Stroke, Vol 24, 64-70, Copyright © 1993 by American Heart Association
TA Glass, DB Matchar, M Belyea and JR Feussner
BACKGROUND AND PURPOSE: The purpose of this study is to examine the impact
of social support on outcome after first stroke in a prospective cohort
study. Although modest evidence exists for the importance of several
psychosocial factors, studies have failed to use widely recognized measures
of outcome and social support, have failed to control for time since onset,
and have not used longitudinal techniques. METHODS: Forty-six surviving
patients were followed for 6 months after stroke. Recovery was measured
using repeated measures of functional status as indicated by the Barthel
Index of activities of daily living. Perceived social support was measured
at 1, 3, and 6 months after onset. Repeated-measures multivariate analysis
of variance was used to analyze changes in functional status. RESULTS:
Significant differences were found across levels of social support in
trajectories of functional status (p = 0.002). A significant three-way
interaction between stroke severity, social support, and outcome was also
found (p = 0.012). Patients with more severe stroke and the largest amount
of social support attained an average Barthel Index that was 68 points
(65%) higher than the group reporting the least support. CONCLUSIONS: High
levels of social support were associated with faster and more extensive
recovery of functional status after stroke. Social support may be an
important prognostic factor in recovery from stroke. Socially isolated
patients may be at particular risk for poor outcome.
ARTICLES
Impact of social support on outcome in first stroke
Department of Epidemiology and Public Health, Yale University, School of Medicine, New Haven, Conn.
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