Gender differences in participation one year after stroke: exploring biopsychosocial predictors for women and men

ABSTRACT

Background

Women appear to have a higher risk for long term restrictions in participation than men. This gender difference is poorly understood, as solely biomedical factors have been examined to date.

Objectives

The aims of this study are (1) to map gender differences in participation outcome one year after stroke, and (2) to identify demographic, stroke-related, or psychological predictors of participation for women and men separately.

Methods

A total of 326 patients (mean age 66.5 ± 12.4y, 35.0% women) completed the restriction and satisfaction subscales of the Utrecht Scale of Evaluation of Rehabilitation-Participation (USER-P) at one year after stroke. Bivariate and multiple linear regression analyses were performed.

Results

Women reported worse scores for restrictions in participation compared to men (median 75.4 versus 87.9 respectively, p = 0.001), especially in physical activities such as daytrips and going out. Satisfaction with participation was similar between women and men. Worse cognitive functioning (β = 0.17) was associated with more restrictions in participation in men only, other predictors of restrictions in participation were similar between women and men. The presence of depressive symptoms (β = -0.49) was associated with worse satisfaction with participation in men, whereas an increased stroke severity (β = -0.29) and the presence of maladaptive psychological factors (β = -0.36) were associated with worse satisfaction with participation in women.

Conclusions

Women experience more restrictions in participation compared to men one year after stroke. Taking into account gender-specific predictors of participation in stroke aftercare is important, as different biopsychosocial factors contribute to problems in participation across women and men.

KEYWORDS:

• Stroke
• gender
• social participation
• community participation
• long-term effects

Acknowledgments

We would like to thank all participants for their contribution to the Restore4Stroke Cohort study.

Disclosure statement

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

Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10749357.2024.2377518

Additional information

Funding

The Restore4Stroke study was funded by the VSB foundation [grant number 89000004] and co-ordinated by ZonMw [Dutch Organization for Health Research and Development, grant number 842003005].