A systematic review of the impact of stroke on social support and social networks: associated factors and patterns of change

Abstract

Objective: Identify what factors are associated with functional social support and social network post stroke; explore stroke survivors' perspectives on what changes occur and how they are perceived. Data sources:The following electronic databases were systematically searched up to May 2015: Academic Search Complete; CINAHL Plus; E-journals; Health Policy Reference Centre; MEDLINE; PsycARTICLES; PsycINFO; and SocINDEX.Review methods: PRISMA guidelines were followed in the conduct and reporting of this review. All included studies were critically appraised using the Critical Appraisal Skills Program tools. Meta-ethnographic techniques were used to integrate findings from the qualitative studies. Given the heterogeneous nature of the quantitative studies, data synthesis was narrative.Results: 70 research reports met the eligibility criteria: 22 qualitative and 48 quantitative reporting on 4,816 stroke survivors. The qualitative studies described a contraction of the social network, with non-kin contact being vulnerable. Although family were more robust network members, significant strain was observed within the family unit. In the quantitative studies, poor functional social support was associated with depression (13/14 studies), reduced quality of life (6/6 studies) and worse physical recovery (2/2 studies). Reduced social network was associated with depression (7/8 studies), severity of disability (2/2 studies) and aphasia (2/2 studies). Although most indicators of social network reduced post stroke (for example, contact with friends, 5/5 studies), the perception of feeling supported remained relatively stable (4/4 studies).3 Conclusion: Following a stroke non-kin contact is vulnerable, strain is observed within the family unit, and poor social support is associated with depressive symptoms. 4A systematic review of the impact of stroke on social support and social networks: associated factors and patterns of change The social impact of having a stroke is considerable. Stroke survivors take part in fewer social activities 1 , family life is disrupted 2 , and contact with friends and the wider network is vulnerable 3 . Social isolation is a commonly reported sequela, and may disproportionately affect those with aphasia (language difficulties) 4 . The two most relevant systematic reviews in the stroke literature have focused on specific aspects of social support post stroke: the association with health-related quality of life 5 and the impact on working age adults 6 . A comprehensive review that explored all factors associated with social support post stroke including recovery and depression, and which analysed how changes to social support were perceived by the stroke survivor, may enable stroke services to be more sensitively designed.For the purposes of this review social support has been conceptualised in terms of function and structure. For quantitative studies, an additional criterion was that only studies using validated measures of functional support were included: when assessing subjective feelings...

What Factors Predict Who Will Have a Strong Social Network Following a Stroke?

“…A recent systematic review of 70 research reports exploring the impact of stroke on social support found that after stroke contact with friends and involvement in social activities reduced, and there was strain within the family unit (Northcott, Moss, Harrison, & Hilari, 2015). Further, there was a consistent association between poor social support and feeling depressed (13/14 studies); aspects of the social network were also associated with depression (7/8 studies) (Northcott et al, 2015). For example, in one study having few social contacts outside the house was found to be the strongest predictor of depression in stroke survivors at 12 months, two years and three years follow up (Astrom, Adolfsson, & Asplund, 1993).…”

“…People with aphasia are excluded from most stroke research exploring social networks (Northcott et al, 2015). Even where people with aphasia have been included, often researchers have relied on proxies (Astrom et al, 1993;Boden-Albala et al, 2005) although there are concerns that proxy responses are not commensurate with self-report (Hilari, Owen, & Farrelly, 2007).…”

Factors Associated with the Walking Ability of Hemiplegic Stroke Patients

“…Social support influences mental health conditions [4], and a high level of social support from family members improves the functional status, and thus, the mental health of patients with stroke [5]. Spirituality is considered to be the essence of one's being and gives meaning and purpose to our existence [6].…”

Outcomes of an Intensive Comprehensive Aphasia Program

“…[4][5][6][7] Additionally, aphasia impacts psychosocial health as many persons with aphasia report increased depression, social isolation, and decreased quality of life. [6][7][8][9][10][11][12][13] Due do the confluence of these many factors, persons with aphasia and family members seek out treatment and support. ICAPs are one type of service that may address some of those issues.…”

“…50 Northcott and colleagues found that reduced social networks following stroke and aphasia was associated with depression. 12 A literature review by Attard and others found that comments from participants in community aphasia groups could be grounded in psychological well-being domains. 51 Comments reflected that groups provided a means to form positive relations with others and to have a purpose in life.…”