Home setting after stroke, facilitators and barriers: A systematic literature review

Abstract

This paper seeks to improve the understanding of the interaction between patients with stroke and the physical environment in their home settings. Stroke care is increasingly performed in the patient's home. Therefore, a systematic review was conducted to identify the existing knowledge about facilitators and barriers in the physical environment of home settings for the stroke rehabilitation process. Based upon Arksey and O'Malley's framework, a Boolean search strategy was performed in the databases; CINAHL, Medline, Web of Science and Scopus. Fifteen articles were retained from the literature search conducted between August and November 2016, and two researchers independently assessed their quality based on the Swedish Council on Health Technology Assessment guidelines. The results suggest that despite the healthcare system's ongoing shift towards home-based rehabilitation, the role played by the physical environment of home settings is still considered a side finding. Moreover, the research appears to focus mainly on how this environment supports mobility and activities of daily living, whereas information regarding the psychosocial and emotional processes that mediate the interaction between stroke survivors and their home setting are missing. A lack of information was also found with regard to the influence of different geographic locations on the stroke rehabilitation process. Future investigations are therefore needed to advance the understanding of the role played by the physical environment of home settings in supporting stroke recovery.

Technologies to improve the participation of stroke patients in their home environment

“…Despite undergoing rehabilitation in the early post-stroke phases, survivors often experience difficulties in participating in their daily activities at home [3]. An experiential gap between the roles they wish to play and the roles they are able to play in their home environment is common [4]. Technologies may contribute to bridging this gap by helping to increase their participation.…”

Fire Acupuncture versus conventional acupuncture to treat spasticity after stroke: A systematic review and meta-analysis

“…Joint convulsion, deformities, and muscle atrophy caused by stroke always result in clinical symptoms that include motor dysfunction, joint swelling, pain, and numbness. These symptoms reduce a patient's quality of life and produce severe physical, psychological, and economic burdens on patients, leading to depression, low self-esteem, despair, and suicidal thoughts [39,40]. More importantly, stroke survivors may have reduced motivation to pursue rehabilitation training due to spasticity, which, in turn, has negative effects on their recovery outcomes [41,42].…”

Understanding Social Risk Variation Across Reintegration of Post-Ischemic Stroke Patients

“…Moreover, incidence of long-term complications and disabilities can strike up to half of all stroke survivors (11), and they may live with the consequences of stroke for over twenty years (12). Therefore, stroke in young adults has major social and economic impacts as it disables individuals in the peak of their most productive years (13,14). These considerations emphasize the importance of the quality of life, social well-being, as well as unmet clinical needs and adequate support of patients during long-term reintegration (15).…”