Impact of Illness Perceptions on Poststroke Activity Engagement and the Moderating Role of Gender

Importance: Beyond existing knowledge of demographic and performance skill factors, establishing relationshipsbetween poststroke activity engagement and illness perceptions sets the stage for the development of moreeffective intervention strategies.Objective: To describe the illness perceptions of community-dwelling people with stroke in the first 2 yrpoststroke; specifically, to examine whether illness perceptions are associated with activity engagement and toexplore the moderating role of gender in these relationships.Design: Cross-sectional study.Setting: Participants were recruited from eight rehabilitation settings in Beijing, China.Participants: 202 community dwellers with stroke.Outcomes and Measures: Activity engagement and illness perceptions were measured with the Mandarin versionof the Assessment of Life Habits and the Chinese version of the Stroke-Specific Illness PerceptionsQuestionnaire–Revised, respectively. Participants’ demographic information, cognitive status, and motor functionwere also collected.Results: Stronger perceptions of consequences and controllability were related to better performance in activityengagement at the personal level, and stronger perceptions of illness coherence were related to betterperformance in activity engagement at the societal level. In addition, gender differences in the relationship betweenillness perceptions and activity engagement were described.Conclusions and Relevance: How people with stroke perceived their conditions dictated their levels of activityengagement in their community of residence. The findings suggest that understanding clients’ illness perceptionsmay assist practitioners in developing comprehensive, targeted interventions to improve activity engagement andmaximize recovery after stroke. Future studies are needed to explore the gender effect of illness perceptions onactivity engagement in people with stroke.What This Article Adds: This study identified the relationships between illness perceptions and level of activityengagement in real-life environments in people with stroke. In addition to motor and cognitive interventions,providing opportunities for clients to gain a better understanding of stroke would facilitate their activity engagementin their real-life environment.