Examining the relationships between environmental barriers and leisure in community-dwelling individuals living with stroke
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OBJECTIVE:: To characterize environmental barriers to leisure participation among individuals living with stroke; examine relationships between environmental barriers and leisure interest and satisfaction; and investigate participant factors associated with the perception of environmental barriers. DESIGN:: Survey. SETTING:: Community. PARTICIPANTS:: Convenience sample of 51 community-dwelling adults less than six months post stroke. INTERVENTIONS:: Not applicable. MAIN OUTCOME MEASURE(S):: Craig Hospital Inventory of Environmental Factors-Short Form. RESULTS:: Physical and structural environmental barriers were reported as the most frequent and large barrier to leisure participation ( n = 26 (51%) rated as "monthly or more," n = 12 (24%) rated as "big problem"). While attitude and support and policy barriers were not as commonly encountered, participants labeled these as "big problem(s)" (attitude and support n = 6 (12%), policy n = 7 (14%)). The presence of depressive symptoms was associated with the frequency in which attitudinal and support (rho = 0.50, P < 0.001), physical and structural (rho = 0.46, P < 0.001), and service and assistance (rho = 0.28, P = 0.04) barriers were reported, as well as magnitude of attitude and support barriers (rho = 0.48, P < 0.001). In multivariable regression analysis, depressive symptoms and walking capacity explained 21% of the variance of the frequency of attitude and support barriers ( P = 0.004), where depressive symptoms was an independent correlate ( P = 0.004). No other factors were associated with environmental barriers to leisure participation. CONCLUSION:: Individuals with stroke report frequent and large physical and structural environmental barriers to leisure participation, which may be associated with the presence of depressive symptoms.
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