Social participation challenges and facilitators among Chinese stroke survivors: a qualitative descriptive study.

backgroundA significant proportion of stroke survivors have participation restrictions. Attaining an in-depth understanding of participation challenges and facilitators is necessary to identify rehabilitation priorities. However, current evidence in the Chinese context is insufficient as cultural norms, expectations, and behaviors may differ across countries. This study aimed to explore experiences of social participation among Chinese stroke survivors and their perceived challenges and facilitators, particularly the cultural issues that impact their social participation.

methodsThis study used a qualitative descriptive approach. Individual face-to-face semi-structured interviews were conducted with 30 first-time or recurrent stroke survivors recruited from a rehabilitation unit and a community health centre in China. Content analysis was used to analyse the data. Reporting complies with the COREQ checklist.

resultsThree investigator-derived categories and 14 subcategories based on data-derived responses were identified. The categories included changes in social participation after stroke, challenges of social participation, and facilitators of social participation. While common factors such as physical limitations, environmental features, and social support emerged as influences on social participation, cultural values were also found to exert a significant impact on survivors' participation behaviors. These values included family-oriented beliefs regarding responsibility towards their children, struggles with societal expectations, and perceptions of social participation being a burden on others.

conclusionsStroke survivors perceived varying degrees of changes in their social participation. Specifically, this study identifies the influence of prevalent cultural values on survivors' participation behaviors, indicating that cultural beliefs and the associated effects on health outcomes should be taken into consideration when developing interventions to enhance social participation after stroke. Potential interventions to empower survivors could aim to improve their stroke-related knowledge, provide psychological encouragement, incorporate skills training to improve communication with family members, and organise peer support groups to augment social support networks.