Perceived participation and autonomy post‐stroke and associated factors: An explorative cross‐sectional study

Abstract

Aims To explore the level and associated factors of perceived participation and autonomy among stroke survivors in Shanghai, China. Design Cross‐sectional explorative study. Methods From January to December 2018, 431 patients presenting at the neurology departments of three hospitals with a confirmed diagnosis of stroke were recruited. Impact on Participation and Autonomy Questionnaire, modified Rankin Scale, Self‐efficacy for Managing Chronic Disease six‐item Scale, Medical Coping Modes Questionnaire and Multidimensional Scale of Perceived Social Support were applied to measure their participation, physical function, self‐efficacy, coping styles, and social support. Results The average score of perceived participation and autonomy was 41.30 (SD 21.22); and 54.3%, 46.9%, 21.6%, and 7.7% of the participants reported poor participation in social relations, family role, autonomy indoors, and autonomy outdoors. Age, physical function, self‐efficacy, friend support, and knowledge of stroke were predictors of post‐stroke participation. Physical function and self‐efficacy were the most relevant factors of nearly all domains of participation except autonomy outdoors, while predictors of autonomy outdoors were social support, resignation coping style, and knowledge of stroke. Conclusion The stroke patients experienced insufficient participation compared with previous studies in western countries. Patients' physical function and self‐efficacy were particularly important and contributed to their participation, while the patient's age, perceived social support, coping styles, and knowledge of stroke also played a role in formulating participation. Impact The results may be used to provide nurses with a better understanding of the participation among stroke patients and assist them in promoting the post‐stroke participation. Nurses should pay special attention to those with older age, worse physical function, lower self‐efficacy, less support, little stroke‐related knowledge, or who applied resignation coping style since those patients might experience lower participation in their daily life. It needs further studies to explore the causal effects of self‐efficacy, coping styles, and social support on post‐stroke participation.

The effect of stigma on social participation in community-dwelling Chinese patients with stroke sequelae: A cross-sectional study

“…On the other hand, because of stigma, patients are reluctant to participate socially, which may incur discrimination. 8 The level of social participation in our study was much lower than that in Li et al’s study 35 with patients over three months poststroke and Chen et al’s study 36 with patients six months poststroke. It can be concluded that social participation levels are different in different phases of stroke survival.…”

“…A much lower level of each domain of social participation among patients with stroke sequelae was found in this study than in other studies that investigated the social participation of common stroke survivors. 3,35,36 Therefore, researchers should pay much more attention to the study of different domains of social participation in the future.…”

“…16 Empirical studies have shown that there are some demographic characteristics (age, gender, education level, etc. ), 15,17 physical characteristics (activities of daily living) 18 and psychosocial factors (social support, 19 coping strategies, 20 depression 21 ) which can influence the social participation of stroke patients. Stigma has been considered to have an important impact on social participation in stroke survivors.…”

Analysis of the resilience level and associated factors among patients with lumbar disc herniation

“…The total score ranged from 12 to 84 with higher indicating higher level of social support. The Chinese version of MSPSS exhibited good reliability and validity ( Li et al., 2020 , 2021b ; Yang et al., 2020 ). In this survey, Cronbach's α coefficient of internal consistency of this scale was 0.949.…”

Association between participation self-efficacy and participation in stroke survivors

“…A prospective study of 52 stroke survivors further reported the role of balance self-efficacy and fall self-efficacy in predicting community reintegration [ 23 ]. A Chinese study also indicated that aside from physical function, self-efficacy was correlated most strongly with participation [ 24 ].…”