Exploring the social participation needs and peer support engagement willingness of stroke patients: a qualitative study

Background Stroke survivors face restricted social participation, yet their hierarchical needs and acceptance of peer support have been insufficiently explored. Aims This qualitative study sought to examine the social participation difficulties, hierarchical rehabilitation needs, and willingness to engage in peer support among stroke patients, grounded in Maslow's hierarchy of needs theory. Methods Semi-structured interviews were conducted with 15 stable-phase stroke patients (mean age 68.5 years; 73% aged ≥ 65 years) recruited from a hospital between March and May 2026. Data were analysed using Colaizzi's seven-step phenomenological method. Results Five themes and 19 subthemes emerged: (1) changes in and adaptation to social roles; (2) multidimensional barriers to social participation; (3) ways and strategies for overcoming difficulties; (4) diversified social participation needs; (5) perceptions, willingness, and preferences regarding peer support. Eleven of 15 participants expressed willingness to join peer support, though preferences for format, content, and peer characteristics varied. Conclusions Based on Maslow’s hierarchy of needs, this qualitative study shows stroke survivors’ social participation needs are complex, hierarchical and dynamic. Intertwined physical, psychological, environmental and socioeconomic barriers limit their social engagement, while their rehabilitation needs advance from basic safety and physiological needs to higher-level needs of belonging, self-esteem and self-actualisation. Peer support was broadly acceptable but requires individualization in format, content, and peer matching. A patient-centred hierarchical intervention combining peer support with family and community care is suggested. Better policies and community environments can narrow disparities to promote survivors’ community reintegration and quality of life.