Self-reported emotional health and social support but not executive function are associated with participation after stroke

ABSTRACT

Background

Participation restrictions continue to be prevalent for community-dwelling stroke survivors. Research is needed to understand the associated post-stroke factors that limit or facilitate optimal participation and quality of life.

Objectives

To investigate emotional health, executive functioning (EF), and social support as predictors of participation restrictions post-stroke.

Methods

Cross-sectional data collected from participants ≥ 6 months after mild stroke with and without aphasia (N = 114) were analyzed using three participation outcome measures: Reintegration to Normal Living Index (RNL), Activity Card Sort (ACS), and the Stroke Impact Scale (SIS) Version 2.0 Participation/Role Function domain. Predictor variables investigated were emotional health (SIS Emotion domain scores), EF (Delis Kaplan Executive Function System Trail Making Condition 4: DKEFS), social support (Medical Outcomes Study Social Support Survey: MOS-SSS), stroke severity (National Institutes of Health Stroke Scale: NIHSS), and education level.

Results

Using multiple regression, these predictors accounted for 26.4% to 40% of the variance for the three participation outcomes. Emotional health was a significant independent predictor across all three measures. Social support was a significant predictor of participation as measured on the RNL. Executive function was not a significant predictor of participation when controlling for the other predictor variables.

Conclusions

Emotional health and social support should be considered as modifiable factors that could optimize meaningful participation and quality of life.

KEYWORDS:

• stroke
• participation
• social support
• emotional health
• executive function

Acknowledgments

We would like to thank the Connor lab for critical feedback on an earlier version of this manuscript.

Disclosure statement

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

Additional information

Funding

Funding was provided by the Program in Occupational Therapy at Washington University and the Department of Occupational Therapy at MGH Institute for Health Professions;Program in Occupational Therapy, Washington University; Department of Occupational Therapy, MGH Institute of Health Professions.