Patterns of participation

Facilitating and hindering aspects related to places for activities outside the home after stroke

Document identifier:
Access full text here:10.1080/11038128.2019.1668958
Keyword: Medical and Health Sciences, Health Sciences, Occupational Therapy, Medicin och hälsovetenskap, Hälsovetenskaper, Arbetsterapi, Activities of daily living, Participation, Places, Society, Stroke, Occupational therapy
Publication year: 2020
Relevant Sustainable Development Goals (SDGs):
SDG 3 Good health and wellbeing
The SDG label(s) above have been assigned by


Background: Being engaged in activities in places outside the home after a stroke can be challenging. Knowledge about what characterize places outside the home is important to support participation.

Objectives: To explore patterns of participation in places for activities outside the home after stroke and whether these patterns were associated with personal and environmental aspects.

Material and methods: Sixty-three people with stroke were interviewed using the Participation in Activities and Places Outside Home (ACT-OUT) questionnaire. A two-step cluster analysis was used to identify patterns of participation and non-parametric test was used to explore potential associations to the patterns of participation.

Results: Four clusters of patterns of participation, based on frequency, familiarity of the place/the way to the place and perceived distance, were identified. The patterns were significantly associated with type of place, activity domain, retained or abandoned participation, transportation and being accompanied by someone. The severity of disability was significantly associated with groups of individuals with different patterns of participation.

Conclusions: Different combinations of aspects facilitated and hindered whether or not participation changed. To support people with stroke in their endeavour to retain or recapture participation, social support is important to consider in relation to transportation, activities and places outside the home.


Camilla Malinowsky

Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), Karolinska Institutet, Stockholm, Sweden
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Alexandra Olofsson

Luleå tekniska universitet; Hälsa och rehabilitering
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Anneli Nyman

Luleå tekniska universitet; Hälsa och rehabilitering
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Maria Larsson-Lund

Luleå tekniska universitet; Hälsa och rehabilitering
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