2022, Article / Letter to editor (Ergotherapie Magazine, vol. 4, (2022), pp. 43-48)Sommige cliënten die ergotherapeut Sandra Jellema tegenkwam waren onnodig inactief. Ze besloot
promotieonderzoek te doen naar de invloed van de fysieke, sociale en maatschappelijke omgeving
op de waardevolle activiteiten van volwassenen die een CVA doormaakten. Ook zoomde ze in op
de invloed die het sociale netwerk heeft op participatie. Dit artikel is een samenvatting van haar
proefschrift.
2022, Article / Letter to editor (Ergotherapie Magazine, vol. 4, (2022), pp. 9-12)Mensen hebben na een beroerte vaak veel geleerd in een revalidatiecentrum. Ze raken dat echter ook
gemakkelijk weer kwijt in de thuissituatie. Hoe kan dat? En wat is de invloed van de omgeving op het
weer oppakken van het leven na een beroerte? Die vragen onderzocht ergotherapeut en onderzoeker
Sandra Jellema in haar promotieonderzoek. Tipje van de sluier: vooral iemands netwerk blijkt erg
belangrijk. Jellema: “Als je doel als ergotherapeut is om participatie mogelijk te maken, dan is de
sociale omgeving een belangrijke knop om aan te draaien.”
2017, Article / Letter to editor (Clinical Rehabilitation, vol. 31, iss. 7, (2017), pp. 936-947)Objective: Identify the environmental factors that influence stroke-survivors' reengagement in personally valued activities and determine what specific environmental factors are related to specific valued activity types. Data sources: PubMed, CINAHL and PsycINFO were searched until June 2016 using multiple search-terms for stroke, activities, disability, and home and community environments. Review methods: An integrated mixed-method systematic review of qualitative, quantitative and mixed-design studies was conducted. Two researchers independently identified relevant studies, assessed their methodological quality and extracted relevant findings. To validly compare and combine the various findings, all findings were classified and grouped by environmental category and level of evidence. Results: The search yielded 4024 records; 69 studies were included. Most findings came from low-evidence-level studies such as single qualitative studies. All findings were consistent in that the following factors facilitated reengagement post-stroke: personal adapted equipment; accessible environments; transport; services; education and information. Barriers were: others' negative attitudes and behaviour; long distances and inconvenient environmental conditions (such as bad weather). Each type of valued activity, such as mobility or work, had its own pattern of environmental influences, social support was a facilitator to all types of activities. Although in many qualitative studies others' attitudes, behaviour and stroke-related knowledge were seen as important for reengagement, these factors were hardly studied quantitatively. Conclusion: A diversity of environmental factors was related to stroke-survivors' reengagement. Most findings came from low-evidence-level studies so that evidence on causal relationships was scarce. In future, more higher-level-evidence studies, for example on the attitudes of significant others, should be conducted.
2016, Article / Letter to editor (Archives of Physical Medicine and Rehabilitation, vol. 97, iss. 6, (2016), pp. 991-1002)Objective: To investigate how reengagement in valued activities poststroke is influenced by environmental factors. Data Sources: PubMed, CINAHL, and PsycINFO were searched to June 2015 using multiple search terms for stroke, activities, disability, and home and community environments, with the following constraints: English, humans, and adults. Study Selection: Studies were included that contained data on how reengagement in valued activities of community-dwelling stroke survivors was influenced by the environment. Two reviewers independently selected the studies. The search yielded 3726 records; 39 studies were eventually included. Data Extraction: Findings were extracted from qualitative, quantitative, and mixed-design studies. Two reviewers independently assessed study quality using the Oxford Critical Appraisal Skills Programme lists and independently extracted results. Data Synthesis: Thematic analysis was conducted on qualitative data, revealing 9 themes related to the iterative nature of the process of reengagement and the associated environmental factors. During the process of reengagement, environmental factors interact with personal and disease-related factors in a gradual process of shaping or abandoning valued activities. The sociocultural context in this case determines what activities are valued and can be resumed by stroke survivors. Social support; activity opportunities and obligations; familiar and accessible environments; resources and reminders; and a step-by-step return facilitate stroke survivors to explore, adapt, resume, and maintain their activities. Social support is helpful at all stages of the process and particularly is important in case stroke survivors are fearful to explore their activity possibilities. The quantitative data identified largely endorsed these findings. No quantitative data were found in respect to the iterative nature of the process, familiar environments, or accessibility. Conclusions: Reengagement in valued activities is a gradual process. In each stage of the process, several environmental factors play a role. During rehabilitation, professionals should pay attention to the role physical and social environmental factors have in reengagement poststroke and find ways to optimize stroke survivors' environments. (C) 2016 by the American Congress of Rehabilitation Medicine