Identifying emotional contributors to participation post-stroke

ABSTRACT

Background

Participation in daily activities is the ultimate goal of stroke rehabilitation. Emotional factors have been considered as contributors to participation, but associations between emotional factors and participation post-stroke have not been fully explored.

Objective

To investigate the extent to which emotional factors contribute to participation post-stroke.

Methods

73 participants were included. Three participation outcomes were used as dependent variables in three models: (1) Stroke Impact Scale (SIS) Participation/Role Function, (2) Activity Card Sort (ACS), and (3) Reintegration to Normal Living (RNL). Main independent variables were six emotional factors: SIS Emotion Function (General emotion), Visual Analog Mood Scale energetic and happy subscales, Patient Health Questionnaire-9 (Depression), State-Trait Anxiety Inventory-Trait Anxiety Scale, and Apathy Evaluation Scale. Covariates of stroke severity and social support were included.

Results

Model 1 showed stroke severity (β = −0.300) and depression (β = −0.268) were significant contributors to SIS Participation/Role Function (R² = 0.368, p < .05). Model 2 indicated that happiness (β = 0.284) and apathy (β = −0.330) significantly contributed to ACS total activity retention (R² = 0.247, p < .05). Model 3 revealed that anxiety (β = −0.348), apathy (β = −0.303), stroke severity (β = −0.184), and social support (β = 0.185) were significant contributors to RNL total score (R² = 0.583, p < .05).

Conclusions

Results suggested that emotional measures of apathy, depression, anxiety, and happiness, but not general emotion, were important contributors to participation post-stroke. These findings suggest that rehabilitation professionals should address individual emotional contributors to facilitate participation post-stroke.

KEYWORDS:

• Stroke
• participation
• emotional factors
• contributors
• regression

Acknowledgments

We would like to thank participants in the project for their contributions and Washington University School of Medicine and MGH Institute of Health Professions for technical support and facilities.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

LC and YL had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. YL and LC contributed to the conception and design of the work. YL conducted the statistical analyses. YL, MN, and LC interpreted the findings. YL drafted the manuscript. YL, MN, and LC contributed to manuscript revision for important intellectual content and approved the submitted version. LC provided technical and material support and supervision of the entire process of developing the manuscript.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

Funds for participant remuneration were provided by the MGH Institute of Health Professions Washington University School of Medicine in St. Louis N/A</#AWARD-ID;> and the Program in Occupational Therapy at Washington University School of Medicine to LC and MN.