Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Predictors of Social Role Functioning After Stroke

Schmid AA, Tu W, Damush TM, Fisher TF, Williams LS. Predictors of Social Role Functioning After Stroke. Paper presented at: American Heart Association / American Stroke Association State-of-the-Art Annual Nursing Symposium; 2010 Feb 23; San Antonio, TX.




Abstract:

Background: Declines in social role functioning (SRF) are related to negative consequences. Few individuals post-stroke receive SRF specific interventions and therefore are unlikely to return to the highest level of function possible. Purpose: Post-stroke SRF is an important part of stroke recovery but is not well understood. Thus our objectives were to: 1) examine the relationships between baseline stroke characteristics (1 month after stroke) and 12 week post-stroke SRF and 2) assess whether depression improvement impacted 12 week SRF. Methods: We completed a secondary data analysis of data derived from the Activate-Initiate- Monitor (AIM) study. AIM was a randomized clinical trial cohort study including depressed and non-depressed patients. We included the SRF domain of the Stroke Specific Quality of Life (SSQoL) Scale. The domain includes 4 items regarding getting out and socializing with friends. Scoring ranges from 1-5, higher scores indicate increased SRF. We dichotomized the variable by the median; low SRF_3.5, high SRF_3.5. Other assessments included: depression (Patient Health Questionnaire); stroke severity (NIHSS); functional status (Rankin); cognition; medical comorbidity; and personality characteristics such as optimism (Life Orientation Test), self-esteem (Rosenberg Self-Esteem Scale), and locus of control(Sense of Control). For those with depression we considered depression improvement as a dichotomous variable. Baseline variables were compared between those with low and high SRF using Chi-square and Students t-tests. We used logistic regression to model the association of baseline independent variables on 12-week SRF in the entire (n_369) and depressed cohort (n_175). Results: Those with high 12 week SRF (n_186) had: less depression (6.33_5.92 vs. 11.25_6.77, p_0.001); less comorbidities (13.08_4.79 vs. 15.91_4.77, p_0.001); increased cognition (5.48_0.77 vs. 5.27_0.90, p_0.020); less stroke severity (NIHSS) (2.12_2.06 vs. 2.60_2.44, p_0.044); increased independence (Rankin)(84% vs. 65%, _0.001); a better locus of control (0.62_0.52 vs. 0.46_0.53, p_0.002); increased optimism (15.54_3.61 vs. 13.68_4.10, p_0.001); and increased self-esteem (39.92_6.20 vs.35.52_7.05, _0.001). Multivariable modeling showed that baseline optimism (OR, 1.070, 95%CI, 1.004 to 1.140) and SRF (OR, 2.91, 95%CI, 1.734 to 4.895) remained in the model as variables independently associated with 12 week high SRF. Of the depressed only cohort (n_175), baseline optimism (OR, 1.095, 95%CI, 1.008 to 1.19) and depression improvement (OR, 7.062, 95%CI, 2.55 to 19.55) were maintained in the model. Conclusion: We found that optimism, even after controlling for baseline SRF, was the only independent predictor of SRF in both the entire and depressed only cohorts. While this link needs to be further explored, optimism may be an avenue for clinicians to address SRF after stroke.





Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.