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

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Title: Stakeholder Perspectives on Built Environmental Factors to Support Stroke Rehabilitation and Return to Everyday Life.
Authors: de Vries L; School of Health and Welfare, Dalarna University, Falun, Sweden., Kylén M; School of Health and Welfare, Dalarna University, Falun, Sweden.; Faculty of Health Science, Kristianstad University, Kristianstad, Sweden., Svensson T; School of Information and Engineering, Dalarna University, Falun, Sweden.; Urban and Regional Studies, Royal Institute of Technology, KTH, Stockholm, Sweden., Sturge J; Department of Design, Production and Management, Faculty of Engineering Technology, University of Twente, Enschede, the Netherlands., Lipson-Smith R; The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, Australia.; The Florey Institute of Neuroscience and Mental Health, Parkville, Australia., Schmidt SM; Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden., Pessah-Rasmussen H; Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, Malmö, Sweden.; Department of Clinical Sciences Lund, Lund University, Lund, Sweden., Elf M; School of Health and Welfare, Dalarna University, Falun, Sweden.
Source: Health expectations : an international journal of public participation in health care and health policy [Health Expect] 2025 Aug; Vol. 28 (4), pp. e70339.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Wiley Country of Publication: England NLM ID: 9815926 Publication Model: Print Cited Medium: Internet ISSN: 1369-7625 (Electronic) Linking ISSN: 13696513 NLM ISO Abbreviation: Health Expect Subsets: MEDLINE
Imprint Name(s): Original Publication: Oxford, UK : Wiley, c1998-
MeSH Terms: Stroke Rehabilitation*/methods , Built Environment* , Stakeholder Participation*, Humans ; Male ; Female ; Middle Aged ; Qualitative Research ; Adult ; Aged ; Interviews as Topic ; Neighborhood Characteristics ; Social Participation ; Environment Design
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 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.
(© 2025 The Author(s). Health Expectations published by John Wiley & Sons Ltd.)
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Grant Information: This study was supported by a FORMAS grant number 2021-01455.
Contributed Indexing: Keywords: built environment; home rehabilitation; life after stroke; person‐centred; qualitative method; rehabilitation process; stroke recovery
Entry Date(s): Date Created: 20250702 Date Completed: 20250702 Latest Revision: 20250704
Update Code: 20250704
PubMed Central ID: PMC12215816
DOI: 10.1111/hex.70339
PMID: 40600503
Database: MEDLINE
Description
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.<br />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.<br />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.<br />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.<br />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.<br />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.<br /> (© 2025 The Author(s). Health Expectations published by John Wiley & Sons Ltd.)
ISSN:1369-7625
DOI:10.1111/hex.70339