The relationship between social cognition and participation in the long term after stroke

Figures & data

Table 1 . Characteristics of stroke patients (n = 118).

	Participants (n = 118) n (%)	Drop-outs (n = 277) n (%)	p-value
Demographic characteristics
Sex, number of men	85 (72.0)	171 (61.7)	0.050
Age in years, mean (SD)
At baseline	63.6 (11.2)	67.9 (13.0)	0.001
At 3–4 years	67.4 (11.1)	–
Education level
Low (1–5)	84 (71.2)	198 (74.4)	0.089
High (6–7)	34 (28.8)	68 (25.6)
Stroke characteristics (baseline)
Type of stroke
Ischaemic	109 (92.4)	260 (93.9)	0.570
Haemorrhagic	9 (7.6)	17 (6.1)
Location of stroke
Left	38 (32.2)	122 (44.0)	0.062
Right	54 (45.8)	113 (40.8)
Vertebrobasilar	26 (22.0)	42 (15.2)
Recurrent stroke	18 (15.3)	29 (10.5)	0.179
Stroke severity	2.0 (±3.0)	2.0 (3.3)	0.474
NIHSS score at baseline, median (SD)
No stroke symptoms (NIHSS 0)	29 (24.6)	65 (23.5)
Minor stroke symptoms (NIHSS 1–4)	69 (58.5)	152 (54.9)
Moderate stroke symptoms (NIHSS 5–12)	18 (15.3)	53 (19.1)
Moderate to severe symptoms (NIHSS > 12)	2 (1.7)	7 (2.5)
Indication of functioning
Barthel Index at baseline, mean (SD)	17.3 (4.4)	16.7 (4.9)	0.232
ADL independent (BI 19–20)	71 (60.2)	157 (56.7)	0.520
ADL dependent (BI < 19)	47 (39.8)	120 (43.3)
Long term functioning (3–4 years)
Indication of cognitive functioning at 3–4 years, mean (SD)
MoCA score	24.5 (3.6)	23.1 (4.1)	0.003
Participation at 3–4 years, mean (SD)
USER-P restrictions	84.6 (19.4)	–
Social cognition at 3–4 years, mean (SD)
FEEST	43.0 (6.2)	–
Cartoon test	21.4 (6.6)	–
Faux pas detection	9.3 (1.1)	–
Faux pas empathy	2.9 (1.2)	–
BEES	32.4 (22.0)	–
Hayling test	3.1 (1.8)	–

Abbreviations: ADL: activities of daily living; BEES: balanced emotional empathy scale; BI: Barthel Index; FEEST: Facial Expressions of Emotion-Stimuli and Tests; MoCA: Montreal cognitive assessment; NIHSS: National Institutes of Health Stroke Scale, USER-P-R: Utrecht Scale for Evaluation of Rehabilitation-Participation.

Table 2. Results of bivariate and multivariate hierarchical multiple regression analysis: determinants of USER-P-R at 3–4 years post-stroke (n = 118).

	Bivariate analyses					Multivariate analyses
	N	B	β	R^2	p	Step 1 β	Step 2 β	Step 3 β
Gender (female)	118	−0.592	−0.014	0.000	0.882	NE	NE	NE
Age	118	−0.412	−0.235*	0.055	0.010	−0.200*	−0.146	−0.068
Education (high)	118	9.982	0.234*	0.055	0.011	0.207*	0.166	0.127
NIHSS	117	−0.198	−0.031	0.001	0.736	NE	NE	NE
BI^a	118	1.130	0.257**	0.066	0.005	0.205*	0.227*	0.224*
MoCA^b	115	1.454	0.235*	0.055	0.012	–	0.161	0.114
FEEST	107	0.289	0.092	0.008	0.348	–	–	−0.072
Cartoon test	113	0.509	0.174	0.030	0.065	–	–	0.022
Faux Pas detection	109	2.938	0.161	0.026	0.094	–	–	0.056
Faux Pas empathy	109	3.062	0.183	0.034	0.056	–	–	0.110
BEES	111	0.143	0.162	0.026	0.090	–	–	0.094
Hayling	115	1.658	0.136**	0.100	0.001	–	–	0.126
Explained variance, R^2						0.148	0.170	0.211

Notes: Step 1: gender, education, BI; step 2: MoCA; step 3: FEEST, Cartoon test, Faux Pas detection, Faux Pas empathy, BEES, Hayling.

Abbreviations: USER-P-R: Utrecht Scale for Evaluation of Rehabilitation-Participation Restrictions subscale; NIHSS: National Institutes of Health Stroke Scale, BI: Barthel Index; MoCA: Montreal Cognitive Assessment; FEEST: Facial Expressions of Emotion-Stimuli and Tests; BEES: Balanced Emotional Empathy Scale; NE: not entered.

^aScores at <4 days after stroke.

^bMoCA was administered together with the social cognitive tests at 3–4 years after stroke.

*p < .05; **p < .01.

Data availability statement

Raw data were generated at six hospitals in the Netherlands. Derived data supporting the findings of this study are available from the corresponding author (CvH) on request.