Abstract
Objective
To investigate how reengagement in valued activities poststroke is influenced by environmental
factors.
Data Sources
PubMed, CINAHL, and PsycINFO were searched to June 2015 using multiple search terms
for stroke, activities, disability, and home and community environments, with the
following constraints: English, humans, and adults.
Study Selection
Studies were included that contained data on how reengagement in valued activities
of community-dwelling stroke survivors was influenced by the environment. Two reviewers
independently selected the studies. The search yielded 3726 records; 39 studies were
eventually included.
Data Extraction
Findings were extracted from qualitative, quantitative, and mixed-design studies.
Two reviewers independently assessed study quality using the Oxford Critical Appraisal
Skills Programme lists and independently extracted results.
Data Synthesis
Thematic analysis was conducted on qualitative data, revealing 9 themes related to
the iterative nature of the process of reengagement and the associated environmental
factors. During the process of reengagement, environmental factors interact with personal
and disease-related factors in a gradual process of shaping or abandoning valued activities.
The sociocultural context in this case determines what activities are valued and can
be resumed by stroke survivors. Social support; activity opportunities and obligations;
familiar and accessible environments; resources and reminders; and a step-by-step
return facilitate stroke survivors to explore, adapt, resume, and maintain their activities.
Social support is helpful at all stages of the process and particularly is important
in case stroke survivors are fearful to explore their activity possibilities. The
quantitative data identified largely endorsed these findings. No quantitative data
were found in respect to the iterative nature of the process, familiar environments,
or accessibility.
Conclusions
Reengagement in valued activities is a gradual process. In each stage of the process,
several environmental factors play a role. During rehabilitation, professionals should
pay attention to the role physical and social environmental factors have in reengagement
poststroke and find ways to optimize stroke survivors' environments.
Keywords
List of abbreviations:
ICF (International Classification of Functioning, Disability and Health), MeSH (Medical Subject Headings)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 05, 2016
Footnotes
Supported by a HAN University of Applied Sciences PhD scholarship.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
