A study in persons later after stroke of the relationships between social participation, environmental factors and...

To explore the impacts of social participation and the environment on depression among people with stroke.

Cross-sectional survey.

Structured interviews in the participants' homes.

Community-dwelling persons with stroke in the rural areas of China ( N = 639).

Not applicable.

Depression (Hamilton Rating Scale for Depression-6), activity and social participation (Chinese version of the World Health Organization's Disability Assessment Schedule 2.0), environmental barriers (Craig Hospital Inventory of Environmental Factors), neurological function (Canadian Neurological Scale).

A total of 42% of the variance in depression was explained by the environmental barriers, neurological function, activity, and social participation factors studied. Social participation, services/assistance, and attitudes/support were directly related to depression; their standardized regression coefficients were 0.530, 0.162, and 0.092, respectively ( p ⩽ 0.01). The physical environment, policies, and neurological function indirectly impacted depression. Depression influences social participation in turn, with a standardized regression coefficient of 0.29 ( p ⩽ 0.01).

Depression and social participation are inversely related. The physical environment, services/assistance, attitudes/support, and policies all impact post-stroke depression.