Social Support Fully Mediates the Association Between Communication Abilities and Social Participation Among Persons with Post-Stroke Aphasia

Background: Communication abilities have been considered to be a key influential factor for social participation in persons with post-stroke aphasia. Previous literature has shown that social support is positively associated with social participation post-stroke. However, few studies have investigated if social support mediates the negative impact of communication difficulties on social participation in persons with aphasia and without aphasia after stroke. Aims: To investigate the mediation effect of social support on the association between communication abilities and social participation in persons with aphasia and without aphasia after stroke. Methods & Procedures: A total of 116 participants who have had a stroke, including 60 persons with aphasia and 56 persons without aphasia, were enrolled. This study used a regression-based mediation analysis using Hayes’s PROCESS macro (SPSS model 4). Measures included the Medical Outcomes Study (MOS) - Social Support Survey as the mediator (perceived social support), the Stroke Impact Scale 2.0 (SIS) communication domain as the independent variable, and the Activity Card Sort (ACS) social activity domain as the dependent variable (social participation). Two separate models were built for persons with aphasia and without aphasia. As post hoc analyses, the four domains of MOS social support (emotional/informational support, affectional support, positive social interaction, and tangible support) were included as a mediator in four individual models. Outcomes & Results: Our results showed that there was no difference in social participation between persons with aphasia and without aphasia after stroke. Perceived social support (b=0.180, 95% CI=0.054~0.352), including emotional/informational support (b=0.182, 95% CI=0.552~0.359), affectionate support (b=0.138, 95% CI=0.020~0.316), and positive social interaction (b=0.178, 95% CI=0.035~0.357), fully mediates the association between communication abilities and social participation in persons with aphasia, but did not for persons without aphasia (p>0.05). Conclusions: The results indicate that perceived social support, specifically emotional/informational support, affectionate support, and positive social interaction, may be used as an intervention approach for improving social participation in persons with post-stroke aphasia.