SOCIAL PARTICIPATION, RESILIENCE, AND COPING TENDENCY IN A SAMPLE OF STROKE SURVIVORS: A MULTI-CENTRE CROSS-SECTIONAL STUDY IN CHINA

Objectives To investigate the association between resilience and social participation and examine the mediation of resilience on coping strategies and social participation. Design A multi-centre cross-sectional study performed from April to July 2022. Participants The study sample comprised 239 stroke survivors (53.1% male). The mean age of participants was 65.4 years. Methods The study was conducted at 3 neurorehabilitation centres in Shanghai, China. The Utrecht Scale for Evaluation of Rehabilitation Participation (USER-P) was used to measure both objective and subjective social participation. Resilience was evaluated using the Connor-Davidson Resilience Scale (CD-RISC), while positive coping tendency was assessed using the Simplified Coping Style Questionnaire (SCSQ). Multivariate linear regression was employed, taking into account confounding factors. In cases where a significant interaction effect was observed, simple slope analysis was conducted to explore the relationship between positive coping tendency and social participation at different levels of resilience. Results The mean scores of social participation frequency, restriction, and satisfaction were 21.80 ± 15.13, 38.92 ± 26.48, and 63.34 ± 22.35, respectively. Higher resilience level was independently associated with higher social participation frequency (B = 0.210, p < 0.001), less participation restriction (B = 0.584, p < 0.001), and higher participation satisfaction (B = 0.250, p < 0.001). Moreover, higher resilience was correlated with more positive coping tendency. More positive coping tendency was related to higher social participation frequency and less participation restriction, but not to social participation satisfaction. Furthermore, individuals at different resilience levels moderated the effect of positive coping tendency on social participation frequency. Conclusion This study underlines the importance of resilience as a potential intervention in enhancing both objective and subjective social participation in stroke survivors, and provides insights into increasing the efficacy of positive coping strategies on social participation. LAY ABSTRACT Stroke causes considerable disability among Chinese adults. Substantial restriction in social participation is observed among stroke survivors. However, the factors associated with post-stroke social participation have not been studied. This multi-centre cross-sectional study examines the relationship between resilience and social participation, as well as the potential mediating role of resilience in the relationship between coping strategies and social participation among individuals who have survived a stroke. The finding that resilience was positively associated with both objective and subjective social participation suggests that resilience-targeted intervention may have the potential to promote social participation in stroke survivors. Furthermore, the moderating effect of resilience on the relationship between positive coping tendencies and participation frequency also presents an opportunity to enhance the effectiveness of positive coping strategies in improving social participation.