Identifying emotional contributors to participation post-stroke

Abstract

Background: Participation in daily activities is the ultimate goal of stroke rehabilitation. Emotional factors have been considered as contributors to participation, but associations between emotional factors and participation post-stroke have not been fully explored.

Objective: To investigate the extent to which emotional factors contribute to participation post-stroke.

Methods: 73 participants were included. Three participation outcomes were used as dependent variables in three models: (1) Stroke Impact Scale (SIS) Participation/Role Function, (2) Activity Card Sort (ACS), and (3) Reintegration to Normal Living (RNL). Main independent variables were six emotional factors: SIS Emotion Function (General emotion), Visual Analog Mood Scale energetic and happy subscales, Patient Health Questionnaire-9 (Depression), State-Trait Anxiety Inventory-Trait Anxiety Scale, and Apathy Evaluation Scale. Covariates of stroke severity and social support were included.

Results: Model 1 showed stroke severity (β = -0.300) and depression (β = -0.268) were significant contributors to SIS Participation/Role Function (R² = 0.368, p < .05). Model 2 indicated that happiness (β = 0.284) and apathy (β = -0.330) significantly contributed to ACS total activity retention (R² = 0.247, p < .05). Model 3 revealed that anxiety (β = -0.348), apathy (β = -0.303), stroke severity (β = -0.184), and social support (β = 0.185) were significant contributors to RNL total score (R² = 0.583, p < .05).

Conclusions: Results suggested that emotional measures of apathy, depression, anxiety, and happiness, but not general emotion, were important contributors to participation post-stroke. These findings suggest that rehabilitation professionals should address individual emotional contributors to facilitate participation post-stroke.

Keywords: Stroke; contributors; emotional factors; participation; regression.