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

• Published in: Clinical rehabilitation Vol. 31; no. 3; pp. 394 - 402
• Main Authors: Zhang, Lifang, Sui, Minghong, Yan, Tiebin, You, Liming, Li, Kun, Gao, Yan
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-03-2017; Sage Publications Ltd
• Subjects: Activities of Daily Living - psychology; Aged; Attitudes; Built environment; China; Chinese languages; Cross-Sectional Studies; Depressive Disorder - diagnosis; Depressive Disorder - etiology; Depressive Disorder - psychology; Disability; Environment Design; Environmental aspects; Environmental health; Female; Humans; Interviews as Topic; Male; Mental depression; Middle Aged; Neurology; Rural areas; Rural communities; Social integration; Social participation; Social Participation - psychology; Socioeconomic Factors; Stroke; Stroke - psychology; Stroke Rehabilitation; Structural equation modeling; China; Stroke; rehabilitation; environment; social participation; structural equation modelling; China; depression
• ISSN: 0269-2155; 1477-0873
• DOI: 10.1177/0269215516641300

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.