Housing Accessibility at Home and Rehabilitation Outcomes After a Stroke: An Explorative Study

HERD. 2023 Oct;16(4):172-186. doi: 10.1177/19375867231178313. Epub 2023 Jun 7.

Abstract

Purpose: To explore if aspects of the physical home environment are related to rehabilitation outcomes among community-living persons poststroke.

Background: Research demonstrates that healthcare environments are important for high-quality care and that the design of the physical environment is associated with improved rehabilitation outcomes. However, relevant research focusing on outpatient care settings, such as the home, is sparse.

Methods: In this cross-sectional study, data on rehabilitation outcomes, physical environmental barriers, and housing accessibility problems were collected during home visits of participants (N = 34), 3 months poststroke. Data were analyzed with descriptive statistics and correlation analysis.

Results: Few participants had adapted their homes, and the relevance of the physical environment was not always discussed with the patient during discharge from the hospital. Accessibility problems were associated with suboptimal rehabilitation outcomes such as worse perceived health and recovery after stroke. Activities most restricted by barriers in the home concerned hand and arm use. Participants who reported one or more falls at home tended to live in houses with more accessibility problems. Perceived supportive home environments were associated with more accessible dwellings.

Conclusions: Many face problems adapting their home environments poststroke, and our findings highlight unmet needs that should be considered in the rehabilitation practice. These findings could be used by architectural planners and health practitioners for more effective housing planning and inclusive environments.

Keywords: built environment; person–environment fit; rehabilitation; shared–decision making; stroke.

MeSH terms

  • Architectural Accessibility
  • Cross-Sectional Studies
  • Housing
  • Humans
  • Stroke Rehabilitation*
  • Stroke*
  • Treatment Outcome