Dynamics of Perceived Social Isolation, Secondary Conditions, and Daily Activity Patterns Among Individuals With Stroke: A Network Analysis of Ecological Momentary Assessment Data.
Yun Shi, Mandy W M Fong, Christopher L Metts and 4 others
PMID 38458373WHAT IT FOUND
Adults after stroke who reported feeling worthless were more likely to report perceived social isolation later.
Isolation also happened alongside being home and alone. In one model, isolation was followed by stress, then leaving home.
Key findings
01Feeling worthless at one survey was associated with perceived social isolation at the next survey.
02Perceived social isolation was associated at the same time with being home and alone.
03In the combined network, perceived social isolation was associated with later stress, and stress was associated with later being out of the home.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study used a modest sample from a single hospital database, so the network patterns may not hold in other stroke populations. The analysis was observational and did not test an intervention, so it cannot show that changing worthlessness, activity, or stress changes perceived social isolation. Participants had mild to moderate stroke and low levels of perceived social isolation, so the findings may not apply to severe stroke or high isolation. The study excluded people with severe communication difficulties, severe apraxia, unilateral visual inattention, or limited visual acuity, so it does not speak to those common stroke impairments. The associations were small, and the 5-point scale may not capture meaningful differences in isolation or symptoms. Some participants were enrolled during the COVID-19 pandemic, which may have affected time spent at home and alone. Frequent survey prompts may have changed participants' usual routines or feelings.
Declared interests
The supplied metadata indicates NIH extramural and non-U.S. government research support. No author conflict-of-interest declaration is included.
The easy way to misread this
Do not read the worthlessness-to-isolation pathway as proof that treating worthlessness reduces isolation. The study observed associations between survey responses and did not test an intervention.