Psychosocial Predictors of Participation Restriction Poststroke in Korea: A Path Analysis

Objective: The present cross-sectional study tested a hypothetical path model consisting of psychosocial factors in relation to activity participation restriction in chronic stroke. Motor and cognitive functions and age; psychological factors consisting of depressive symptoms, hopeful thinking, and self-esteem; and activities of daily living and social support served as psychosocial factors. Method: Data were collected from 171 community-dwelling individuals with chronic stroke in Korea. Path analysis was conducted to test the model fit between the obtained data and the hypothetical model to examine the direct and indirect effects of variables on participation restriction. Results: Among the psychosocial factors, psychological factors and activities of daily living played the most significant role in predicting the degree of participation restriction, as well as mediating the relationship. Motor and cognitive functions were mediated by activities of daily living, and social support was mediated by psychological factors to affect participation restriction. Among the psychological factors, hopeful thinking exhibited the strongest relationship. Conclusion: To increase stroke survivors' participation during the course of rehabilitation, psychosocial factors as well as biological factors should be included in a multidimensional treatment approach.