Functional activities and social participation after stroke in rural China: a qualitative study of barriers and facilitators

Objective: To explore the perspectives of stroke survivors in China's rural areas, particularly with respect to environmental barriers and facilitators related to their functional activity and social participation. Design: Qualitative content analysis. A cross-sectional study. Setting: In-depth interviewing in the participants' homes. Subjects: In total, 18 community-dwelling stroke survivors in the rural areas of China. Results: The sub-themes to functional activity and social participation were restricted life-space mobility, reduced daily activities, and shrunken social networks. The main environmental facilitator was family support, which positively affected all facets of the participants' lives, including assistance in daily living, assistance in gaining access to healthcare, and performing environmental modifications. The main barriers involved were physical barriers (toilet barriers, lack of assistive devices, barriers to getting out) and vague and complex regulations. Conclusion: Stroke survivors in rural China experienced environmental barriers mainly including physical barriers and complex regulations. The nuclear family's support is an important environmental facilitator.