke severity, poorer functional and cognitive status, and comorbidities. [28][29][30][31] Our knowledge about participation restriction in stroke is limited because research to date has primarily focused on examining it as a mediator of caregivers' level of distress and/or depression, rather than exploring its specific risk factors. 12,32 Most studies have also been cross-sectional in design.…”