Article

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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS