Social Support Mediates the Association Between Abilities and Participation After Stroke

Area of Science:

• Neurorehabilitation
• Occupational Therapy
• Psychosocial Factors in Health

Background:

• Stroke survivors often experience participation restrictions impacting daily life.
• The role of social support in mediating the relationship between abilities and participation post-stroke is not well understood.
• The Person-Environment-Occupation-Performance (PEOP) model provides a framework to examine these complex interactions.

Purpose of the Study:

• To investigate social support as a mediator between individual abilities and occupational participation in stroke survivors.
• To compare these associations in persons with aphasia (PWA) and persons without aphasia (PWOA).
• To explore the influence of cognitive and physical abilities on participation in demanding activities.

Main Methods:

• A cross-sectional study design was employed.
• Participants included 50 persons with aphasia (PWA) and 59 persons without aphasia (PWOA).
• Data were collected on person factors (physical impairment, cognition), social support, and occupational participation using the Activity Card Sort.

Main Results:

• Cognition was significantly associated with participation in cognitively demanding activities for both PWA and PWOA.
• Social support mediated the cognition-participation link exclusively for PWA.
• Physical impairment was associated with participation in mobility-demanding activities for PWOA, but social support did not mediate this relationship.

Conclusions:

• Social support is a critical factor enabling persons with aphasia (PWA) to engage in cognitively demanding activities post-stroke.
• For persons without aphasia (PWOA), physical abilities are more directly linked to mobility participation.
• Interventions aimed at enhancing social support may be particularly beneficial for PWA's occupational participation.