Impact of Illness Perceptions on Poststroke Activity Engagement and the Moderating Role of Gender

Abstract

Abstract Importance: Beyond existing knowledge of demographic and performance skill factors, establishing relationships between poststroke activity engagement and illness perceptions sets the stage for the development of more effective intervention strategies. Objective: To describe the illness perceptions of community-dwelling people with stroke in the first 2 yr poststroke; specifically, to examine whether illness perceptions are associated with activity engagement and to explore the moderating role of gender in these relationships. Design: Cross-sectional study. Setting: Participants were recruited from eight rehabilitation settings in Beijing, China. Participants: 202 community dwellers with stroke. Outcomes and Measures: Activity engagement and illness perceptions were measured with the Mandarin version of the Assessment of Life Habits and the Chinese version of the Stroke-Specific Illness Perceptions Questionnaire–Revised, respectively. Participants’ demographic information, cognitive status, and motor function were also collected. Results: Stronger perceptions of consequences and controllability were related to better performance in activity engagement at the personal level, and stronger perceptions of illness coherence were related to better performance in activity engagement at the societal level. In addition, gender differences in the relationship between illness perceptions and activity engagement were described. Conclusions and Relevance: How people with stroke perceived their conditions dictated their levels of activity engagement in their community of residence. The findings suggest that understanding clients’ illness perceptions may assist practitioners in developing comprehensive, targeted interventions to improve activity engagement and maximize recovery after stroke. Future studies are needed to explore the gender effect of illness perceptions on activity engagement in people with stroke. What This Article Adds: This study identified the relationships between illness perceptions and level of activity engagement in real-life environments in people with stroke. In addition to motor and cognitive interventions, providing opportunities for clients to gain a better understanding of stroke would facilitate their activity engagement in their real-life environment.