Cawood Judy, Visagie Surona
Centre for Rehabilitation studies, Stellenbosch University, South Africa.
Afr J Disabil. 2015 Oct 30;4(1):198. doi: 10.4102/ajod.v4i1.198. eCollection 2015.
Environmental factors compound or diminish the effects of impairments; therefore they have a direct influence on participation of stroke survivors.
To determine environmental barriers and facilitators to participation experienced by a group of stroke survivors in the Western Cape province of South Africa.
A descriptive, mixed methods study was conducted in 2011. Quantitative data was collected with the core set for stroke (environmental factors), from 53 stroke survivors, sampled through proportional, stratified, random sampling. Data is presented through graphs and tables. Qualitative data was collected from five purposively sampled participants and thematically analysed.
Under products and technology, participants regarded assets, food, products and technology for daily living, transportation, mobility and communication, and access to buildings as barriers. The physical geography and attitudes of friends and society created further barriers. With regard to services, systems and policies - housing, communication, transport and social services created barriers. Health services, as well as support from health care service providers and family were considered facilitators.
A lack of assets compounded barriers with regard to food, products for daily use, communication and transport. Barriers to participation were exacerbated by a lack of services, systems and implementation of policies focused on the inclusion of people with disabilities, as well as minimal access to assistive devices. Recommendations include provision of assistive devices, structural changes to houses, yards, roads and buildings, lobbying for accessible, affordable public transport, access audits of public buildings, and inclusion of non-governmental organisations and home-based care services in a seamless network of care.
环境因素会加重或减轻损伤的影响；因此，它们对中风幸存者的参与有直接影响。
确定南非西开普省一组中风幸存者参与活动时遇到的环境障碍和促进因素。
2011年进行了一项描述性混合方法研究。通过按比例分层随机抽样，从53名中风幸存者那里收集了中风核心数据集（环境因素）的定量数据。数据通过图表呈现。从五名有目的抽样的参与者那里收集了定性数据并进行了主题分析。
在产品和技术方面，参与者认为资产、食品、日常生活用品和技术、交通、出行和通信以及建筑物的可达性是障碍。自然地理环境以及朋友和社会的态度造成了更多障碍。在服务、系统和政策方面，住房、通信、交通和社会服务构成了障碍。卫生服务以及医疗服务提供者和家庭的支持被视为促进因素。
资产匮乏加剧了在食品、日常用品、通信和交通方面的障碍。由于缺乏侧重于残疾人融入的服务、系统和政策实施，以及辅助设备的获取极少，参与障碍进一步加剧。建议包括提供辅助设备、对房屋、院子、道路和建筑物进行结构改造、游说提供无障碍且价格合理的公共交通、对公共建筑进行可达性审计，以及将非政府组织和居家护理服务纳入无缝护理网络。
