Social Isolation and Physical Barriers in the Houses of Stroke Survivors in Rural China

Arch Phys Med Rehabil. 2016 Dec;97(12):2054-2060. doi: 10.1016/j.apmr.2016.07.007. Epub 2016 Jul 30.

Abstract

Objective: To describe the home barriers and social isolation of stroke survivors in the rural areas of China and to explore which home barriers are associated with social isolation.

Design: Cross-sectional survey.

Setting: Structured interviews and observation in the participants' homes.

Participants: Community-dwelling stroke survivors in the rural areas of China (N=818).

Interventions: Not applicable.

Main outcome measures: Physical barriers in rural homes were surveyed using a home fall hazards assessment. Social isolation was identified if ≥2 of the following indicators were observed: low frequency of getting out of the home, lacking leisure activities, and living alone in the previous 3 months.

Results: The prevalence rates of 18 among 30 home barriers were >20%, and the highest was 93% (lack of handrails in the bathroom). The prevalence of social isolation was 30%. Three home barriers were independently related to social isolation. These were a distant toilet (odds ratio [OR], 2.363; 95% confidence interval [CI], 1.527-3.658; P<.001), unsuitable seating (OR, 1.571; 95% CI, 1.026-2.404; P=.038), and inaccessible light switches (OR, 1.572; 95% CI, 1.064-2.324; P=.023).

Conclusions: Many barriers exist in the houses of stroke survivors in rural China. Some of them are related to social isolation. Eliminating or decreasing home barriers could be a feasible and effective approach to reducing social isolation.

Keywords: Architectural accessibility; China; Environment; Rehabilitation; Social isolation; Stroke.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Architectural Accessibility / statistics & numerical data
  • China
  • Cross-Sectional Studies
  • Female
  • Housing / statistics & numerical data*
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Mobility Limitation
  • Quality of Life
  • Residence Characteristics / statistics & numerical data
  • Rural Population / statistics & numerical data*
  • Self Care
  • Social Isolation / psychology*
  • Socioeconomic Factors
  • Stroke / epidemiology*
  • Stroke / psychology*
  • Survivors / psychology