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What environmental factors influence resumption of valued activities post stroke: a systematic review of qualitative and quantitative findings.

Abstract：

OBJECTIVE:Identify the environmental factors that influence stroke-survivors' reengagement in personally valued activities and determine what specific environmental factors are related to specific valued activity types. DATA SOURCES:PubMed, CINAHL and PsycINFO were searched until June 2016 using multiple search-terms for stroke, activities, disability, and home and community environments. REVIEW METHODS:An integrated mixed-method systematic review of qualitative, quantitative and mixed-design studies was conducted. Two researchers independently identified relevant studies, assessed their methodological quality and extracted relevant findings. To validly compare and combine the various findings, all findings were classified and grouped by environmental category and level of evidence. RESULTS:The search yielded 4024 records; 69 studies were included. Most findings came from low-evidence-level studies such as single qualitative studies. All findings were consistent in that the following factors facilitated reengagement post-stroke: personal adapted equipment; accessible environments; transport; services; education and information. Barriers were: others' negative attitudes and behaviour; long distances and inconvenient environmental conditions (such as bad weather). Each type of valued activity, such as mobility or work, had its own pattern of environmental influences, social support was a facilitator to all types of activities. Although in many qualitative studies others' attitudes, behaviour and stroke-related knowledge were seen as important for reengagement, these factors were hardly studied quantitatively. CONCLUSION:A diversity of environmental factors was related to stroke-survivors' reengagement. Most findings came from low-evidence-level studies so that evidence on causal relationships was scarce. In future, more higher-level-evidence studies, for example on the attitudes of significant others, should be conducted.

journal_name

Clin Rehabil

journal_title

Clinical rehabilitation

authors

Jellema S,van Hees S,Zajec J,van der Sande R,Nijhuis-van der Sanden MW,Steultjens EM

doi

10.1177/0269215516671013

subject

Has Abstract

pub_date

2017-07-01 00:00:00

pages

936-947

issue

eissn

0269-2155

issn

1477-0873

pii

0269215516671013

journal_volume

pub_type

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What environmental factors influence resumption of valued activities post stroke: a systematic review of qualitative and quantitative findings.