Facilitators and barriers of life-space mobility in older adults with ischemic stroke: a descriptive qualitative study based on the COM-B
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Introduction Older adults with ischemic stroke are particularly vulnerable to restricted life-space mobility, which is linked to adverse health outcomes. This study aimed to explore facilitators and barriers of life-space mobility among older adults with ischemic stroke using the COM-B model and to inform the development of targeted interventions. Methods A descriptive qualitative design was adopted. Semi-structured, face-to-face interviews were conducted from June to September 2025 at the Hospital of Jiangnan University. Purposive maximum variation sampling was used to recruit 28 participants, including older adults with ischemic stroke and their caregivers. The interview guide was informed by the COM-B model, and data were analyzed using thematic analysis and mapped onto COM-B domains. This study was reported in accordance with the COREQ Checklist. Result Factors associated with life-space mobility in older adults with ischemic stroke were categorized using the COM-B model: (1) capability factors, reflecting the influence of physical and psychological capability, including symptom burden, lack of knowledge, positive self-perception, and impaired self-determination; (2) opportunity factors, reflecting the influence of social and environmental opportunities, including family support, overprotective caregiving, social withdrawal, inadequate assistive-device and mobility support and environmental barriers; and (3) motivation factors, reflecting the influence of reflective and a
Abstract
Introduction Older adults with ischemic stroke are particularly vulnerable to restricted life-space mobility, which is linked to adverse health outcomes. This study aimed to explore facilitators and barriers of life-space mobility among older adults with ischemic stroke using the COM-B model and to inform the development of targeted interventions. Methods A descriptive qualitative design was adopted. Semi-structured, face-to-face interviews were conducted from June to September 2025 at the Hospital of Jiangnan University. Purposive maximum variation sampling was used to recruit 28 participants, including older adults with ischemic stroke and their caregivers. The interview guide was informed by the COM-B model, and data were analyzed using thematic analysis and mapped onto COM-B domains. This study was reported in accordance with the COREQ Checklist. Result Factors associated with life-space mobility in older adults with ischemic stroke were categorized using the COM-B model: (1) capability factors, reflecting the influence of physical and psychological capability, including symptom burden, lack of knowledge, positive self-perception, and impaired self-determination; (2) opportunity factors, reflecting the influence of social and environmental opportunities, including family support, overprotective caregiving, social withdrawal, inadequate assistive-device and mobility support and environmental barriers; and (3) motivation factors, reflecting the influence of reflective and automatic motivation, including lack of motivation, fear of falling, and Self-limiting habits. Conclusion This study applied of the COM-B model to identified the complex and multidimensional factors that influence life-space mobility in older adults with ischemic stroke, while also revealing the influence of the Chinese sociocultural context on life-space mobility in this population. These findings provide a basis for the design of comprehensive, targeted interventions across the capability, opportunity, and motivation domains to improve life-space mobility in older adults with ischemic stroke.