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Stakeholder Perspectives on Built Environmental Factors to Support Stroke Rehabilitation and Return to Everyday Life

de Vries, Laila ; Kylén, Maya LU orcid ; Svensson, Tony ; Sturge, Jodi ; Lipson-Smith, Ruby ; Schmidt, Steven M LU orcid ; Pessah-Rasmussen, Hélène LU and Elf, Marie (2025) In Health Expectations 28(4).
Abstract

BACKGROUND: The transition to undertaking rehabilitation in the home or local neighbourhood calls for an extensive understanding of which aspects of the built environment are important for people with stroke.

OBJECTIVE: This qualitative study aims to explore how home and local neighbourhood environments support or hinder rehabilitation for people who have had a stroke from the perspectives of various stakeholders.

METHODS: Through a purposive selection method, data were collected through semi-structured interviews with 16 stakeholders: people with stroke (n = 3), significant others (n = 3), healthcare professionals (n = 4), care managers (n = 3) and architects (n = 3). Content analysis was used to identify patterns and... (More)

BACKGROUND: The transition to undertaking rehabilitation in the home or local neighbourhood calls for an extensive understanding of which aspects of the built environment are important for people with stroke.

OBJECTIVE: This qualitative study aims to explore how home and local neighbourhood environments support or hinder rehabilitation for people who have had a stroke from the perspectives of various stakeholders.

METHODS: Through a purposive selection method, data were collected through semi-structured interviews with 16 stakeholders: people with stroke (n = 3), significant others (n = 3), healthcare professionals (n = 4), care managers (n = 3) and architects (n = 3). Content analysis was used to identify patterns and create themes.

FINDINGS: Sixteen stakeholders, including 12 women and 4 men aged 30-74, participated in this study. Our findings identify areas linked to the WHO age-friendly environment framework, which addresses environmental limitations relevant to stroke rehabilitation. The categories used and factors identified: (1) Outdoor environments: accessibility, safety and supportiveness. (2) Transport and mobility: accessible and reach central services. (3) Housing: adaptations, layout and accessibility. (4) Social participation: spaces that are varied and flexible. (5) Social inclusion and non-discrimination: shared decision-making. (6) Civic engagement and employment: supporting environments. (7) Communication and information: digital accessibility. (8) Community and health services: patient-centred approach and access to varied rehabilitation.

CONCLUSION: This study brings together multiple perspectives from key stakeholders with experience within stroke care. By integrating insights, these findings highlight how built environmental factors in the home and local neighbourhood can support the transition to home-based rehabilitation, which can improve recovery and return to everyday life. In turn, this study contributes to the innovative development of home and neighbourhood environments to influence and support stroke rehabilitation. Linking the findings to the WHO framework increases our understanding of a supportive environment for people with stroke, but also for people with other long-term conditions.

PATIENT OR PUBLIC CONTRIBUTION: This qualitative study is part of a comprehensive research project '(Built Environments to support rehabilitation for people with stroke, B-SURE)', which aims to investigate how factors in the built environment influence stroke rehabilitation and to develop built environment solutions. B-SURE has a participatory methodology that essentially includes and involves the stakeholders in the multiple stages of the study and ensures an iterative and collaborative process.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Stroke Rehabilitation/methods, Male, Female, Middle Aged, Qualitative Research, Adult, Aged, Built Environment, Stakeholder Participation, Interviews as Topic, Neighborhood Characteristics, Social Participation, Environment Design
in
Health Expectations
volume
28
issue
4
article number
e70339
publisher
Wiley-Blackwell
external identifiers
  • pmid:40600503
ISSN
1369-6513
DOI
10.1111/hex.70339
language
English
LU publication?
yes
additional info
© 2025 The Author(s). Health Expectations published by John Wiley & Sons Ltd.
id
d079143c-32ac-43dd-a23b-f4893340c9cc
date added to LUP
2025-07-07 13:12:35
date last changed
2025-07-09 07:46:15
@article{d079143c-32ac-43dd-a23b-f4893340c9cc,
  abstract     = {{<p>BACKGROUND: The transition to undertaking rehabilitation in the home or local neighbourhood calls for an extensive understanding of which aspects of the built environment are important for people with stroke.</p><p>OBJECTIVE: This qualitative study aims to explore how home and local neighbourhood environments support or hinder rehabilitation for people who have had a stroke from the perspectives of various stakeholders.</p><p>METHODS: Through a purposive selection method, data were collected through semi-structured interviews with 16 stakeholders: people with stroke (n = 3), significant others (n = 3), healthcare professionals (n = 4), care managers (n = 3) and architects (n = 3). Content analysis was used to identify patterns and create themes.</p><p>FINDINGS: Sixteen stakeholders, including 12 women and 4 men aged 30-74, participated in this study. Our findings identify areas linked to the WHO age-friendly environment framework, which addresses environmental limitations relevant to stroke rehabilitation. The categories used and factors identified: (1) Outdoor environments: accessibility, safety and supportiveness. (2) Transport and mobility: accessible and reach central services. (3) Housing: adaptations, layout and accessibility. (4) Social participation: spaces that are varied and flexible. (5) Social inclusion and non-discrimination: shared decision-making. (6) Civic engagement and employment: supporting environments. (7) Communication and information: digital accessibility. (8) Community and health services: patient-centred approach and access to varied rehabilitation.</p><p>CONCLUSION: This study brings together multiple perspectives from key stakeholders with experience within stroke care. By integrating insights, these findings highlight how built environmental factors in the home and local neighbourhood can support the transition to home-based rehabilitation, which can improve recovery and return to everyday life. In turn, this study contributes to the innovative development of home and neighbourhood environments to influence and support stroke rehabilitation. Linking the findings to the WHO framework increases our understanding of a supportive environment for people with stroke, but also for people with other long-term conditions.</p><p>PATIENT OR PUBLIC CONTRIBUTION: This qualitative study is part of a comprehensive research project '(Built Environments to support rehabilitation for people with stroke, B-SURE)', which aims to investigate how factors in the built environment influence stroke rehabilitation and to develop built environment solutions. B-SURE has a participatory methodology that essentially includes and involves the stakeholders in the multiple stages of the study and ensures an iterative and collaborative process.</p>}},
  author       = {{de Vries, Laila and Kylén, Maya and Svensson, Tony and Sturge, Jodi and Lipson-Smith, Ruby and Schmidt, Steven M and Pessah-Rasmussen, Hélène and Elf, Marie}},
  issn         = {{1369-6513}},
  keywords     = {{Humans; Stroke Rehabilitation/methods; Male; Female; Middle Aged; Qualitative Research; Adult; Aged; Built Environment; Stakeholder Participation; Interviews as Topic; Neighborhood Characteristics; Social Participation; Environment Design}},
  language     = {{eng}},
  number       = {{4}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Health Expectations}},
  title        = {{Stakeholder Perspectives on Built Environmental Factors to Support Stroke Rehabilitation and Return to Everyday Life}},
  url          = {{http://dx.doi.org/10.1111/hex.70339}},
  doi          = {{10.1111/hex.70339}},
  volume       = {{28}},
  year         = {{2025}},
}