Lifang Zhang1,2, Minghong Sui3,4, Tiebin Yan3, Liming You2, Kun Li2, Yan Gao2. 1. 1 School of Nursing, Youjiang Medical College for Nationalities, Baise, China. 2. 2 School of Nursing, Sun Yat-sen University, Guangzhou, China. 3. 3 Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. 4. 4 Department of Rehabilitation Medicine, Shenzhen Sixth People's Hospital, Shenzhen, China.
Abstract
OBJECTIVE: To explore the impacts of social participation and the environment on depression among people with stroke. DESIGN: Cross-sectional survey. SETTING: Structured interviews in the participants' homes. SUBJECTS: Community-dwelling persons with stroke in the rural areas of China ( N = 639). INTERVENTIONS: Not applicable. MAIN MEASURES: 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). RESULTS: 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). CONCLUSIONS: Depression and social participation are inversely related. The physical environment, services/assistance, attitudes/support, and policies all impact post-stroke depression.
OBJECTIVE: To explore the impacts of social participation and the environment on depression among people with stroke. DESIGN: Cross-sectional survey. SETTING: Structured interviews in the participants' homes. SUBJECTS: Community-dwelling persons with stroke in the rural areas of China ( N = 639). INTERVENTIONS: Not applicable. MAIN MEASURES: 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). RESULTS: 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). CONCLUSIONS:Depression and social participation are inversely related. The physical environment, services/assistance, attitudes/support, and policies all impact post-stroke depression.
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