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OBJECTIVES: This study explored the effect of the interaction between intrinsic capacity and social support on the activities of daily living in the older adults. METHODS: A total of 3,124 older adults participated in the study. Data on the assessment of intrinsic capacity as well as activities of daily living (ADL) and social support were collected. The latent growth curve model (LGCM) was used to examine the effect of the interaction between social support and intrinsic capacity on the activities of daily living in the older adults. RESULTS: A total of 3,730 older adults were included at baseline, and 3,124 older adults completed the 4-year follow-up. The ADL score of the older adults showed a significant downward trend with time over 4 years (ß=-0.115, P<0.05). In the elderly population with high intrinsic capacity, the ADL of individuals with low levels of social participation decreased significantly over time (ß=-0.114, P=0.012). In the elderly group with low intrinsic capacity, the ADL of individuals with low levels of social participation (ß=-0.245, P=0.005) and high levels of life care (ß=-0.167, P=0.001) decreased significantly over time. CONCLUSION: This is the first longitudinal study to explore the effects of interactions among intrinsic capacity, social participation and family support on the trajectory of ADL in the older adults from the perspective of the life course. Social participation can effectively improve functional ability of older adults with low intrinsic capacity. Life care is beneficial for maintaining the functional ability of older adults with intact intrinsic capacity, but it accelerates the deterioration of the functional ability of older adults with low intrinsic capacity.

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Introduction: This study aimed to identify the dual trajectories of social participation (SP) and frailty index (FI) among Chinese older adults, and investigate common influential factors of both trajectories. Methods: Utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008-2018 surveys, 1,645 individuals were analyzed. A group-based dual trajectory model and logistic regression were used to examine trajectories, their interrelations and shared influencing factors. Results: This study identified three SP, two FI trajectories and six distinct sub-groups of individuals. The study confirmed a long-term, interrelated relationship between two outcomes and identified some common factors. Compared to participants in the lower SP trajectory, those who followed the middle SP trajectory and higher SP trajectory had increased probabilities of belonging to the slow-growth FI trajectory (90.28 and 99.71%, respectively). And the participants in the slow-growth FI exhibited higher probabilities of belonging to the middle SP and the higher SP trajectory (37.64 and 25.34% higher, respectively) compared with those in the rapid-growth FI trajectory. Age, marital status, and drinking status were mutual factors associated with the dual trajectories. Discussion: The results showed significant associations between higher levels of frailty and lower levels of social participation. Related intervention policies should consider the dual trajectories and the common factors that underlie these trajectories of SP and FI.

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Loneliness is a relatively new topic in the field of health and social policy. A pivotal requirement for the formulation of effective policies addressing loneliness in Germany lies in the access to comprehensive, longitudinal data.In 2024, the first "Loneliness Barometer" was conducted by the Loneliness Network Germany (KNE) at the Institute for Social Work and Social Pedagogy e. V. (ISS e. V.) on behalf of the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (BMFSFJ). It is a report on the long-term development of loneliness within the German population (18 years and older), for which representative data from the German Socio-Economic Panel (SOEP, 1992-2021) were analysed. The loneliness barometer is also intended to provide evidence-based statements on the long-term development of loneliness burdens in Germany in the future.This article provides an insight into the decisions made in the development of the Loneliness Barometer methodology and presents selected key findings from the first Loneliness Barometer. Leveraging data from the German Socio-Economic Panel (SOEP), the Loneliness Barometer underscores the multifaceted disparities faced by individuals grappling with heightened loneliness levels. These disparities manifest across various domains: diminished health outcomes, constrained social and financial resources encompassing education and employment, reduced economic participation, curtailed political engagement and heightened scepticism towards democratic institutions. The article concludes with considerations of the limitations and future development possibilities of the Loneliness Barometer.

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Forming therapeutic relationships is considered important within psychiatric and mental health nursing. One way of achieving this is through social interaction when engaging in joint activities. However, introducing and using nursing interventions based on joint activities in psychiatric inpatient care has proven challenging. Since staff motivation is important, researching the meaning of engaging in joint activities from the nursing professional's point of view can provide information that is relevant in this area. This study aims to illuminate the meaning of participating in joint activities with patients as narrated by nursing professionals in psychiatric inpatient care. Narrative interviews with 14 nursing professionals with experience from psychiatric inpatient care were conducted. Data were analysed using phenomenological hermeneutics and reported following the consolidated criteria for reporting qualitative research (COREQ) guidelines. Results illuminate that engaging in joint activities means being open to a process of learning. Four themes contributed to this understanding: Struggling with uncertainty, discovering aspects of the other, unfolding paths to self-fulfilment and sharing personhood. Being open to a process of learning means being willing to face uncertainty when engaging in activities as well as being open to learning about oneself as well as the other. Through openness to this process of learning, a sharing of personhood can be achieved, where the nursing professional and the patient approach becoming two persons. Illuminating the meaning of joint activities from the nursing professionals' perspective may provide valuable insights related to introducing and using interventions focusing on joint activities.

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Functional limitations refer to the dependency to perform activities of daily living. Increasing evidence has demonstrated a bidirectional association between functional limitations and cognitive functioning, although the exact mechanism remains unclear. This study investigated whether social participation bidirectionally mediates the association between functional limitations and cognitive decline. We analyzed a sample of 16,385 middle-aged and older adults (aged over 50 years) using longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS; Waves 1-4). We utilized a cross-lagged panel model to examine the bidirectional mediation of social participation between functional limitations and cognitive functioning over a span of eight years. The results indicated that social participation bidirectionally and partially mediated the relationship between the onset of functional limitations and cognitive decline, indicating that social participation may play an important role in mitigating the disablement process.

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Dairy products formulated with bioactives are widely distributed in Japan, but it remains to be clear whether a regular consumption of these products would help reduce the risks of incidental functional disability and dementia in older adults. This study aimed to investigate Japanese subjects aged ≥65 y (n=629) that routinely consumed three functional dairy products, a calcium-enriched milk supplemented with Bifidobacterium longum BB536, a yogurt supplemented with lactoferrin, B. longum BB536 and heat-killed Lacticaseibacillus paracasei MCC1849, and a drinkable yogurt supplemented with lactoferrin, B. longum BB536 and heat-killed L. paracasei MCC1849, through a home delivery service. Intake frequency and intake duration of these functional dairy products were compared with the risk scores of incident functional disability and dementia, developed by the Japan Gerontological Evaluation Study. In the participants aged <75 y, the incident functional disability risk was significantly maintained or decreased in the participants with the long intake duration level compared with the short intake duration level (OR, 95% CI: 0.48, 0.25-0.93). In the participants aged ≥75 y, the dementia risk was significantly maintained or decreased in the participants with the high intake frequency level compared with the low intake frequency level (OR, 95% CI: 0.46, 0.22-0.95). A high intake frequency or long term duration of these functional dairy products may be effective in preventing an aging-related increase in the risks of incident functional disability and dementia in older adults, but this warrants further investigation using different products containing different bioactives.

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Social isolation matters for health and longevity, but little research examines transitions into or out of social isolation or whether transitions are gendered or socially patterned. We described gender-specific trends in breadth and lack of social participation over 6 years overall and by age, country of origin, geographic location, education, wealth, and household income. We used three waves of CLSA data to evaluate changes in social isolation (0-1 activities) and broad social participation (5+ activities) in adults aged 45-75 (n = 24,788), by gender and socio-demographics, in linear and multinomial logistic regressions with post-estimated predicted probabilities. The number of social activities decreased over time, with greater declines for women. About half the sample (more men than women) stayed not highly socially active (<5 activities) and almost 1 in 5 became not highly socially active. Most adults (77 %) remained not socially isolated and 14 % became or remained socially isolated. Women were more likely than men to remain not highly socially active and less likely to have multiple social isolation transitions. Broad social participation changed over time for several subgroups of women and men, with gender differences notable for income levels. Social disparities in social isolation transitions differed by gender only for education. Older age and socioeconomically disadvantaged adults had higher probabilities of becoming socially isolated or becoming less socially active. Findings indicated the diversity of social activities declined as Canadians age into later life and transitions in both social isolation and social participation differed between genders, especially for specific vulnerable subpopulations.

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BACKGROUND: Social participation as a protective factor against cognitive decline was one of the targets in the AgeWell.de study, a multi-domain interventional trial in a sample of older adults at increased risk for dementia. This study aimed to examine differential effects of the intervention and other influencing factors on social participation throughout the trial. METHODS: A longitudinal analysis of study data at the primary follow-up after 24 months (n = 819) was conducted. The Lubben Social Network Scale (LSNS-6) was used to assess quantitative aspects of social networks, and self-reported social activities were classified using a three-tiered categorical framework to capture qualitative aspects. RESULTS: A positive effect of the intervention was observed at the qualitative framework level, with an OR of 1.38 [95% CI: 1.05-1.82] for achieving or maintaining higher social participation at follow-up, while no effect could be detected on quantitative social network characteristics. Later phases of the Covid-19 pandemic showed a negative impact on the level of social participation at follow-up with an OR of 0.84 [95% CI: 0.75-0.95]. CONCLUSIONS: These findings suggest that by focusing on qualitative aspects of social participation as a component of dementia prevention, future interventions can promote enriched social interactions within established social networks. TRIAL REGISTRATION: German Clinical Trials Register (DRKS) ID DRKS00013555.

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Tabletop roleplaying games (TRPGs) are an increasingly popular occupation but are still relatively unknown to occupational therapists. This study sought to understand the overall experience, benefits, and consequences of playing TRPGs and the relationship to other occupations. A qualitative research design with a thematic analysis was employed using semi-structured interviews with fifteen participants who had played TRPGs. Participants ranged in age from 20 to 52 years old and six identified as female, eight as male and one as nonbinary. The researchers gleaned four themes which include: (1) Social Connection and Collaboration; (2) Occupational Participation; (3) Creativity; and (4) Societal Perceptions. This research highlights aspects of the game that people enjoy, and skills developed during gameplay translate outside of the game. It suggests possible therapeutic uses of TRPGs that should be validated with future research.

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Background: Mental health challenges are encountered by frail older adults as the population ages. The extant literature is scant regarding the correlation between depressive symptoms and social participation among frail older adults. Methods: This study is based on an analysis of data from China Health and Retirement Longitudinal Study (CHARLS) participants aged 60 and older who are frail. A frailty index (FI) was developed for the purpose of assessing the frailty level of the participants. Additionally, latent class analysis (LCA) was employed to classify the participants' social engagement patterns in 2015 and 2018. The study used ordered logistic regression to examine the relationship between social participation type and depressive symptoms. We also used Latent Transition Analysis (LTA) methods to explore the impact of changes in social activity types on depressive symptoms after three years of follow-up in 2018. In addition, the response surface analysis (RSM) investigation explored the relationship among FI, depression, and social participation. Results: A total of 4,384 participants completed the baseline survey; three years later, 3,483 were included in the follow-up cohort. The baseline survey indicates that female older adults in rural areas who are single, have lower incomes, shorter sleep durations, and lighter weights exhibited more severe depressive symptoms. Social participation patterns were categorized into five subgroups by LCA. The findings indicate that individuals classified as "board game enthusiasts" (OR, 0.62; 95% CI, 0.47-0.82) and those as "extensive social interaction" (OR,0.67; 95% CI, 0.49-0.90) have a significantly lower likelihood of developing depressive symptoms compared to the "socially isolated" group. We also discovered that "socially isolated" baseline participants who transitioned to the "helpful individual" group after three years had significantly greater depressed symptoms (OR, 1.56; 95% CI, 1.00-2.44). More social activity types and less FI are linked to lower depression in our study. Conclusion: The results of the study emphasize the importance of social participation patterns and the number of social participation types in relation to the severity of depression among frail older adults individuals. This study's findings may provide important insights for addressing depressive symptoms in frail older adults person.

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Background. Limited knowledge is available regarding the impact of oculopharyngeal muscular dystrophy (OPMD) impairments on participation in daily and social activities, which currently hinders occupational therapy practice in this population. Purpose. To describe social participation and explore influencing factors in individuals with OPMD. Methods. Thirty-four individuals were assessed with outcome measures of social participation restrictions, mobility, dysphagia, and fatigue. Spearman correlations and stepwise multiple regression analyses were used. Findings. Results show a negative impact of OPMD on the social participation level, which was more important in participants aged over 60 years. Walking speed was found to be the main factor influencing participation levels for daily and social activities, with faster walking associated with higher participation. Conclusions. This study emphasizes the impact of OPMD impairments and limitations on social participation level. While dysphagia is obviously an important impairment to consider, interventions for mobility limitations should also be considered during clinical follow-up.

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Aim: To measure the social participation of people in Saudi Arabia during the COVID-19 pandemic. Subject and methods: A cross-sectional survey was conducted among people in Saudi Arabia to measure their participation in social activities during the COVID-19 pandemic. A validated questionnaire of Social Participation Scale was used to collect data from five main regions in Saudi Arabia through social media platforms. Means, frequencies, and percentages were calculated through descriptive analysis. Mean scores and standard deviation of social participation of participants were also presented. Results: The total number of participants was 1,560 including Saudi (87.3%) and non-Saudi (12.7%) nationals. Most participants (60.2%) were female. The age of participants ranged between 16 and 24 years old. Around 62.1% of participants were married, 63.2% were educated, 48.4 were employed and 82% were from the Eastern region. Around 72% of participants earned <10,000 riyals per month compared to those (27.3%) who earned <5,000 riyals per month. A total 72.7% of the participants have been diagnosed by COVID-19. The mean score of social participation was 47.81 (SD = 0.27). Most participants (62.7%) reported that social participation was severely restricted. Around 68.2% of the participants were quarantined at the facilities. Conclusion: The social participation of people in Saudi Arabia had been severely restricted during the COVID-19 pandemic. An early assessment of people's social participation would help to identify their problems and needs, to help them improve their participation in social activities and thus increase their overall quality of life.

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OBJECTIVE: This study aims to explore the relationship between Internet use and intrinsic capability among Chinese older adults, and the potential mediating role of social participation. METHODS: We verified the correlation between Internet use and intrinsic capacity using multiple linear regression and verified the mediating role of social participation using the Sobel and Bootstrap tests. RESULTS: The results of multiple linear regression show that there is a significant positive association between Internet use and intrinsic capacity (B = 0.717, p < .001); and social participation plays a mediating role, explaining a total of 20.5% of the association (indirect effect = 0.147, 95% CI: 0.067-0.227). CONCLUSION: Our findings suggest that Internet use significantly improves intrinsic capacity among Chinese older adults, with social participation playing a mediating role. Increasing Internet adoption rates and promoting social participation may help improve intrinsic capacity among older adults.

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PURPOSE: This study analyzes levels of social participation in patients with breast cancer on average 5 years following primary surgery as compared to women in the general population. In addition, the role of breast cancer-related complaints and medical data as possible influencing factors on levels of patients' social participation is investigated. METHODS: A total of n = 454 patients after primary surgery (t0) were recruited for a third follow-up study, and n = 372 completed this survey (t3), corresponding to a response rate of 82.2%. For measuring breast cancer-related complaints, participants completed a written questionnaire. Social participation was measured by a questionnaire on different leisure activities that was taken from the Socio-Economic Panel Study. Medical information was extracted from medical reports at t0. A principal component analysis was carried out to identify different dimensions of social participation. Chi2-tests and logistic regression analyses were applied to analyze social participation as compared to the general population and the role of possible medical and diagnosis-related influencing factors thereby. RESULTS: Compared to the general population, patients show lower levels of social participation in the domains "socio-cultural participation" and "participation in institutions," while no significant differences for "social participation in the private sphere" and "social participation via social media" were found. Psychological symptoms, pain, and a history of mastectomy were most strongly associated with restrictions in social participation. CONCLUSIONS: Our study suggests that social withdrawal may happen due to disease-related symptoms, preventing some breast cancer patients from participating fully in society. Cancer-related follow-ups should address this issue and support patients' reintegration into society through appropriate therapeutic interventions.

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OBJECTIVES: As populations age, the issue of social participation among older adults has gained prominence. Studies indicate variability in social participation trajectories among this demographic, yet the transition patterns and their effects on depression remain unclear. This longitudinal study aims to explore the latent classes and transition patterns in social participation among older adults and to evaluate their effects on depression. METHODS: Data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2014 (T1) and 2018 (T2) were analyzed, including 2293 older adults. Latent class analysis (LCA) and latent transition analysis (LTA) were employed to identify latent classes of social participation at T1 and T2, as well as the transition probabilities between these classes. Multinomial logistic regression was used to examine predictors of transitions, and depression levels at T2 were compared across transition patterns. RESULTS: The LCA results supported a 3-class model labeled as low, moderate, and high social participation. The probabilities of remaining stable and transitioning to other classes were similar across the three classes (ranging from 0.50 to 0.54). Age, gender, and other baseline characteristics emerged as significant predictors of transition patterns. Older adults experiencing positive transitions exhibited reduced depression compared to those in their original class over time, while those with negative transitions showed increased depression. CONCLUSIONS: This research prompts a deep understanding of social participation dynamics in older adults and their effects on depression. Identifying social participation classes and transition patterns could inform interventions to enhance social participation and reduce depression among older adults.

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INTRODUCTION: This study aimed to explore the patterns of association between dual-tasking, cognition, ambulation disability, fatigue, and self-efficacy and their pathways in predicting social participation in persons with multiple sclerosis (MS). METHODS: Adults with MS (n = 1162) completed an online survey. Social participation was assessed by the Quality of Life in Neurological Disorders. The Dual-task Impact on Daily-Living Activities Questionnaire, Multiple Sclerosis Walking Scale-12v2, and Modified Fatigue Impact Scale measured dual-tasking, ambulation, and fatigue, respectively. Fall Efficacy Scale-International and Self-Efficacy for Community Mobility were assessed and modeled as a latent variable for efficacy. RESULTS: The correlation matrix showed significant associations of social participation with dual-tasking, cognition, ambulation, efficacy, and fatigue (all p < 0.001) and interrelationships among the independent variables (p < 0.05). The final model showed excellent global model fit (CFI = 0.99, TLI = 0.96), with all variables significantly predicting social participation either directly or indirectly. Efficacy significantly mediated the effects of dual-tasking (ß=-0.32, p < 0.001) and ambulation disability (ß=-0.42, p < 0.001) on social participation. CONCLUSION: This study indicated that dual-tasking, ambulation disability, fatigue, and efficacy play important roles in social participation in persons with MS. The findings can help provide insight into factors that may underpin social participation and offer targets for interventions in persons with MS.

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Objectives: Social activities are important and influential factors for healthy aging. However, limited information is available regarding the associations of the type and intensity of social participation with health and well-being. This study aimed to investigate how various types of social activities are associated with several dimensions of health outcomes. Methods: This cross-sectional study utilized data from the Seventh Korean Longitudinal Study of Aging, which included 5,526 adults aged 60 years and older. Multivariate linear regression analysis was employed to analyze the associations of social activities with depression, self-rated health, and life satisfaction. Additionally, subgroup analyses by sex and age were performed. Results: Among the participants, 73.5% reported involvement in at least 1 of the 4 types of social engagement. After adjustment for all covariates, individuals who participated in any social activity reported better self-rated health and higher life satisfaction compared to those who did not participate. However, the intensity of engagement in different social activities had varying impacts on subjective health outcomes. An increased level of participation was associated with a lower rate of depression and improved self-rated health. However, no significant differences were observed in the relationship between the intensity of participation in activities (with the exception of alumni societies or family councils) and life satisfaction. Conclusion: This study suggests that to improve their health, older adults in the Republic of Korea should not only engage in social activities but also do so actively and regularly.

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The basic premise of this study is that the traditional method to treating all older people as coming from the same distribution misspecifies the true model and ignores potentially important information in wellbeing outcomes of social participation. Using data from the China Longitudinal Aging Social Survey (CLASS), this paper proposes a finite mixture model (FMM) to identify the heterogeneous relationship between volunteer participation and older people's subjective well-being (SWB) and then explore the determinants of wellbeing heterogeneity in volunteer participation. The results reveal that older people can be classified into two latent subgroups, that is the volunteering beneficiary group (accounting for about 42%) and the volunteering non-beneficiary group (accounting for about 58%). The FMM is therefore more appropriate in estimating the complex impact of volunteering. Rural older people with poorer health, weaker social networks, better economic status, and better community environments are more likely to benefit from volunteer participation. Our findings have suggested some practical implications to increase the probability of benefit from volunteer participation.

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This article analyzes the state of social participation in health in the Region of the Americas, framing it within the regional context and commitments assumed by the Member States of the Pan American Health Organization. It aims to provide regional input to the discussion of a resolution on social participation for universal health coverage, health, and well-being at the 77th World Health Assembly in 2024. In the Americas, social participation has evolved from a utilitarian approach to a fundamental aspect of health system governance, enshrined within legal frameworks and recognized as a citizen's right. Regional resolutions emphasize inclusive policies and intersectoral action to tackle health inequities, meanwhile the World Health Organization handbook on social participation underscores the need for inclusive governance mechanisms and addressing power imbalances. Informed by Member States' recommendations and scientific literature, the article emphasizes the importance of addressing power imbalances, strengthening legal frameworks, and enhancing capacities of governments and populations. It stresses adapting social participation mechanisms to diverse cultural contexts and ensuring meaningful community involvement in decision-making. Finally, the article advocates for a comprehensive approach to social participation grounded in principles of equity, democracy, and human rights; and fundamentally as an essential component of the primary health care approach. It calls for integrating social participation into health system governance, policy dialogues, capacity-building, and evaluation to ensure effective participatory processes.

En este artículo se analiza el estado de la participación social en materia de salud en la Región de las Américas dentro del marco del contexto regional y los compromisos asumidos por los Estados Miembros de la Organización Panamericana de la Salud. El objetivo es proporcionar aportes regionales para las deliberaciones en torno a una resolución sobre la participación social para la cobertura universal de salud, la salud y el bienestar en la 77.a Asamblea Mundial de la Salud en el 2024.En la Región de las Américas, la participación social ha evolucionado de un enfoque utilitarista a ser considerada un aspecto fundamental de la gobernanza de los sistemas de salud, consagrado en los marcos jurídicos y reconocido como un derecho ciudadano. Las resoluciones regionales hacen hincapié en las políticas inclusivas y las medidas intersectoriales para abordar las inequidades en materia de salud, mientras que el manual de la Organización Mundial de la Salud sobre participación social destaca la necesidad de mecanismos de gobernanza inclusivos y el abordaje de los desequilibrios de poder.Basándose en las recomendaciones de los Estados Miembros y la bibliografía científica, el artículo subraya la importancia de abordar los desequilibrios de poder, fortalecer los marcos jurídicos y mejorar las capacidades de los gobiernos y las poblaciones. Hace hincapié en adaptar los mecanismos de participación social a contextos culturales diversos y garantizar una participación trascendente de la comunidad en la toma de decisiones.Por último, el artículo aboga por un enfoque integral de la participación social basado en principios de equidad, democracia y derechos humanos; y, fundamentalmente, como un componente esencial del enfoque de atención primaria de salud. Insta a integrar la participación social en la gobernanza del sistema de salud, los diálogos sobre las políticas, la creación de capacidad y la evaluación para garantizar procesos participativos eficaces.

Este artigo analisa a situação da participação social em saúde na Região das Américas tendo em conta o contexto regional e os compromissos assumidos pelos Estados Membros da Organização Pan-Americana da Saúde. O objetivo é oferecer contribuições regionais para a discussão de uma resolução sobre participação social para cobertura universal de saúde, saúde e bem-estar na 77ª Assembleia Mundial da Saúde, em 2024.Na Região das Américas, a participação social evoluiu, deixando de ser uma abordagem utilitarista para se tornar um aspecto fundamental de governança do sistema de saúde, consagrada por marcos legais e reconhecida como um direito dos cidadãos. As resoluções regionais enfatizam políticas inclusivas e ações intersetoriais para combater iniquidades em saúde, e o manual da Organização Mundial da Saúde sobre participação social ressalta a necessidade de contar com mecanismos inclusivos de governança e abordar desequilíbrios de poder.Com base nas recomendações dos Estados Membros e na literatura científica, o artigo destaca a importância de abordar desequilíbrios de poder, reforçar marcos legais e fortalecer as capacidades dos governos e das populações. Além disso, enfatiza a necessidade de adaptar mecanismos de participação social a diversos contextos culturais e assegurar um envolvimento significativo da comunidade na tomada de decisões.Por fim, o artigo defende uma abordagem abrangente de participação social com base em princípios de equidade, democracia e direitos humanos e, fundamentalmente, como um componente essencial da abordagem de atenção primária em saúde. O artigo urge a integração da participação social na governança do sistema de saúde, em diálogos sobre políticas, no desenvolvimento de capacidades e na avaliação, a fim de assegurar processos participativos efetivos.

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BACKGROUND: Social participation is an important index of rehabilitation and social reintegration in patients after total knee arthroplasty (TKA). However, most existing studies focus on improving patients' functioning and activities, with only a few examining the social participation among patients after TKA. Therefore, the study aims to investigate the heterogeneity of social participation in patients three months after TKA and analyze subgroup influencing factors, to promote functional exercise and postoperative follow-up in specific patients. METHODS: This cross-sectional study recruited 255 patients who underwent TKA in a Tertiary Hospital in Jinan City, China, from March to July 2022. Three months after having undergone TKA, participants' data were collected using the Numeric Pain Rating Scale, the Chinese version of the Tampa Scale of Kinesiophobia, the 10-item Kessler Psychological Distress Scale, Hospital for Special Surgery Knee-rating Scale, and Impact on Participation and Autonomy Questionnaire. Latent profile analysis was used to identify categories of patients' social participation. Multiple logistic regression analysis was used to analyze the influencing factors of the different subgroups. RESULTS: Three months after TKA, the patients were divided into three subgroups: low social participation group (17.9%), moderate social participation group (40.8%), and high social participation group (41.3%). The vast majority of patients who underwent TKA exhibited moderate-to-high level of social participation. The multiple logistic regression analysis results showed that age, degree of pain, knee function, and kinesiophobia were the influencing factors of the potential profiles of social participation in patients three months after TKA (p < 0.05). CONCLUSION: These results support a distinct categorical feature of social participation among patients three months after undergoing TKA. Medical staff need to provide targeted guidance according to the potential classification characteristics of social participation to improve the level of social participation and promote rehabilitation of patients.

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