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Social Support as a Predictor of Community Participation After Stroke

Participation is a primary goal of neurorehabilitation; however, most individuals post stroke experience significant restrictions in participation as they attempt to resume their everyday roles and routines. Despite this emphasis on participation, there is a paucity of evidence-based interventions f...

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Autores principales: Erler, Kimberly S., Sullivan, Virginia, Mckinnon, Sarah, Inzana, Rebecca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6763952/
https://www.ncbi.nlm.nih.gov/pubmed/31616364
http://dx.doi.org/10.3389/fneur.2019.01013
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author Erler, Kimberly S.
Sullivan, Virginia
Mckinnon, Sarah
Inzana, Rebecca
author_facet Erler, Kimberly S.
Sullivan, Virginia
Mckinnon, Sarah
Inzana, Rebecca
author_sort Erler, Kimberly S.
collection PubMed
description Participation is a primary goal of neurorehabilitation; however, most individuals post stroke experience significant restrictions in participation as they attempt to resume their everyday roles and routines. Despite this emphasis on participation, there is a paucity of evidence-based interventions for optimizing this outcome and a limited understanding of factors that contribute to poor participation outcomes. Caregiver support at discharge from inpatient rehabilitation positively influences physical and psychological outcomes after stroke but more research is needed to understand the association between social support and participation. This study aimed to examine the independent contribution of perceived social support to participation 3 months post discharge from inpatient stroke rehabilitation. This study was a secondary analysis of the Stroke Recovery in Underserved Populations 2005–2006 data. Participants were adults ≥55 years old, living in the community 3 months post discharge from inpatient rehabilitation for ischemic stroke (n = 422). Hierarchical linear regressions were performed. The primary variables of interest were the PAR-PRO Measure of Home and Community Participation and the Duke–University of North Carolina Functional Social Support Questionnaire. Perceived social support at discharge from inpatient rehabilitation for ischemic stroke contributed uniquely to the variance in participation 3 months later (β = 0.396, P < 0.001) after controlling for race, sex, age, years of education, comorbidities, stroke symptoms, depression, FIM Motor, and FIM Cognitive. Social support accounted for 12.2% of the variance in participation and was the strongest predictor of participation relative to the other independently significant predictors in the model including FIM Motor and depression. There is already a focus on caregiver training during inpatient rehabilitation related to basic self-care, transfers, and medical management. These findings suggest the need for rehabilitation professionals to also address social support during discharge planning in the context of promoting participation. Given the findings, expanding caregiver training is necessary but novel interventions and programs must be carefully developed to avoid increasing caregiver burden.
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spelling pubmed-67639522019-10-15 Social Support as a Predictor of Community Participation After Stroke Erler, Kimberly S. Sullivan, Virginia Mckinnon, Sarah Inzana, Rebecca Front Neurol Neurology Participation is a primary goal of neurorehabilitation; however, most individuals post stroke experience significant restrictions in participation as they attempt to resume their everyday roles and routines. Despite this emphasis on participation, there is a paucity of evidence-based interventions for optimizing this outcome and a limited understanding of factors that contribute to poor participation outcomes. Caregiver support at discharge from inpatient rehabilitation positively influences physical and psychological outcomes after stroke but more research is needed to understand the association between social support and participation. This study aimed to examine the independent contribution of perceived social support to participation 3 months post discharge from inpatient stroke rehabilitation. This study was a secondary analysis of the Stroke Recovery in Underserved Populations 2005–2006 data. Participants were adults ≥55 years old, living in the community 3 months post discharge from inpatient rehabilitation for ischemic stroke (n = 422). Hierarchical linear regressions were performed. The primary variables of interest were the PAR-PRO Measure of Home and Community Participation and the Duke–University of North Carolina Functional Social Support Questionnaire. Perceived social support at discharge from inpatient rehabilitation for ischemic stroke contributed uniquely to the variance in participation 3 months later (β = 0.396, P < 0.001) after controlling for race, sex, age, years of education, comorbidities, stroke symptoms, depression, FIM Motor, and FIM Cognitive. Social support accounted for 12.2% of the variance in participation and was the strongest predictor of participation relative to the other independently significant predictors in the model including FIM Motor and depression. There is already a focus on caregiver training during inpatient rehabilitation related to basic self-care, transfers, and medical management. These findings suggest the need for rehabilitation professionals to also address social support during discharge planning in the context of promoting participation. Given the findings, expanding caregiver training is necessary but novel interventions and programs must be carefully developed to avoid increasing caregiver burden. Frontiers Media S.A. 2019-09-20 /pmc/articles/PMC6763952/ /pubmed/31616364 http://dx.doi.org/10.3389/fneur.2019.01013 Text en Copyright © 2019 Erler, Sullivan, Mckinnon and Inzana. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Erler, Kimberly S.
Sullivan, Virginia
Mckinnon, Sarah
Inzana, Rebecca
Social Support as a Predictor of Community Participation After Stroke
title Social Support as a Predictor of Community Participation After Stroke
title_full Social Support as a Predictor of Community Participation After Stroke
title_fullStr Social Support as a Predictor of Community Participation After Stroke
title_full_unstemmed Social Support as a Predictor of Community Participation After Stroke
title_short Social Support as a Predictor of Community Participation After Stroke
title_sort social support as a predictor of community participation after stroke
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6763952/
https://www.ncbi.nlm.nih.gov/pubmed/31616364
http://dx.doi.org/10.3389/fneur.2019.01013
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