Participation restriction and associated factors among stroke survivors in Amhara region comprehensive specialized hospitals, Northwest Ethiopia; multi-center cross sectional study

Abstract

Background: Participation restriction is the leading cause of disability and dependency in stroke survivors. It is closely related to impaired activities of daily living, reduced capacity for independent living, and decreased functional performance. But there is no known evidence regarding participation restriction and its risk factors among stroke survivors in Ethiopia, particularly in the study area. Objective: To assess the prevalence of participation restriction and associated factors among stroke survivors in Amhara Region Comprehensive Specialized Hospitals, Northwest Ethiopia Methods: A multi-center institutional-based cross-sectional study was conducted from June 26 to August 30, 2024. Systematic random sampling was used to select 292 study participants. A structured interviewer-administered questionnaire and chart review were used to collect data. To assess participation restriction, a Utrecht Scale for Evaluation of Rehabilitation-Participation was used. Both bivariable and multivariable logistic regression analyses were performed to identify factors associated with participation restriction. Variables with a p-value less than 0.05 in multivariable analysis were considered statistically significant. Result: A total of 292 participants were included in this study. The prevalence of participation restriction among stroke survivors was 64.7% (95% CI: 58.9, 70.2). Significant factors associated with participation restriction included being female (AOR: 2.31, 95% CI: 1.15, 4.66), aged 60 years and older (AOR: 3.77, 95% CI: 1.42,10.01), presence of comorbidity (AOR: 2.47, 95% CI: 1.14, 5.36), anxiety (AOR: 2.80, 95% CI: 1.28, 6.14), stroke duration of 2-6 months (AOR:3.76,95%CI:1.73,8.2), and depression (AOR: 5.22, 95% CI: 2.35,11.59) were significantly associated with participation restriction. Conclusion and recommendations: Nearly two-thirds of the study participants had participation restriction. Being female aged 60years and older, stroke duration of 2-6 months, having comorbidity, depression, and anxiety were significantly associated with participation restriction. Therefore, early screening and cognitive behavioral therapy for stroke survivors are essential to reduce participation restriction