Acceptance of disability in stroke: a systematic review

Mervyn Jun Rui Lim; Jaclyn Tan; Arturo Yong Yao Neo; Brandon Chin Jie Ng; Miho Asano

doi:10.1016/j.rehab.2023.101790

Acceptance of disability in stroke: a systematic review

Ann Phys Rehabil Med. 2024 Mar;67(2):101790. doi: 10.1016/j.rehab.2023.101790. Epub 2023 Dec 19.

Authors

Mervyn Jun Rui Lim¹, Jaclyn Tan², Arturo Yong Yao Neo³, Brandon Chin Jie Ng³, Miho Asano⁴

Affiliations

¹ Division of Neurosurgery, University Surgical Centre, National University Health System, 1E Kent Ridge Rd, Singapore 119228 Singapore; Ministry of Health Holdings, Singapore, 1 Maritime Square 099253, Singapore. Electronic address: mervynlim@u.nus.edu.
² Division of Neurosurgery, University Surgical Centre, National University Health System, 1E Kent Ridge Rd, Singapore 119228 Singapore.
³ Ministry of Health Holdings, Singapore, 1 Maritime Square 099253, Singapore.
⁴ Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Singapore 117549, Singapore.

PMID: 38118296
DOI: 10.1016/j.rehab.2023.101790

Abstract

Background: Evidence for the association between acceptance of disability (AOD) and positive rehabilitation outcomes, as well as for the use of AOD measurements in stroke rehabilitation practice, has increased in the international literature in the last decade. However, measurement tools for AOD are heterogenous and there has not been a systematic review summarizing the current evidence on the use of AOD measures and factors associated with AOD.

Objective: This study aimed to summarize current evidence on measurement tools used, present existing AOD scores in people with stroke and identify risk factors for and protective factors against poor AOD in people with stroke.

Methods: The original design and protocol of this systematic review were registered with PROSPERO. The included studies were published from 2008 to 2020 and identified from 5 databases-PubMed, EMBASE, CINAHL Plus, PsycInfo, and the Cochrane Library-using the following inclusion criteria: participants diagnosed with stroke and aged ≥16 years, measurement of AOD, and published in English in a peer-reviewed scientific journal. Review articles were excluded.

Results: Five measurement tools for AOD were reported. The Revised Acceptance of Disability Scale (ADS-R) and the acceptance subscale of the Illness Cognition Questionnaire (ICQ) had the highest internal consistency. Scores ranged from 71.7 to 74.2 on the ADS-R, 16.9-18.3 on the ICQ, 16.5-26.9 on the Acceptance of Illness Scale, and 87.8-93.2 on the Attitudes towards Disabled Persons Form A. Poorer function and depressive symptoms were associated with poor AOD, whereas religious beliefs, support from others, and an understanding of stroke were associated with better AOD.

Conclusions: The ADS-R and the acceptance subscale of the ICQ are currently the most reliable measurement tools for measuring AOD in people with stroke. Further research to validate the measurement tools is required. This may help to identify people who require additional support.

Trial registration: PROSPERO International Prospective Register of Systematic Reviews CRD42017077063; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=77063.

Keywords: Acceptance; Disability; Measurement tools; Stroke; Systematic review.

Publication types

Review

MeSH terms

Disabled Persons*
Humans
Stroke Rehabilitation*
Stroke*
Systematic Reviews as Topic