New handicap scale for elderly in hospital

A systematic review of instruments assessing participation: challenges in defining participation

OBJECTIVES

To evaluate: (1) whether instruments which intend to measure participation actually do and (2) how frequently specific aspects and domains of participation are addressed.

DATA SOURCES

A systematic search was performed in PubMed.

STUDY SELECTION

Included were patient-reported instruments that primarily aim to measure participation.

DATA EXTRACTION

The full-text instruments were extracted from the articles or obtained from the authors. Two reviewers independently rated each item of the included instruments as measuring participation (yes, no, or undetermined). For each item, the specific aspect and domain of participation were categorized.

DATA SYNTHESIS

Included were 103 instruments (2445 items). Of the included items, 619 items concerned participation and 217 concerned undetermined items. In total, 68 instruments contained at least 1 (sub)scale with 50% or more participation or undetermined items. The participation items referred to the participation aspects: participation problems (53%), participation accomplishment (31%), and satisfaction with participation (9%). The domains of the participation items concerned: work/study (27%), social life (27%), general participation (19%), and home (11%). The undetermined items mainly referred to domains about leisure (43%), transport (26%), and shopping (12%).

CONCLUSIONS

According to our working definition of participation, most instruments that aim to measure participation do so only to a limited extent. These instruments mainly assess aspects of participation problems and participation accomplishment. The domains of participation covered by these instruments primarily include work/study, social life, general participation, home, leisure, transport, and shopping.

Measuring the consequences of osteoarthritis and joint pain in population-based studies: can existing health measurement instruments capture levels of participation?

OBJECTIVE

To identify health measurement instruments to investigate levels of participation associated with joint pain in a population survey questionnaire.

METHOD

A comprehensive electronic search of the published literature was performed to identify potential instruments that could measure participation. All items from identified instruments were assessed for the ability to measure participation by 2 experienced and 2 inexperienced assessors. Agreement was determined in terms of actual agreement (%) and agreement beyond chance (kappa).

RESULTS

Twenty-seven instruments (912 items) were identified. Agreement between the experienced assessors occurred in 86% of items (kappa = 0.70, 95% confidence interval [95% CI] 0.65-0.75) and between the inexperienced assessors in 72% (kappa = 0.40, 95% CI 0.34-0.46). The greatest proportion of participation items in one instrument was 82%.

CONCLUSION

None of the identified instruments consisted entirely of participation items. The concept of participation and its translation into measurement for use in the general population is likely to need further development.