Person and Environment Factors Supporting Self-Care Performance and Social Participation After Mild Stroke.

Mild stroke survivors seldom receive occupational therapy services as their deficits are assumed to be minor enough to not affect their daily occupations. Yet many mild stroke survivors report deficits in self-care performance and social participation. This study investigates person and environment factors influencing self-care performance and social participation among mild stroke survivors, using the Person-Environment-Occupation-Performance (PEOP) model. A retrospective cohort analysis of 736 mild stroke survivors was conducted using electronic health records. Person factors included demographic characteristics and clinical characteristics, and environment factors included the Social Vulnerability Index. The analysis included logistic regression. Approximately, 10% of patients reported deficits in self-care or social participation. Disability level was the only person factor associated with self-care performance. Person factors affecting social participation included mobility and unemployment. Socioeconomic status was associated with both occupation measures. Occupational therapy practitioners must address the person and environment factors affecting mild stroke survivors' self-care performance and social participation.

Person and Environment Factors Supporting Mild Stroke Survivors' Ability to Take Care of Themselves and Their Social LivesThis study looked at what happens to people after they have had a mild stroke. We wanted to find out what makes some people independent in taking care of themselves and able to socialize after a mild stroke, whereas others have more difficulty. To do this, we looked at many factors that were measured in the patients' hospital record, such as age, type of stroke, and where they live. We used their address to determine information about their neighborhood and how that may affect their independence and social lives. We found that patients who were less disabled had an easier time taking care of themselves. We found that patients who had difficulty moving or were unemployed had difficulty with their social lives. A patient's social life was also associated with whether they got therapy. Patients who lived in low-income neighborhoods had difficulties with taking care of themselves and with their social lives. Occupational therapists must understand the importance of addressing these factors when supporting patients with a mild stroke with their ability to take care of themselves and engage in their social lives.

Experiences With Mobile Health-Enabled Ambulatory Monitoring Among Stroke Survivors: A Qualitative Study.

Inquiring into the experiences of stroke survivors toward ambulatory monitoring is crucial for optimizing user adoption, design, implementation, and sustainability of ambulatory monitoring in the stroke population. This study was aimed to identify facilitators and barriers for ambulatory monitoring among stroke survivors, as well as their suggestions for development and implementation of ambulatory monitoring. We conducted individual semi-structured interviews with 40 stroke survivors who received ambulatory monitoring. The interviews were analyzed using thematic content analysis. Six themes about facilitators associated with ambulatory monitoring emerged: (1) user support, (2) technological features, (3) convenience, (4) personal strategies, (5)social influence, and (6)time commitment. Three themes about barriers to using ambulatory monitoring emerged: (1) personal factors, (2) functionality, (3) study design. Three themes about suggestions emerged: (1) personalization, (2) functionality, and (3) interactive feedback. As mobile health technology is becoming more popular, the findings of this study provide timely implications and practical considerations for ambulatory monitoring in the stroke population.

Understanding the experiences of individuals with stroke toward ambulatory monitoringAmbulatory monitoring overcomes many limitations of traditional paper­pencil assessment and laboratory-based testing, emerging as a promising tool to assess daily functioning. However, there has been low adoption of ambulatory monitoring by people with chronic conditions. In this study, the researchers interviewed 40 individuals with stroke about their experiences, including facilitators, barriers, and suggestions associated with ambulatory monitoring. The findings identified six types of facilitators that should be included in the design of future ambulatory monitoring to enhance pleasant user experiences, three types of barriers that should be excluded to improve adherence, and three types of suggestions that should be considered to meet the needs of individuals with stroke. These important findings will be timely to inform the development of ambulatory monitoring for the stroke population.

Racial disparities among mild stroke survivors: predictors of home discharge from a retrospective analysis.

BACKGROUND: Half of all strokes are classified as mild, and most mild stroke survivors are discharged home after their initial hospitalization without any post-acute rehabilitation despite experiencing cognitive, psychosocial, motor, and mobility impairments. OBJECTIVES: To investigate the demographic and clinical characteristics of mild stroke survivors and their association with discharge location. METHODS: This is a retrospective analysis of mild stroke survivors from 2015-2023 in an academic medical center. Demographic characteristics, clinical measures, and discharge locations were obtained from the electronic health record. The Social Vulnerability Index was used to measure the community vulnerability. Associations between variables and discharge location were examined using bivariate logistic regression analysis. RESULTS: There were 2,953 mild stroke survivors included in this study. The majority of participants were White (65.46%), followed by Black (19.40%). Black stroke survivors and individuals with higher social vulnerability had a higher proportion of discharges to skilled nursing facilities (p = 0.001). Black patients and patients with high vulnerability in housing type and transportation were less likely to be discharged home. CONCLUSIONS: Mild stroke survivors have a high rate of home discharge, potentially because less severe stroke symptoms have a reduced need for intensive care. Racial disparities in discharge location were evident, with Black stroke survivors experiencing higher rates of institutionalized care and lower likelihood of being discharged home compared to White counterparts, emphasizing the importance of addressing these disparities for equitable healthcare delivery and optimal outcomes.

An Exploratory Study of Young Stroke Survivors' Lived Experiences: A Multi-Methods Study Using Developmental Theory.

Young adults make up 10% of strokes that occur in the United States each year. Little research has shown the developmental and occupational disruption as a result of stroke for this population. The objective of this study was to describe young stroke survivors' perceived disruptions using developmental theory. A multiple methods study was conducted with community-dwelling stroke survivors between the ages of 18 and 40 using Patient-Reported Outcomes Measurement Information System (PROMIS) measures and qualitative interviews. Five themes were reported from the qualitative data: stroke and health, work and school, romantic relationships, parenting, and other social relationships. PROMIS measure results were not significantly different from the normed population despite challenges revealed during qualitative interviews. Qualitative data showed variations in post-stroke deficits and occupational performance that could not be meaningfully captured by the PROMIS measures alone. Occupational therapy practitioners should use developmental theory to guide their understanding of occupational disruptions in young stroke survivors.