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Title: Examining the relationships between environmental barriers and leisure in community-dwelling individuals living with stroke
Authors: Tang, A
Sun, B
Pang, MYC 
Harris, JE
Issue Date: 1-Apr-2019
Source: Clinical rehabilitation, 1 Apr. 2019, v. 33, no. 4, p. 796-804
Abstract: 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.
Keywords: Depression
Leisure activities
Publisher: SAGE Publications
Journal: Clinical rehabilitation 
ISSN: 0269-2155
EISSN: 1477-0873
DOI: 10.1177/0269215518818234
Rights: This is the accepted version of the publication Tang, Ada, et al. “Examining the Relationships between Environmental Barriers and Leisure in Community-Dwelling Individuals Living with Stroke.” Clinical Rehabilitation, vol. 33, no. 4, Apr. 2019, pp. 796–804. Copyright © 2018 (The Author(s)). DOI: 10.1177/0269215518818234.
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