Article

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.

Langue : ANGLAIS