The relationship of physical function to social integration following stroke

Stroke is a leading cause of serious, long-term disability in this country. Much of the research on stroke rehabilitation has focused on physical /functional recovery as the predominant measure of outcome. Despite general recognition of the psycho-social impact of stroke on the patient and family, there is a gap in knowledge of social issues and integration into societal, family, and community roles post-stroke. The objective of this study was to examine the relationship of overall stroke recovery, functional status and depression to social integration after stroke. The study used a quantitative, descriptive correlational survey design in which a convenience sample of 48 stroke survivors was assessed via mailed survey at a single time point as to functional status and social integration to examine the relationship between these variables. Post-stroke depression and time elapsed since stroke were covariates in the model. Descriptive statistics and multiple regression analyses were performed to evaluate the contribution of each predictor variable on the main variable of interest, social integration. The response rate was 21.4%, with a total of 48 surveys containing usable data returned. The results showed that functional status, overall stroke recovery, and depression are highly significant predictors of social integration, explaining 62% of the variance (adjusted R square). Depression was negatively correlated (-.74) with social integration with significance of .01 (two-tailed). Overall stroke recovery was positively correlated to social integration (.58) with significance of .01 (two-tailed). Of lesssignificance was the correlation between overall stroke recovery and depression. An Independent Samples (t-test) analysis demonstrated no significant difference in social integration scores based on time elapsed since stroke. The remaining significant finding was that employment status following stroke dropped significantly (from 48% to 4.2%), and post-stroke employment status correlates to social integration (.034). This research clearly demonstrates that physical functional recovery alone does not assure social integration. Other factors, including depression and perceptions of overall stroke recovery, are significant factors and must be addressed in the rehabilitation process to promote social integration. This research has significant practical application to providers planning and delivering rehabilitation services to stroke survivors.