Social Support and Health-Related Quality of Life in Community-Dwelling Stroke Survivors

SIGNIFICANCE: A goal of occupational therapy intervention is to improve health-related quality of life (HRQOL) for stroke survivors. The importance of HRQOL has been recognized in many stroke clinical trials. In the current study, we investigated what specific aspects of HRQOL are important to community-dwelling stroke survivors and determined whether there is a relationship between stroke survivors’ perception of HRQOL and social support. The information gleaned from this study is important to occupational therapy practitioners in the promotion of health and wellness in community-based stroke survivors.

INNOVATION: This study is unique in that it provides descriptive first-hand accounts from individuals on their experiences as stroke survivors living in the community. We partnered with a one-of-a-kind, community-based organization whose mission is to empower stroke survivors and their families to overcome the challenges of life after stroke. Community-dwelling stroke survivors who frequent this organization volunteered to disclose what aspects of quality of life are significant as part of their ongoing recovery in participation with daily life. We utilized focus groups to capture rich, descriptive qualitative data. Additionally, we used quantitative research measures to find associations between stroke survivors’ perception of HRQOL and social support.

APPROACH: In this study, we attempted to answer the following research questions: What aspects of HRQOL are important to community-dwelling stroke survivors? What is the nature of the relationship between stroke survivors’ perceptions of HRQOL and social support?

The American Occupational Therapy Association’s (AOTA’s) Centennial Vision has identified health and wellness as a fundamental societal need in the 21st century, and the occupational therapy profession supports efforts to promote health and to prevent disability; furthermore, one of the key purposes of health promotion is improved health, well-being, and social participation of clients. In line with AOTA’s stance on health and wellness, we investigated what aspects of HRQOL are deemed important to stroke survivors.

METHOD: We used a mixed-methodological research design (descriptive quantitative and phenomenological qualitative). The setting was a community-based stroke center. Participants included 14 community-dwelling individuals at various stages of recovery poststroke. Participants were excluded if they scored less than 23 on the Mini-Mental Status Examination or if they were non-English speaking. Measures included focus group interviews; the RAND Short-Form—36, Version 2 (SF–36v.2); and the Social Support Questionnaire (SSQ).

Focus groups were audio recorded, field notes were taken, and field notes and audio recordings were transcribed from focus group interviews verbatim. Line-by-line coding was used to identify specific emerging themes on HRQOL and social support. Data from the SF–36v.2 and SSQ were inputted into SPSS, and Pearson r correlations were used to determine associations between participants’ perception of HRQOL and social support. Regression analysis was used to determine whether social support scores account for variability in HRQOL scores.

RESULTS: Descriptive demographic information on the 14 participants was compiled. Codes in data were collapsed into five primary themes, which are discussed in the presentation. Participant quotations are shared. Statistically significant correlations between HRQOL and social support were found.

CONCLUSION: Results suggest the significance for occupational therapy practitioners to expand their practice with stroke survivors to include more interventions on social support and community participation.