Objectives: To describe how first-stroke survivors perceive their participation and the problems with such participation in life and to determine the factors associated with perceived participation at three months after hospital discharge.
Design: A cross-sectional study.
Setting: Patients were recruited from a tertiary hospital in Shanghai, China and they were followed up in their homes.
Subjects: Two hundred and fifty-seven first-stroke survivors discharged for three months participated in this study.
Measures: The Chinese version of the Impact on Participation and Autonomy questionnaire, Barthel Index, Chinese Stroke Scale, Hospital Anxiety and Depression Scale and Social Support Rating Scale.
Results: One hundred thirty-four (52.1%) and 147 (57.2%) participants perceived their participation as poor to very poor in the domains of family role and autonomy outdoors, respectively. Conversely, 208 (80.9%) and 228 (88.7%) participants perceived their participation to be fair to good in the domains of social relations and autonomy indoors, respectively. The ability to perform activities of daily life was the strongest correlate of participation in the domains of autonomy indoors, family role, and autonomy outdoors, whereas anxiety was the strongest correlate of participation in the domain of social relations.
Conclusions: Activities of daily living were significantly associated with perceived participation in almost all domains. In contrast, anxiety was an important factor in predicting participation in the domain of social relations. These findings suggest the need to explore different strategies of promoting participation for each domain.
Keywords: Participation (WHO ICF); activities of daily living; mental health; rehabilitation; stroke.