Community Integration Research: Stroke Survivors

The relationship of physical function to social integration after stroke.

Baseman S, Fisher K, Ward L, Bhattacharya A. Cooper University Hospital, Camden, NJ, USA.  J Neurosci Nurs. 2010 Oct;42(5):237-44.

Stroke is a leading cause of death and a 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. There is a gap in knowledge of social issues and integration into societal, family, and community roles after stroke. A descriptive, correlational survey design was used to examine the relationships of functional status, depression, and overall stroke recovery to social integration in a convenience sample of ischemic stroke survivors. The survey response rate was 21.4%. Results showed that functional status, overall stroke recovery, and depression are highly significant predictors of social integration, explaining 62% of the variance (adjusted R2). Comorbid depression was negatively (-.74) and significantly (.01, two-tailed) correlated to social integration, such that higher levels of depression are associated with lower levels of social integration. Finally, employment status after stroke dropped from 48% to 4.2%, and poststroke employment status was correlated to social integration (significance = .03). Care for patients with chronic conditions like stroke should address all domains of the individual-physical, psychosocial, and environmental. Factors including depression and perceptions of overall stroke recovery are significant and should be addressed in the rehabilitation process to better promote social integration. Social integration is an important and understudied aspect of stroke recovery that warrants further research.


Stroke and neurodegenerative disorders: 4. Community integration.

Edgley SLew H, Moroz A, Chae J, Lombard L, Camiolo Reddy C. NYU School of Medicine, Rusk Institute of Rehabilitation Medicine, New York, NY PM&R 2009 Mar; 1(3):S27-S34.

This self-directed learning module highlights common rehabilitation issues in stroke survivors with chronic impairments with emphasis on community integration. It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on management of shoulder pain, management of hypertonia, secondary stroke prevention, vocational reintegration including strategies for return to driving, and treatment of sexual dysfunction following stroke. The goal of this article is to improve the learner’s ability to implement community integration strategies after a stroke.

The role of social support in the family and community integration of right-hemisphere stroke survivors.

Egbert N, Koch L, Coeling H, Ayers D.  School of Communication Studies, Kent State University, Kent, Ohio 44242, USA.  Health Commun. 2006;20(1):45-55.

The goal of this project was to understand better the communicative processes by which social support can assist right-hemisphere stroke survivors in the process of community integration. Open-ended interviews were conducted with 12 right-hemisphere stroke survivors and their family caregivers. The transcribed interviews revealed 7 challenges (physical, cognitive-perceptual, emotional, relationship, employment, financial, and challenges to activities of daily living) and three types of resources (formal external, informal external, and internal). Stroke survivors’ internal resources were shown to be essential for facilitating community integration. Implications for researchers and health care providers are discussed within the framework of Hobfoll’s (1988) conservation of resources theory.