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

Abstract Background A 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 c...

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Main Authors: Xiaojuan Wan, Dorothy Ngo Sheung Chan, Janita Pak Chun Chau, Yu Zhang, Zhi’e Gu, Limei Xu
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-21592-z
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author Xiaojuan Wan
Dorothy Ngo Sheung Chan
Janita Pak Chun Chau
Yu Zhang
Zhi’e Gu
Limei Xu
author_facet Xiaojuan Wan
Dorothy Ngo Sheung Chan
Janita Pak Chun Chau
Yu Zhang
Zhi’e Gu
Limei Xu
author_sort Xiaojuan Wan
collection DOAJ
description Abstract Background A 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. Methods This 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. Results Three 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. Conclusions Stroke 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.
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spelling doaj-art-24313895fe254325aa5545a3d3ad12d12025-02-09T12:58:27ZengBMCBMC Public Health1471-24582025-02-0125111210.1186/s12889-025-21592-zSocial participation challenges and facilitators among Chinese stroke survivors: a qualitative descriptive studyXiaojuan Wan0Dorothy Ngo Sheung Chan1Janita Pak Chun Chau2Yu Zhang3Zhi’e Gu4Limei Xu5School of Nursing, Yangzhou UniversityNethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong KongNethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong KongSchool of Nursing, Yangzhou UniversityNorthern Jiangsu People’s Hospital, Affiliated Hospital of Yangzhou UniversityWenfeng Community Health Service CentreAbstract Background A 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. Methods This 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. Results Three 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. Conclusions Stroke 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.https://doi.org/10.1186/s12889-025-21592-zChallenges and facilitatorsCultural valuesQualitative study: social participationSocial supportStroke survivors
spellingShingle Xiaojuan Wan
Dorothy Ngo Sheung Chan
Janita Pak Chun Chau
Yu Zhang
Zhi’e Gu
Limei Xu
Social participation challenges and facilitators among Chinese stroke survivors: a qualitative descriptive study
BMC Public Health
Challenges and facilitators
Cultural values
Qualitative study: social participation
Social support
Stroke survivors
title Social participation challenges and facilitators among Chinese stroke survivors: a qualitative descriptive study
title_full Social participation challenges and facilitators among Chinese stroke survivors: a qualitative descriptive study
title_fullStr Social participation challenges and facilitators among Chinese stroke survivors: a qualitative descriptive study
title_full_unstemmed Social participation challenges and facilitators among Chinese stroke survivors: a qualitative descriptive study
title_short Social participation challenges and facilitators among Chinese stroke survivors: a qualitative descriptive study
title_sort social participation challenges and facilitators among chinese stroke survivors a qualitative descriptive study
topic Challenges and facilitators
Cultural values
Qualitative study: social participation
Social support
Stroke survivors
url https://doi.org/10.1186/s12889-025-21592-z
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