The role of positive affect on social participation following stroke

Abstract

Purpose: To examine the association between positive affect and social participation in adults with first-time stroke after in-patient medical rehabilitation. Methods: A prospective cohort design using information from the Stroke Recovery in Underserved Populations database (SRUP) for the years 2005–2006. Data were collected at discharge from in-patient medical rehabilitation and 3 months post-discharge. Participants were aged 50 and older with first-time stroke (n = 605) and admitted to 1 of 11 in-patient medical rehabilitation facilities across the United States. Primary measures included a positive affect scale and a home and community social participation instrument. Results: The mean age was 71.6 years, 50.3% were women, and 56.5% were married. Results of cumulative logit models showed each 1 point increase in positive affect was significantly associated with a 17% odds of higher social participation (OR: 1.17, 95% CI 1.10, 1.25), after adjusting for demographics, clinical characteristics, and negative affect. Conclusions: High positive affect at discharge from in-patient medical rehabilitation was associated with higher levels of social participation 3 months post-discharge. The significant association between higher positive affect and higher levels of social participation adds to accumulating evidence linking positive affect with beneficial physical and psychological outcomes after an acute event such as stroke.

Implications for Rehabilitation

• This study shows positive affect associated with greater social participation 3 months post-discharge from in-patient medical rehabilitation.

• Positive affect may be a critical factor in the recovery trajectory of the stroke patient.

• The assessment of positive affect during in-patient medical rehabilitation may identify those at risk for poor social participation post-discharge and may lead to the design of innovative interventions aimed at the re-integration of stroke individuals into the community.

Keywords::

• Participation
• emotions
• stroke

Acknowledgements

The authors are grateful to Chantele Singleton M.S., CHES, for her assistance in the editing and formatting of the manuscript.

Declaration of Interest: This work was supported by the National Center for Medical Rehabilitation Research for I-M. Berges (grant no. R03- HD058216), and the National Institutes of Health and the National Institute of Aging for G. Ostir (grants no. R01-AG024806).