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Terwee CB, Elders PJM, Blom MT, Beulens JW, Rolandsson O, Rogge AA, Rose M, Harman N, Williamson PR, Pouwer F, Mokkink LB, Rutters F. Patient-reported outcomes for people with diabetes: what and how to measure? A narrative review. Diabetologia 2023; 66:1357-1377. [PMID: 37222772 PMCID: PMC10317894 DOI: 10.1007/s00125-023-05926-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/03/2023] [Indexed: 05/25/2023]
Abstract
Patient-reported outcomes (PROs) are valuable for shared decision making and research. Patient-reported outcome measures (PROMs) are questionnaires used to measure PROs, such as health-related quality of life (HRQL). Although core outcome sets for trials and clinical practice have been developed separately, they, as well as other initiatives, recommend different PROs and PROMs. In research and clinical practice, different PROMs are used (some generic, some disease-specific), which measure many different things. This is a threat to the validity of research and clinical findings in the field of diabetes. In this narrative review, we aim to provide recommendations for the selection of relevant PROs and psychometrically sound PROMs for people with diabetes for use in clinical practice and research. Based on a general conceptual framework of PROs, we suggest that relevant PROs to measure in people with diabetes are: disease-specific symptoms (e.g. worries about hypoglycaemia and diabetes distress), general symptoms (e.g. fatigue and depression), functional status, general health perceptions and overall quality of life. Generic PROMs such as the 36-Item Short Form Health Survey (SF-36), WHO Disability Assessment Schedule (WHODAS 2.0), or Patient-Reported Outcomes Measurement Information System (PROMIS) measures could be considered to measure commonly relevant PROs, supplemented with disease-specific PROMs where needed. However, none of the existing diabetes-specific PROM scales has been sufficiently validated, although the Diabetes Symptom Self-Care Inventory (DSSCI) for measuring diabetes-specific symptoms and the Diabetes Distress Scale (DDS) and Problem Areas in Diabetes (PAID) for measuring distress showed sufficient content validity. Standardisation and use of relevant PROs and psychometrically sound PROMs can help inform people with diabetes about the expected course of disease and treatment, for shared decision making, to monitor outcomes and to improve healthcare. We recommend further validation studies of diabetes-specific PROMs that have sufficient content validity for measuring disease-specific symptoms and consider generic item banks developed based on item response theory for measuring commonly relevant PROs.
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Affiliation(s)
- Caroline B Terwee
- Amsterdam UMC, Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Methodology, Amsterdam, the Netherlands.
| | - Petra J M Elders
- Amsterdam Public Health Research Institute, Methodology, Amsterdam, the Netherlands
- Amsterdam UMC, Department of General Practice, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marieke T Blom
- Amsterdam Public Health Research Institute, Methodology, Amsterdam, the Netherlands
| | - Joline W Beulens
- Amsterdam UMC, Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Olaf Rolandsson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Alize A Rogge
- Center for Patient-Centered Outcomes Research, Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Rose
- Center for Patient-Centered Outcomes Research, Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nicola Harman
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Paula R Williamson
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Frans Pouwer
- Steno Diabetes Center Odense, Odense, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Amsterdam UMC, Department of Medical Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Lidwine B Mokkink
- Amsterdam UMC, Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Methodology, Amsterdam, the Netherlands
| | - Femke Rutters
- Amsterdam UMC, Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Ackermans T, Tytgat H, Beaucage-Gauvreau E, Severijns P, Overbergh T, van de Loock K, Schelfaut S, Zabjek K, Scheys L, Moke L. Applying the ICF model in adult spinal deformity: disability in terms of participation should be incorporated in the care pathway. Spine Deform 2023; 11:433-438. [PMID: 36260208 DOI: 10.1007/s43390-022-00598-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/28/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the participation restriction of adult spinal deformity (ASD) patients, and its relation with the impairments in body structure and function, and activity limitation, as this important information regarding the individual's perspective on the social impact of the disease on their life is presently not captured. METHODS Forty-three ASD patients participated in the study and completed the impact on participation and autonomy (IPA) questionnaire to assess the level of participation. Activity limitations and impairments were measured with the Balance Evaluation Systems Test (BESTest) and Scoliosis Research Society-22r (SRS-22). Also, age, body height, body weight, BMI, Mini-mental state examination and Cumulative Illness Rating Scale were assessed. A univariate linear regression analysis was conducted to investigate the relationship between the IPA and the independent variables, whereas a multivariate analysis identified the significant predictive variables for the IPA questionnaire. RESULTS The univariate analysis identified performance on the BESTest and SRS-22 as significantly (p < 0.001) related to the IPA questionnaire. The multiple regression analysis revealed that the performance on BESTest (p = 0.073) and SRS-22 (p < 0.001) independently predicted the IPA questionnaire, explaining 73.5% of its variance. CONCLUSION To fully understand the impact of ASD on the individual's functioning, disability and health-status, it is suggested that questionnaires on participation to society should be considered, together with clinical postural tests (e.g. the BESTest) and questionnaires related to HRQOL (e.g. the SRS-22), in the ASD care path. This additional information should allow the surgeon to make a more informed selection of surgical patients.
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Affiliation(s)
- Thijs Ackermans
- Institute for Orthopaedic Research and Training (IORT), Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Hannes Tytgat
- Institute for Orthopaedic Research and Training (IORT), Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Erica Beaucage-Gauvreau
- Institute for Orthopaedic Research and Training (IORT), Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Pieter Severijns
- Institute for Orthopaedic Research and Training (IORT), Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.,Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Thomas Overbergh
- Institute for Orthopaedic Research and Training (IORT), Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | | | | | - Karl Zabjek
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lennart Scheys
- Institute for Orthopaedic Research and Training (IORT), Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.,Division of Orthopaedics, University Hospitals Leuven, Leuven, Belgium
| | - Lieven Moke
- Institute for Orthopaedic Research and Training (IORT), Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.,Division of Orthopaedics, University Hospitals Leuven, Leuven, Belgium
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O'Hoski S, Kuspinar A, Richardson J, Wald J, Goldstein R, Beauchamp MK. Responsiveness of the late life disability instrument to pulmonary rehabilitation in people with COPD. Respir Med 2023; 207:107113. [PMID: 36608861 DOI: 10.1016/j.rmed.2023.107113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/30/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
PURPOSE To establish the responsiveness of the disability component of the Late Life Function and Disability Instrument (LLDI) and its Computer Adaptive Test (LLDI-CAT) in people with chronic obstructive pulmonary disease (COPD). METHOD Participants completed the LLDI, LLDI-CAT and measures of physical function, health-related quality of life (HRQOL) and symptom severity before and after pulmonary rehabilitation (PR), and global rating of change (GRC) scales at the end of PR. Responsiveness was explored by calculating correlations between LLDI and LLDI-CAT change scores and change scores on the other measures, and calculating the area under the receiver operating characteristic curve (AUC) for the ability of the LLDI and LLDI-CAT to discriminate between participants who were improved versus unchanged. We hypothesized fair correlations (-0.3 to -0.5 or 0.3 to 0.5) with other measures and considered an AUC≥0.7 acceptable. Minimal important differences (MIDs) were estimated using anchor- and distribution-based approaches. RESULTS Fifty participants (mean (SD) age 69.8 (7.9) years) completed the study. Only the limitation dimension of the LLDI showed improvement at follow-up (z = 2.4, p = 0.018) and was able to discriminate between participants who were improved versus unchanged (AUC 0.7 (95% CI 0.6-0.9)). Correlations between change scores were as hypothesized between the participation measures and measures of at least two other constructs. CONCLUSION This study provides MID values for the LLDI and LLDI-CAT to support their clinical application. The limitation dimension of the LLDI appears to be particularly responsive to PR in people with COPD.
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Affiliation(s)
- Sachi O'Hoski
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada; Respiratory Research, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON, M6M 2J5, Canada.
| | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada.
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada.
| | - Joshua Wald
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada; Firestone Institute for Respiratory Health, St. Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
| | - Roger Goldstein
- Respiratory Research, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON, M6M 2J5, Canada.
| | - Marla K Beauchamp
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada; Respiratory Research, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON, M6M 2J5, Canada; Firestone Institute for Respiratory Health, St. Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
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Antunes AAM, de Sousa Junior RR, Vaz DV. Measuring subjective aspects of participation in adults with disabilities: A systematic review of the coverage, content validity and internal structure of standardised instruments. Clin Rehabil 2022; 37:177-198. [PMID: 36082959 DOI: 10.1177/02692155221123545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To systematically review evidence on the coverage, content validity and internal structure of self-report measures capturing subjective aspects of participation for adults with disabilities. DATA SOURCES EMBASE, MEDLINE and reference lists were searched until July 10th, 2022 for articles on measurement properties of instruments measuring participation as defined in the International Classification of Functioning, Disability and Health, from a subjective perspective. METHOD Each instrument was assessed for its coverage of subjective aspects of participation. The Consensus-based Standards for the Selection of Health Measurement Instruments were used to assess the quality of each study. Content validity and internal structure (structural validity, internal consistency and cross-cultural validity) were rated against published standards and qualified by the adapted Grading of Recommendations Assessment, Development and Evaluation. RESULTS Thirty-eight studies regarding 10 instruments were analysed. Most instruments mix activity and participation items. Only the Measure of Experiential Aspects of Participation (with high-quality evidence of sufficient structural validity and generally sufficient internal consistency), the Participation Enfranchisement and the Community Integration Measure showed adequate coverage. For all instruments, evidence of content validity is of low- to very low quality. There is high-quality evidence that the Participation Scale is not unidimensional. CONCLUSION In general, the coverage and the evidence for content validity and internal structure of measures capturing experiential aspects of participation are limited. The Measure of Experiential Aspects of Participation has the best level of evidence in support of its use. The score of the Participation Scale cannot be considered an adequate reflection of participation.
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Affiliation(s)
- Ana Amélia Moraes Antunes
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, 28114Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Rodrigues de Sousa Junior
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, 28114Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Daniela Virgínia Vaz
- Physical Therapy Department and Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, 28114Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Chen M, Dutt AS, Nair R. Systematic review of reviews on Activities of Daily Living measures for children with developmental disabilities. Heliyon 2022; 8:e09698. [PMID: 35761927 PMCID: PMC9233222 DOI: 10.1016/j.heliyon.2022.e09698] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/11/2022] [Accepted: 06/07/2022] [Indexed: 12/12/2022] Open
Abstract
Background There seems to be a lack of consensus on the concept and domains of Activities of Daily Living (ADL) measured among children and adolescents with developmental disabilities (DD), despite a significant number of existing measures of ADL and associated constructs, and two prevailing theoretical frameworks (i.e., the cognitive-social-practical framework, and the activity-and-participation framework). Aims This systematic review (SR) aims to identify articles that systematically reviewed measures of ADL for children and adolescents aged 7-18 years with DD to evaluate the quality of included articles, and describe the measures and domains identified. Methods and Procedures: Searches were conducted in PubMed®, Academic Search Complete® (EBSCOhost), Education Source Search® (EBSCOhost), ERIC® (EBSCOhost), and PsychInfo® (EBSCOhost). 14,931 articles were identified, and two researchers completed title screening, abstract screening, and full-text screening, with disagreements resolved. Out of these 14,931 articles, fourteen were included, which resulted in a total of 163 ADL measures. Out of the 163 ADL measures, forty-eight met the criteria and were included for analysis. PRISMA and COSMIN checklists were used to appraise the methodological quality of the included articles. Outcomes and results Results indicated that most of the 14 systematic review articles did not provide information on instrument development and content validity of their included measures. Analysis of the identified 48 measures of ADL and its associated constructs revealed heterogeneity in domains covered, although there were seven domains that were most often included. Conclusions and implications Implications in terms of practice, research, and policy are further discussed.
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Affiliation(s)
- Mo Chen
- Office of Education Research, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, 637616, Singapore
| | - Anuradha S. Dutt
- Psychology, and Child and Human Development, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, 637616, Singapore
| | - Rahul Nair
- Department of Dentistry—Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
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Schröder D, Heesen G, Heinemann S, Hummers E, Jablonka A, Steffens S, Mikuteit M, Niewolik J, Overbeck TR, Kallusky J, Müller F. Development and Validation of a Questionnaire to Assess Social Participation of High Risk-Adults in Germany During the COVID-19 Pandemic. Front Public Health 2022; 10:831087. [PMID: 35558532 PMCID: PMC9086897 DOI: 10.3389/fpubh.2022.831087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Restrictions to contain the COVID-19 pandemic affect the social participation of people worldwide. Especially those at high risk for a severe disease tend to abstain from social gatherings. While there are a few questionnaires to measure social participation in elderly or chronic patients, a valid survey instrument that includes pandemic-related social participation is needed. Methods We developed a social participation questionnaire that aims to assess pandemic-related restrictions in social participation. Items were developed using a theory and literature-based approach and then compiled in a discursive process involving experts and lay people. This was followed by the validation of the questionnaire through a cross-sectional survey on 431 individuals. Items with low item-total correlations and low factor loadings using exploratory factor analysis [EFA] were excluded. Using EFA on the remaining items, the factor structure was retrieved and tested with a confirmatory factor analysis [CFA]. Internal consistency was assessed with Chronbachs α. Results Initially, 27 items were developed which were used for validation. 13 items were excluded due to low item-total correlations and factors loadings. EFA of the remaining 14 items revealed three factors which were identified as domains “active social participation,” “wellbeing,” and “restrictions”. CFA showed an acceptable model fit using the three-dimensional structure. Chronbachs α of 0.81 and McDonalds Ω of 0.87 indicate good internal consistency. Correlation analysis showed an association between the developed questionnaire and previously-established participation and mental health scales. Conclusion This study suggests that our 14 item questionnaire is of high reliability and validity and can be used to measure social participation during a pandemic.
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Affiliation(s)
- Dominik Schröder
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Gloria Heesen
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Stephanie Heinemann
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Alexandra Jablonka
- Department of Rheumatology and Immunology, Hannover Medical School, Hanover, Germany.,German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Hanover, Germany
| | - Sandra Steffens
- Department of Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Marie Mikuteit
- Department of Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Jacqueline Niewolik
- Department of Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Tobias R Overbeck
- Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Jonathan Kallusky
- Department of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center, Göttingen, Germany
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Knightbridge L, Bourke-Taylor HM, Hill KD. Healthy ageing through participation in community situated activities: A scoping review of assessment instruments to support occupational therapy practice. Aust Occup Ther J 2022; 69:493-509. [PMID: 35445413 PMCID: PMC9546241 DOI: 10.1111/1440-1630.12802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/24/2022] [Accepted: 04/02/2022] [Indexed: 11/29/2022]
Abstract
Introduction The occupational therapy profession has an essential role to play in healthy ageing that includes enabling participation, a construct that according to The International Classification of Functioning, Disability and Health (ICF), incorporates an environmental context. Environmental barriers and enablers of participation in community‐situated activities for people over the age of 65 have been identified. To support practice, occupational therapists require assessments with demonstrated content validity including comprehensive coverage of the construct. The purpose of this scoping review study was to investigate what instruments are available to assess community participation for people over the age of 65 that included environmental factors. Methods A scoping review of the literature was conducted, utilising the Joanna Briggs Institute (JBI) scoping review methodology. The evidence source was review articles and inclusion criteria were that they reviewed instruments to assess participation that could be used for people over the age of 65. Items extracted from included instruments were evaluated against a preset list of community‐participation and environment categories that had been developed from the ICF. Results Twenty‐three review studies met inclusion criteria and from these 240 instruments were extracted. Twenty instruments were retained after exclusions and from these, 540 instrument items were extracted. Of these, 280 (47%) were coded as community‐participation, and only 20 (3.4%) as environment items. Fourteen of the instruments included no environment items. Conclusions No instrument was identified that comprehensively assessed community participation including the related environmental factors. Such an instrument is required to enable occupational therapy practitioners to support healthy ageing. The development of such an instrument will strengthen the profession's capacity to develop new ways of delivering services to older adults in line with emerging ways that aged care will be delivered and to advance its essential role in healthy ageing.
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Affiliation(s)
- Lisa Knightbridge
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University-Peninsula Campus, Frankston, VIC, Australia
| | - Helen M Bourke-Taylor
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University-Peninsula Campus, Frankston, VIC, Australia
| | - Keith D Hill
- School of Primary and Allied Health Care, Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Faculty Medicine Nursing and Health Sciences, Monash University (Peninsula Campus), Frankston, VIC, Australia
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Hashidate H, Shimada H, Fujisawa Y, Yatsunami M. An Overview of Social Participation in Older Adults: Concepts and Assessments. Phys Ther Res 2021; 24:85-97. [PMID: 34532203 DOI: 10.1298/ptr.r0013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022]
Abstract
In older adults, social participation is an important component of rehabilitation and health promotion. Several studies have attempted to describe the definition and concepts of social participation, and there were many outcomes to measure social participation. This overview provides information about representative social participation and related concepts that have been defined in the literature. A standardized definition of social participation has not been developed; commonly, recognition for social participation was proposed as focused on involvement in social activities that provide interaction with others in a society or community. Many instruments assess the various aspects of social participation. Because of operational definition and diversity in social participation, performance in social participation was adopted as an aspect of assessment. Further discussions are needed to clarify the definition of social participation and evaluate the instruments used to assess social participation for it to be useful for rehabilitation and health promotion. In doing so, determining and developing assessment and intervention based on the purpose or perspective of social participation in older adults with and without disabilities is important.
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Affiliation(s)
- Hiroyuki Hashidate
- Department of Physical Therapy, School of Health Sciences, Kyorin University, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Yuhki Fujisawa
- Department of Physical Therapy, School of Health Sciences, Kyorin University, Japan
| | - Mitsunobu Yatsunami
- Department of Physical Therapy, School of Health Sciences, Kyorin University, Japan
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Cytera C, Thyen U. ["I Think it is Important in Many Aspects in Life" - Young Adults' Perception of Participation]. REHABILITATION 2021; 60:384-392. [PMID: 34058772 DOI: 10.1055/a-1491-7365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This study explores young adults' lay perception of participation. It focuses on the definition of the concept and the life areas in which the target group views it as important to take part in. METHODS In guided group interviews (N=6), 20 young adults with and without disabilities were surveyed about their perception of participation. To also include people with more severe disabilities, proxy interviews (N=3) were conducted. The data of the interview were analyzed via qualitative content analysis based on Mayring. RESULTS Participation is understood as being multifaceted and individually different. Six aspects of participation definition could be detected: togetherness; social inclusion/participation in society; open-mindedness/interest; equal opportunities/equal treatment; freedom of choice/autonomy; to have a voice. Besides that, seven areas of participation were mentioned as important for young adults: social environment; work/education; leisure; media; mobility; politics/finances; self-administration. CONCLUSION Within young adults' complex perception of participation, social aspects are particularly important, besides equal rights and autonomy. Participation in sexuality and new media is given a crucial value, which is why these topics should be given more attention to. Life areas in which participation is described as relevant can vary depending on the interests of the individual. This demonstrates the subjective character of the concept, and the importance to consider the perception and preference of a person or a group.
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Affiliation(s)
- Chirine Cytera
- Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Deutschland.,Institut für Psychologie, Universität Greifswald, Deutschland
| | - Ute Thyen
- Klinik für Kinder- und Jugendmedizin, Universität zu Lübeck, Deutschland
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Pfeiffer B, Piller A, Bevans K, Shiu C. Reliability of the Participation and Sensory Environment Questionnaire: Community Scales. RESEARCH IN AUTISM SPECTRUM DISORDERS 2019; 64:84-93. [PMID: 32818040 PMCID: PMC7430946 DOI: 10.1016/j.rasd.2019.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND The Participation and Sensory Environment Questionnaire (P-SEQ): Community Scales is a parent report questionnaire designed to examine the impact of the sensory environment on participation within community activities for children with autism spectrum disorder (ASD). METHODS This study used a cross sectional quantitative design to establish the reliability and discriminate validity of the P-SEQ: Community Scales. RESULTS This study established the initial reliability of the questionnaire including internal consistency of 0.98 test-retest reliability of 0.76. The P-SEQ: Community Scales demonstrated significant differences in item distribution for children without ASD as compared to those with ASD, an essential aspect of construct validity. CONCLUSIONS The results of this study indicate that the questionnaire is a reliable tool that can be used to assess the impact of sensory environment's impact on participation in community activities. Identified barriers can be modified to support participation in community tasks.
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Affiliation(s)
- Beth Pfeiffer
- Department of Rehabilitation Sciences, Temple University 1101 W Montgomery Ave, 3rd Floor, Philadelphia, PA 19122
| | - Aimee Piller
- Piller Child Development, LLC, PO Box 50218, Phoenix, AZ 85076
| | - Katherine Bevans
- Department of Rehabilitation Sciences, Temple University 1101 W Montgomery Ave, 3rd Floor, Philadelphia, PA 19122
| | - Chengshi Shiu
- School of Nursing, Yale University, 400 West Campus Dr, Orange, CT 06477
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Ezekiel L, Collett J, Mayo NE, Pang L, Field L, Dawes H. Factors Associated With Participation in Life Situations for Adults With Stroke: A Systematic Review. Arch Phys Med Rehabil 2019; 100:945-955. [DOI: 10.1016/j.apmr.2018.06.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 01/09/2023]
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Tarvonen-Schröder S, Kaljonen A, Laimi K. Comparing functioning in spinal cord injury and in chronic spinal pain with two ICF-based instruments: WHODAS 2.0 and the WHO minimal generic data set covering functioning and health. Clin Rehabil 2019; 33:1241-1251. [PMID: 30935211 DOI: 10.1177/0269215519839104] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate whether the two briefest validated ICF-based (International Classification of Functioning, Disability and Health) tools can detect differences between different spinal conditions. DESIGN Cross-sectional study. SETTING University hospital rehabilitation clinic. SUBJECTS A total of 84 patients with spinal cord injury and 81 with chronic spinal pain. MAIN MEASURES Disability evaluated using self-reported and proxy 12-item WHODAS 2.0 ((World Health Organization Disability Assessment Schedule), and physician-rated WHO minimal generic data set covering functioning and health. FINDINGS The two measures used showed severe disability in both patient populations, those with spinal cord injury (mean age 47.5 years, SD 13.2) and those with chronic spinal pain (mean age 47.2 years, SD 9.5), WHODAS patient sum being 18.4 (SD 9.6) versus 22.0 (SD 9.0), P < 0.05, and the WHO generic data set 15.6 (SD 4.4) versus 14.2 (SD 3.7), P < 0.01, respectively. Correlations between patient and proxy ratings and between the two disability scales were mostly strong. Severe restrictions were found in the working ability of both the populations, in mobility of patients with spinal cord injury and in pain function of patients with chronic spinal pain. In this tertiary clinic patient population, patients with spinal pain perceived more problems in emotional and cognitive functions, and in participation than patients with spinal cord injury. CONCLUSIONS Both scales were able to find differences between two patient populations with severe disability.
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Affiliation(s)
- Sinikka Tarvonen-Schröder
- 1 Department of Rehabilitation and Brain Trauma, Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland
| | - Anne Kaljonen
- 2 Department of Biostatistics, University of Turku, Turku, Finland
| | - Katri Laimi
- 3 Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
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Romli MH, Wan Yunus F, Mackenzie L. Overview of reviews of standardised occupation-based instruments for use in occupational therapy practice. Aust Occup Ther J 2019; 66:428-445. [PMID: 30821362 DOI: 10.1111/1440-1630.12572] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Using standardised instruments is one approach to support evidence-based practice. Referring to systematic reviews is an option to identify suitable instruments. However, with an abundance of systematic reviews available, therapists are challenged to identify an appropriate instrument to use. Therefore, this overview of reviews aimed to summarise relevant systematic review findings about standardised occupation-based instruments relevant for occupational therapy practice. METHODS An overview of reviews was conducted. A systematic search was performed on four databases up to March 2018. Included systematic reviews were analysed for quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). RESULTS A total of 2187 articles were identified after removing duplicates. Ultimately, 58 systematic reviews were identified that yielded 641 instruments. From those, 45 instruments were selected for appraisal as they met the inclusion criteria of being developed mainly by occupational therapists and were recommended in the summarised findings from the systematic reviews. The instruments were classified according to the following occupation domains: (i) multidimensional, (ii) activities of daily living, (iii) productivity, (iv) social, (v) sleep/rest, (vi) sexuality and (vii) spirituality. No systematic review was identified that specifically focussed on occupations related to school/education, leisure and play. DISCUSSION Certain occupation domains such as activities of daily living, social and sleep/rest received high attention amongst researchers. There is a need for systematic reviews of instruments to measure education/school, play and leisure. Limited numbers of instruments were developed by occupational therapists outside the occupation domain of activities of daily living, and in areas of practice other than children and older people. Nevertheless, this overview can give some guidance for occupational therapists in selecting a suitable occupational therapy instrument for practice.
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Affiliation(s)
- Muhammad Hibatullah Romli
- Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.,Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Farahiyah Wan Yunus
- Occupational Therapy Programme, Faculty of Health Sciences, Centre for Rehabilitation and Special Needs, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, Lidcombe, New South Wales, Australia
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Terwee CB, Crins MHP, Boers M, de Vet HCW, Roorda LD. Validation of two PROMIS item banks for measuring social participation in the Dutch general population. Qual Life Res 2019; 28:211-220. [PMID: 30203302 PMCID: PMC6339674 DOI: 10.1007/s11136-018-1995-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND The Patient-Reported Outcomes Measurement Information System (PROMIS) item banks 'Ability to Participate in Social Roles and Activities' (35 items) and 'Satisfaction with Social Roles and Activities' (44 items) were developed to measure (satisfaction with) participation more efficiently and precisely than current instruments, by using Computerized Adaptive Testing (CAT). We validated these item banks in a Dutch general population. METHODS Participants in an internet panel completed both item banks. Unidimensionality, local dependence, monotonicity, Graded Response Model item fit, Differential Item Functioning (DIF) for age, gender, education, region, ethnicity, and language (Dutch compared to US Social Supplement), and reliability were assessed. RESULTS A representative Dutch sample of 1002 people participated. We found for the Ability to Participate and Satisfaction with Participation item banks, respectively, sufficient unidimensionality (CFI: 0.971, 0.960; TLI: 0.970, 0.958; RMSEA: 0.108, 0.108), no local dependence, sufficient monotonicity (H: 0.75, 0.73), good item fit (2 out of 35 items, 1 out of 44 items with S-X2p-value < 0.001). No DIF was found. We found a reliability of at least 0.90 with simulated CATs in 86% and 94% of the participants with on average 4.7 (range 2-12) and 4.3 (range 3-12) items, respectively. DISCUSSION The PROMIS participation item banks showed sufficient psychometric properties in a general Dutch population and can be used as CAT. PROMIS CATs allow reliable and valid measurement of participation in an efficient and user-friendly way with limited administration time.
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Affiliation(s)
- C B Terwee
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - M H P Crins
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
| | - M Boers
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
- Amsterdam Rheumatology and Immunology Center, VU University Medical Center, Amsterdam, The Netherlands
| | - H C W de Vet
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - L D Roorda
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
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Comparing disability between traumatic brain injury and spinal cord injury using the 12-item WHODAS 2.0 and the WHO minimal generic data set covering functioning and health. Clin Rehabil 2018; 32:1676-1683. [DOI: 10.1177/0269215518785945] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To compare disability between two patient groups using short validated tools based on International Classification of Functioning, Disability and Health (ICF). Design: Cross-sectional study. Setting: University hospital specialist outpatient clinic. Subjects: A total of 94 patients with traumatic brain injury and 59 with spinal cord injury. Main measures: Disability evaluated using self-reported and proxy 12-item WHODAS 2.0 (World Health Organization Disability Assessment Schedule), and physician-rated WHO minimal generic data set covering functioning and health. Results: The two measures used showed severe but very different disabilities in these patient groups. Disability was assessed worse by physicians in the spinal cord injury population (sum 15.8 vs. 12.7, P = 0.0001), whereas disability assessed by the patients did not differ significantly between the two groups (sum 18.4 vs. 21.2). Further analysis revealed that in patients with “high disability” (the minimal generic data set score ⩾15), self-reported functioning was more severely impaired in the traumatic brain injury group compared to the spinal cord injury group (29.7 vs. 21.4, P < 0.0001), with no difference between these two diagnostic groups in patients with “low disability” (the minimal generic data set below 15). Patients with traumatic brain injury perceived more difficulties in cognition, getting along and participation, patients with spinal cord injury in mobility and self-care. Conclusion: Both generic measures were able to detect severe disability but also to detect differences between two patient populations with different underlying diagnoses.
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Lami F, Egberts K, Ure A, Conroy R, Williams K. Measurement properties of instruments that assess participation in young people with autism spectrum disorder: a systematic review. Dev Med Child Neurol 2018; 60:230-243. [PMID: 29230802 DOI: 10.1111/dmcn.13631] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 01/18/2023]
Abstract
AIM To systematically review the measurement properties of instruments assessing participation in young people with autism spectrum disorder (ASD). METHOD A search was performed in MEDLINE, PsycINFO, and PubMed combining three constructs ('ASD', 'test of participation', 'measurement properties'). Results were restricted to articles including people aged 6 to 29 years. The 2539 identified articles were independently screened by two reviewers. For the included articles, data were extracted using standard forms and their risk of bias was assessed. RESULTS Nine studies (8 cross-sectional) met the inclusion criteria, providing information on seven different instruments. The total sample included 634 participants, with sex available for 600 (males=494; females=106) and age available for 570, with mean age for these participants 140.58 months (SD=9.11; range=36-624). Included instruments were the school function assessment, vocational index, children's assessment of participation and enjoyment/preferences for activities of children, experience sampling method, Pediatric Evaluation of Disability Inventory, Computer Adaptive Test, adolescent and young adult activity card sort, and Patient-Reported Outcomes Measurement Information System parent-proxy peer relationships. Seven studies assessed reliability and validity; good properties were reported for half of the instruments considered. Most studies (n=6) had high risk of bias. Overall the quality of the evidence for each tool was limited. INTERPRETATION Validation of these instruments, or others that comprehensively assess participation, is needed. Future studies should follow recommended methodological standards. WHAT THIS PAPER ADDS Seven instruments have been used to assess participation in young people with autism. One instrument, with excellent measurement properties in one study, does not comprehensively assess participation. Studies of three instruments that incorporate a more comprehensive assessment of participation have methodological limitations. Overall, limited evidence exists regarding measurement properties of participation assessments for young people with autism.
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Affiliation(s)
- Francesca Lami
- Department of Paediatrics, Faculty of MDHS, The University of Melbourne, Melbourne, Victoria, Australia.,Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Kristine Egberts
- Department of Paediatrics, Faculty of MDHS, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alexandra Ure
- Department of Paediatrics, Faculty of MDHS, The University of Melbourne, Melbourne, Victoria, Australia.,Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Rowena Conroy
- Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Neurodevelopment and Disability, The Royal Children's Hospital, Melbourne, Victoria, Australia.,School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Katrina Williams
- Department of Paediatrics, Faculty of MDHS, The University of Melbourne, Melbourne, Victoria, Australia.,Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Neurodevelopment and Disability, The Royal Children's Hospital, Melbourne, Victoria, Australia
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Measuring participation in patients with chronic back pain-the 5-Item Pain Disability Index. Spine J 2018; 18:307-313. [PMID: 28735767 DOI: 10.1016/j.spinee.2017.07.172] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/05/2017] [Accepted: 07/17/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Of the three broad outcome domains of body functions and structures, activities, and participation (eg, engaging in valued social roles) outlined in the World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF), it has been argued that participation is the most important to individuals, particularly those with chronic health problems. Yet, participation is not commonly measured in back pain research. PURPOSE The aim of this study was to investigate the construct validity of a modified 5-Item Pain Disability Index (PDI) score as a measure of participation in people with chronic back pain. STUDY DESIGN A validation study was conducted using cross-sectional data. PATIENT SAMPLE Participants with chronic back pain were recruited from a multidisciplinary pain center in Alberta, Canada. OUTCOME MEASURES The outcome measure of interest is the 5-Item PDI. METHODS Each study participant was given a questionnaire package containing measures of participation, resilience, anxiety and depression, pain intensity, and pain-related disability, in addition to the PDI. The first five items of the PDI deal with social roles involving family responsibilities, recreation, social activities with friends, work, and sexual behavior, and comprised the 5-Item PDI seeking to measure participation. The last two items of the PDI deal with self-care and life support functions and were excluded. Construct validity of the 5-Item PDI as a measure of participation was examined using Pearson correlations or point-biserial correlations to test each hypothesized association. RESULTS Participants were 70 people with chronic back pain and a mean age of 48.1 years. Forty-four (62.9%) were women. As hypothesized, the 5-Item PDI was associated with all measures of participation, including the Participation Assessment with Recombined Tools-Objective (r=-0.61), Late-Life Function and Disability Instrument: Disability Component (frequency: r=-0.66; limitation: r=-0.65), Work and Social Adjustment Scale (r=0.85), a global perceived participation scale (r=0.54), employment status (r=-0.30), and the Usual Activity domain of the 15D (r=0.50). The expected correlations observed indicating a moderate or strong association provided supporting evidence for the construct validity of the 5-Item PDI as a measure of participation. The Oswestry Disability Index and the 5-Item PDI were also strongly correlated (r=0.70). The 5-Item PDI was associated to a lesser degree with depressive symptoms and resilience, as measured by the Hospital Anxiety and Depression Scale (HADS) (r=0.25) and the Connor-Davidson Resilience Scale (r=-0.28), as would be expected. No statistically significant association was found between the 5-Item PDI and the HADS Anxiety score. CONCLUSIONS It is important that outcome measures of participation are included in back pain research to gauge the effects of painful spinal conditions and interventions on maintaining valued social roles. A simple, concise measure would be very useful for this purpose in clinical and research settings. The results of this study support the construct validity of the 5-Item PDI as a brief measure of participation in people with chronic back pain. These findings are likely most applicable to those with chronic back pain attending pain clinics and other tertiary centers for care.
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Federici S, Bracalenti M, Meloni F, Luciano JV. World Health Organization disability assessment schedule 2.0: An international systematic review. Disabil Rehabil 2016; 39:2347-2380. [PMID: 27820966 DOI: 10.1080/09638288.2016.1223177] [Citation(s) in RCA: 221] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE This systematic review examines research and practical applications of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) as a basis for establishing specific criteria for evaluating relevant international scientific literature. The aims were to establish the extent of international dissemination and use of WHODAS 2.0 and analyze psychometric research on its various translations and adaptations. In particular, we wanted to highlight which psychometric features have been investigated, focusing on the factor structure, reliability, and validity of this instrument. METHOD Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology, we conducted a search for publications focused on "whodas" using the ProQuest, PubMed, and Google Scholar electronic databases. RESULTS We identified 810 studies from 94 countries published between 1999 and 2015. WHODAS 2.0 has been translated into 47 languages and dialects and used in 27 areas of research (40% in psychiatry). CONCLUSIONS The growing number of studies indicates increasing interest in the WHODAS 2.0 for assessing individual functioning and disability in different settings and individual health conditions. The WHODAS 2.0 shows strong correlations with several other measures of activity limitations; probably due to the fact that it shares the same disability latent variable with them. Implications for Rehabilitation WHODAS 2.0 seems to be a valid, reliable self-report instrument for the assessment of disability. The increasing interest in use of the WHODAS 2.0 extends to rehabilitation and life sciences rather than being limited to psychiatry. WHODAS 2.0 is suitable for assessing health status and disability in a variety of settings and populations. A critical issue for rehabilitation is that a single "minimal clinically important .difference" score for the WHODAS 2.0 has not yet been established.
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Affiliation(s)
- Stefano Federici
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Marco Bracalenti
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Fabio Meloni
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Juan V Luciano
- b Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu , St. Boi De Llobregat , Spain.,c Primary Care Prevention and Health Promotion Research Network (RedIAPP) , Madrid , Spain
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Ballert CS, Hopfe M, Kus S, Mader L, Prodinger B. Using the refined ICF Linking Rules to compare the content of existing instruments and assessments: a systematic review and exemplary analysis of instruments measuring participation. Disabil Rehabil 2016; 41:584-600. [PMID: 27414962 DOI: 10.1080/09638288.2016.1198433] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Existing instruments measuring participation may vary with respect to various aspects. This study aimed to examine the comparability of existing instruments measuring participation based on the International Classification of Functioning, Disability and Health (ICF) by considering aspects of content, the perspective adopted and the categorization of response options. METHODS A systematic literature review was conducted to identify instruments that have been commonly used to measure participation. Concepts of identified instruments were then linked to the ICF following the refined ICF Linking Rules. Aspects of content, perspective adopted and categorization of response options were documented. RESULTS Out of 315 instruments identified in the full-text screening, 41 instruments were included. Concepts of six instruments were linked entirely to the ICF component Activities and Participation; of 10 instruments still 80% of their concepts. A descriptive perspective was adopted in most items across instruments (75%), mostly in combination with an intensity rating. An appraisal perspective was found in 18% and questions from a need or dependency perspective were least frequent (7%). CONCLUSION Accounting for aspects of content, perspective and categorization of responses in the linking of instruments to the ICF provides detailed information for the comparison of instruments and guidance on narrowing down the choices of suitable instruments from a content point of view. Implications for Rehabilitation For clinicians and researchers who need to identify a specific instrument for a given purpose, the findings of this review can serve as a screening tool for instruments measuring participation in terms of the following: • Their content covered based on the ICF. • The perspective adopted in the instrument (e.g., descriptive, need/dependency or appraisal). • The categorization of their response options (e.g., intensity or frequency).
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Affiliation(s)
- Carolina S Ballert
- a Swiss Paraplegic Research, ICF Unit , Nottwil , Switzerland.,b Department of Health Sciences and Health Policy , University of Lucerne , Lucerne , Switzerland
| | - Maren Hopfe
- a Swiss Paraplegic Research, ICF Unit , Nottwil , Switzerland.,b Department of Health Sciences and Health Policy , University of Lucerne , Lucerne , Switzerland
| | - Sandra Kus
- c Department of Medical Informatics, Biometry and Epidemiology - IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health , Ludwig-Maximilians-University (LMU) , Munich , Germany
| | - Luzius Mader
- b Department of Health Sciences and Health Policy , University of Lucerne , Lucerne , Switzerland
| | - Birgit Prodinger
- a Swiss Paraplegic Research, ICF Unit , Nottwil , Switzerland.,b Department of Health Sciences and Health Policy , University of Lucerne , Lucerne , Switzerland.,d ICF Research Branch a Cooperation Partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI) , Nottwil , Switzerland
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Babulal GM, Tabor Connor L. The measure of stroke environment (MOSE): development and validation of the MOSE in post-stroke populations with and without aphasia. Top Stroke Rehabil 2016; 23:348-57. [PMID: 27077978 DOI: 10.1080/10749357.2016.1143697] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The purpose of this paper is to present the development and psychometric properties of a new environmental measure that identifies barriers and facilitators in receptivity, physical environment and communication for post-stroke populations, including survivors with aphasia. METHODS The Measure of Stroke Environment (MOSE) was developed using information from semi-structured interviews and three pilot studies. Reliability and validity were assessed in 43 post-stroke participants. RESULTS The MOSE contains 47 items across 33 questions in three domains (receptivity, physical environment, communication). Internal consistency reliability was high (.83 to .85) across each domain and over the entire assessment (.91). Convergent validity showed moderate correlation with the Stroke Impact Scale (.33 to .37), the National Institute of Health Stroke Scale (-.31 to -.46) and the Boston Diagnostic Aphasia Examination (.55 to .61). Persons with aphasia had significantly lower scores on the communication domain. Stroke survivors with (26% overall difficulty) and without aphasia (31% overall difficulty) continue to experience difficulty ≥ 2 years post-stroke. DISCUSSION The MOSE offers a brief, reliable and valid assessment of environmental barriers and facilitators to participation for post-stroke survivors reintegrating into their communities. Stroke survivors with very mild deficits continue to experience barriers from the environment many years post-stroke. These barriers are not typically identified during the rehabilitation process but persist post-reintegration. CONCLUSION The MOSE is able to determine how frequently a stroke survivor faces challenges in their environment and how that impacts his or her participation.
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Affiliation(s)
- Ganesh M Babulal
- a Program in Occupational Therapy , Washington University School of Medicine, St. Louis , MO , USA.,b Department of Neurology , Washington University School of Medicine , St. Louis , MO , USA
| | - Lisa Tabor Connor
- a Program in Occupational Therapy , Washington University School of Medicine, St. Louis , MO , USA.,b Department of Neurology , Washington University School of Medicine , St. Louis , MO , USA.,c Department of Radiology , Washington University School of Medicine , St. Louis , MO , USA
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Jeong Y, Law M, Stratford P, DeMatteo C, Kim H. Cross-cultural validation and psychometric evaluation of the Participation and Environment Measure for Children and Youth in Korea. Disabil Rehabil 2016; 38:2217-28. [PMID: 26728903 DOI: 10.3109/09638288.2015.1123302] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To develop the Korean version of the Participation and Environment Measure for Children and Youth (KPEM-CY) and examine its psychometric properties. METHOD The PEM-CY was cross-culturally translated into Korean using a specific guideline: pre-review of participation items, forward/backward translation, expert committee review, pre-test of the KPEM-CY and final review. To establish internal consistency, test-retest reliability and construct validity of the KPEM-CY, 80 parents of children with disabilities aged 5-13 years were recruited in South Korea. RESULTS Across the home, school and community settings, 76% of participation items and 29% of environment items were revised to improve their fit with Korean culture. Internal consistency was moderate to excellent (0.67-0.92) for different summary scores. Test-retest reliability was excellent (>0.75) in the summary scores of participation frequency and extent of involvement across the three settings and moderate to excellent (0.53-0.95) in all summary scores at home. Child's age, type of school and annual income were the factors that significantly influenced specific dimensions of participation and environment across all settings. CONCLUSIONS Results indicated that the KPEM-CY is equivalent to the original PEM-CY and has initial evidence of reliability and validity for use with Korean children with disabilities. Implications for rehabilitation Because 'participation' is a key outcome of the rehabilitation, measuring comprehensive participation of children with disabilities is necessary. The PEM-CY is a parent-report survey measure to assess comprehensive participation of children and youth and environment, which affect their participation, at home, school and in the community. A cross-cultural adaptation process is mandatory to adapt the measurement tool to a new culture or country. The Korean PEM-CY has both reliability and validity and can therefore generate useful clinical data for Korean children with disabilities.
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Affiliation(s)
- Yunwha Jeong
- a School of Rehabilitation Science, McMaster University , Hamilton , ON , Canada
| | - Mary Law
- a School of Rehabilitation Science, McMaster University , Hamilton , ON , Canada
| | - Paul Stratford
- a School of Rehabilitation Science, McMaster University , Hamilton , ON , Canada
| | - Carol DeMatteo
- a School of Rehabilitation Science, McMaster University , Hamilton , ON , Canada
| | - Hwan Kim
- b College of Rehabilitation Sciences, Daegu University , Kyeongsan , South Korea
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Schmidt H, Kunnig A. Family Board: A new means for people with visual impairment to communicate inner pictures of social relations. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2016. [DOI: 10.1177/0264619615610157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Visual impairment often entails changes in social relations. In order to identify supportive needs and provide tailored support, it is helpful to analyse these changes. Non-verbal methods have proven useful to facilitate this process but had so far not been available for visually impaired people. The Family Board, an established method of depicting social relations, was adapted for use by blind people and pilot-tested in this study. After adaptation and pretest, seven visually impaired adults undergoing rehabilitative treatment volunteered to participate in this qualitative pilot-study. Results showed that the method of the Family Board was well accepted and that the adapted board provides a feasible new non-verbal medium of communication for visually impaired people. The Family Board could be used to complement qualitative methods in further research on changes of social relations due to the loss of eyesight, to follow changes during coping and adaptation and to monitor effects of counselling.
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Mudge S, Rewi D, Channon A. Identifying an outcome measure to assess the impact of Mobility Dogs. Disabil Rehabil Assist Technol 2015; 12:73-83. [DOI: 10.3109/17483107.2015.1079267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Suzie Mudge
- Centre for Person Centred Research, AUT University, Auckland and
| | - Dallas Rewi
- School of Rehabilitation and Occupation Studies, AUT University, Auckland, New Zealand
| | - Alexis Channon
- Centre for Person Centred Research, AUT University, Auckland and
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Hammel J, Magasi S, Heinemann A, Gray DB, Stark S, Kisala P, Carlozzi NE, Tulsky D, Garcia SF, Hahn EA. Environmental barriers and supports to everyday participation: a qualitative insider perspective from people with disabilities. Arch Phys Med Rehabil 2015; 96:578-88. [PMID: 25813890 DOI: 10.1016/j.apmr.2014.12.008] [Citation(s) in RCA: 162] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 12/09/2014] [Accepted: 12/11/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe environmental factors that influence participation of people with disabilities. DESIGN Constant comparative, qualitative analyses of transcripts from 36 focus groups across 5 research projects. SETTING Home, community, work, and social participation settings. PARTICIPANTS Community-dwelling people (N=201) with diverse disabilities (primarily spinal cord injury, traumatic brain injury, and stroke) from 8 states. INTERVENTIONS None. MAIN OUTCOME MEASURES Environmental barriers and supports to participation. RESULTS We developed a conceptual framework to describe how environmental factors influence the participation of people with disabilities, highlighting 8 domains of environmental facilitators and barriers (built, natural, assistive technology, transportation, information and technology access, social support and attitudes, systems and policies, economics) and a transactional model showing the influence of environmental factors on participation at the micro (individual), mesa (community), and macro (societal) levels. Focus group data validated some International Classification of Functioning, Disability and Health environmental categories while also bringing unique factors (eg, information and technology access, economic quality of life) to the fore. Data were used to construct items to enable people with disabilities to assess the impact of environmental factors on everyday participation from their firsthand experience. CONCLUSIONS Participants with disabilities voiced the need to evaluate the impact of the environment on their participation at the immediate, community, and societal levels. The results have implications for assessing environmental facilitators and barriers to participation within rehabilitation and community settings, evaluating outcomes of environmental interventions, and effecting system and policy changes to target environmental barriers that may result in societal participation disparities versus opportunities.
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Affiliation(s)
- Joy Hammel
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL; Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL.
| | - Susan Magasi
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL
| | - Allen Heinemann
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - David B Gray
- Program in Occupational Therapy, Washington University, St Louis, MO
| | - Susan Stark
- Occupational Therapy, Neurology and Social Work, Washington University, St Louis, MO
| | - Pamela Kisala
- Department of Physical Therapy, University of Delaware College of Health Sciences, Newark, DE
| | - Noelle E Carlozzi
- Center for Clinical Outcomes and Assessment Research, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Ann Arbor, MI
| | - David Tulsky
- Department of Physical Therapy, University of Delaware College of Health Sciences, Newark, DE; Kessler Foundation Research Center, West Orange, NJ
| | - Sofia F Garcia
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Elizabeth A Hahn
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL; Center for Patient-Centered Outcomes, Northwestern University Feinberg School of Medicine, Chicago, IL
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Requejo PS, Furumasu J, Mulroy SJ. Evidence-Based Strategies for Preserving Mobility for Elderly and Aging Manual Wheelchair Users. TOPICS IN GERIATRIC REHABILITATION 2015; 31:26-41. [PMID: 26366040 PMCID: PMC4562294 DOI: 10.1097/tgr.0000000000000042] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Elderly and aging manual wheelchair (MWC) users have increased risk for accelerated loss of function and mobility that greatly limits independence and affects quality of life. This review paper addresses important issues for preserving function and mobility for elderly and aging individuals who use a MWC by presenting the current available evidence and recommendations. These include recommendations for maximizing function, by decreasing pain, improving the ability to self-propel, and prolonging mobility and endurance through ergonomics, individualized wheelchair selection and configuration, and adaptations for increasing the capacity to handle the daily mobility demands through training, strengthening, and exercise. Each recommendation is supported by current research in each relevant area.
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Affiliation(s)
- Philip S. Requejo
- Physical Therapy Department, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, Downey, CA 90242, USA
- Rehabilitation Engineering Program, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, Downey, CA 90242, USA
- Pathokinesiology Laboratory, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, Downey, CA 90242, USA
| | - Jan Furumasu
- Physical Therapy Department, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, Downey, CA 90242, USA
| | - Sara J. Mulroy
- Physical Therapy Department, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, Downey, CA 90242, USA
- Pathokinesiology Laboratory, Rancho Los Amigos National Rehabilitation Center, 7601 E. Imperial Highway, Downey, CA 90242, USA
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Brütt AL, Schulz H, Andreas S. Psychometric properties of an instrument to measure activities and participation according to the ICF concept in patients with mental disorders. Disabil Rehabil 2014; 37:259-67. [PMID: 24833419 DOI: 10.3109/09638288.2014.918189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE The International Classification of Functioning, Disability and Health (ICF) conceptualizes the bio-psycho-social model of health and illness, but cannot be used as an assessment instrument in routine care. The objective of this study was to psychometrically test a self-report instrument for measuring activities and social participation (ICF-Mental-A&P) of psychotherapy patients. METHODS For the psychometric evaluation of the ICF-Mental-A&P, participants completed a questionnaire on symptoms, interpersonal problems and quality of life at admission and at discharge of in-patient treatment. A consecutive sample of 2256 patients diagnosed with at least one mental disorder was recruited from eight in-patient units in Germany. RESULTS After item selection, the ICF-Mental-A&P contained 31 items comprising six subscales examined by confirmatory factor analysis. Subscales had acceptable internal consistency (α = 0.78-0.90) and test-retest correlations (r = 0.71-0.86). There were several expected correlations (r ≥ 0.6) between ICF-Mental-A&P scores and measures of symptoms and interpersonal problems. CONCLUSIONS Findings suggest that the ICF-Mental-A&P is a comprehensive, reliable measure of activities and participation according to the ICF concept for patients with mental disorders. It may therefore be an important instrument in clinical practice and could help to determine and evaluate functioning-related and patient-focused treatment outcomes.
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Affiliation(s)
- Anna Levke Brütt
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany and
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Ramstad K, Loge JH, Jahnsen R, Diseth TH. Self-reported mental health in youth with cerebral palsy and associations to recurrent musculoskeletal pain. Disabil Rehabil 2014; 37:144-50. [PMID: 24786760 DOI: 10.3109/09638288.2014.913703] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To explore self-reports on emotional, conduct, hyperactivity and peer problems and on prosocial behaviour in youth with cerebral palsy (CP), compare the reports to normative data and to mothers' reports and to analyse if recurrent CP-related musculoskeletal pain (RMP) influence the self-reports. METHODS Eighty-one youth with CP (mean age 14.2 years, 40 boys) were assessed by clinical examination, interview and the questionnaire Strengths and Difficulties Questionnaire (SDQ) filled in by the youths and their mothers. Gross motor function (GMFCS) was: level I 43%, level II 41%, level III 12% and level IV-V 4%. RESULTS Compared to normative data, youth with CP reported similar levels of peer problems, less conduct problems (p < 0.01), less hyperactivity problems (p < 0.01) and more prosocial behaviour (p < 0.01). Compared to the mothers' reports, youth with CP reported lower levels of peer problems (p < 0.01). Twenty-six boys (65%) and 28 girls (68%) had RMP. Girls, but not boys with RMP reported a higher level of peer problems (p = 0.02) than youth without RMP. CONCLUSION Self-report on mental health in addition to parental proxy-report is important because it yields additional information. Peer acceptance and the impact of pain on peer problems and participation are candidate topics for further research.
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Affiliation(s)
- Kjersti Ramstad
- Department of Clinical Neuroscience, Division of Women and Children, Oslo University Hospital , Oslo , Norway
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Mueller M, Strobl R, Jahn K, Linkohr B, Ladwig KH, Mielck A, Grill E. Impact of vertigo and dizziness on self-perceived participation and autonomy in older adults: results from the KORA-Age study. Qual Life Res 2014; 23:2301-8. [PMID: 24719016 DOI: 10.1007/s11136-014-0684-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE The impact of vertigo and dizziness on healthy ageing, and especially on participation, is not fully understood. The objective of this study was to investigate the association of vertigo and dizziness with self-perceived participation and autonomy in older non-institutionalised individuals, adjusted for the presence of other health conditions. Specifically, we wanted to investigate the different effects of vertigo and dizziness on specific components of participation, i.e. restrictions in indoor and outdoor autonomy, family role, social life and relationships, and work and education. METHODS Data originate from the second wave of the German KORA-Age cohort study collected in 2012. Participation and autonomy was investigated with the Impact on Participation and Autonomy Questionnaire. We used robust regression to analyse the association of vertigo and dizziness with self-perceived participation and autonomy adjusted for covariates. RESULTS A total of 822 participants (49.6% female) had a mean age of 78.1 years (SD 6.39). Participation and autonomy were significantly lower in participants with vertigo and dizziness across all domains. Adjusted for age, sex, and chronic conditions, vertigo and dizziness were significantly associated with participation restrictions in all domains except social life and relationships. CONCLUSION The results of our study indicate that vertigo and dizziness contribute to restrictions in participation and autonomy in individuals of older age. Recognising vertigo and dizziness as independent contributors to loss of autonomy and decreased chances for independent living may create new options for patient care and population health, such as the designing of complex interventions to maintain participation and autonomy.
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Affiliation(s)
- Martin Mueller
- Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany,
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Ben Ari (Shevil) E, Johansson S, Ytterberg C, Bergström J, von Koch L. How are cognitive impairment, fatigue and signs of depression related to participation in daily life among persons with multiple sclerosis? Disabil Rehabil 2014; 36:2012-8. [DOI: 10.3109/09638288.2014.887797] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Fairhall N, Sherrington C, Cameron ID, Blyth F, Naganathan V, Clemson L, Le Couteur D, Handelsman DJ, Waite L, Cumming RG. Predicting participation restriction in community-dwelling older men: the Concord Health and Ageing in Men Project. Age Ageing 2014; 43:31-7. [PMID: 23927887 DOI: 10.1093/ageing/aft111] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND participation restriction, defined as 'problems an individual may experience in involvement in life situations' (e.g. work and leisure), reflects difficulty functioning at a societal level and is a key component of disability. Our objective was to describe changes in participation in older men over a 2-year period and to identify baseline variables associated with participation and change in participation over the 2-year period. METHODS one thousand and three hundred and twenty-seven community-dwelling men aged 70 years or over who completed the baseline and 2-year follow-up phases of the Concord Health and Ageing in Men Project, a population-based cohort study in Sydney, Australia, were studied. Participation restriction and a range of other variables were measured using self-report and performance measures. Regression analyses were conducted to examine factors associated with participation and change in participation. RESULTS over the 2-year period, participation in life roles deteriorated in 47.3% (627/1,327) of men, stayed the same in 20.7% (275/1,327) and improved in the remainder (32.0%). Overall, there was a significant deterioration in participation (P < 0.001). Reduced participation at 2-year follow-up was significantly associated with the following baseline factors: age, more comorbidities, mild cognitive impairment or dementia, lower mood, weakness, slower gait, worse activities of daily living performance, driving and baseline participation score. These variables explained 56% of the variance in participation at 2 years. CONCLUSION participation in life roles worsened over a 2-year period in some community-dwelling older men. A number of associated factors were identified, which may provide targets for intervention to improve participation among older men.
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Affiliation(s)
- Nicola Fairhall
- Musculoskeletal Division, The George Institute for Global Health, PO Box M201 Missenden Road, Sydney, NSW 2050, Australia
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Stevelink SAM, van Brakel WH. The cross-cultural equivalence of participation instruments: a systematic review. Disabil Rehabil 2013; 35:1256-68. [PMID: 23789790 DOI: 10.3109/09638288.2012.731132] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Concepts such as health-related quality of life, disability and participation may differ across cultures. Consequently, when assessing such a concept using a measure developed elsewhere, it is important to test its cultural equivalence. Previous research suggested a lack of cultural equivalence testing in several areas of measurement. This paper reviews the process of cross-cultural equivalence testing of instruments to measure participation in society. METHODS An existing cultural equivalence framework was adapted and used to assess participation instruments on five categories of equivalence: conceptual, item, semantic, measurement and operational equivalence. For each category, several aspects were rated, resulting in an overall category rating of 'minimal/none', 'partial' or 'extensive'. The best possible overall study rating was five 'extensive' ratings. Articles were included if the instruments focussed explicitly on measuring 'participation' and were theoretically grounded in the ICIDH(-2) or ICF. Cross-validation articles were only included if it concerned an adaptation of an instrument developed in a high or middle-income country to a low-income country or vice versa. RESULTS Eight cross-cultural validation studies were included in which five participation instruments were tested (Impact on Participation and Autonomy, London Handicap Scale, Perceived Impact and Problem Profile, Craig Handicap Assessment Reporting Technique, Participation Scale). Of these eight studies, only three received at least two 'extensive' ratings for the different categories of equivalence. The majority of the cultural equivalence ratings given were 'partial' and 'minimal/none'. The majority of the 'none/minimal' ratings were given for item and measurement equivalence. CONCLUSION The cross-cultural equivalence testing of the participation instruments included leaves much to be desired. A detailed checklist is proposed for designing a cross-validation study. Once a study has been conducted, the checklist can be used to ensure comprehensive reporting of the validation (equivalence) testing process and its results. IMPLICATIONS FOR REHABILITATION • Participation instruments are often used in a different cultural setting than initial developed for. • The conceptualization of participation may vary across cultures. Therefore, cultural equivalence – the extent to which an instrument is equally suitable for use in two or more cultures – is an important concept to address. • This review showed that the process of cultural equivalence testing of the included participation instruments was often addressed insufficiently. • Clinicians should be aware that application of participations instruments in a different culture than initially developed for needs prior testing of cultural validity in the next context.
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Affiliation(s)
- S A M Stevelink
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, The Netherlands.
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Noreau L, Cobb J, Bélanger LM, Dvorak MF, Leblond J, Noonan VK. Development and Assessment of a Community Follow-Up Questionnaire for the Rick Hansen Spinal Cord Injury Registry. Arch Phys Med Rehabil 2013; 94:1753-65. [DOI: 10.1016/j.apmr.2013.03.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 03/05/2013] [Accepted: 03/08/2013] [Indexed: 10/27/2022]
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Hermsen LAH, Terwee CB, Leone SS, van der Zwaard B, Smalbrugge M, Dekker J, van der Horst HE, Wilkie R. Social participation in older adults with joint pain and comorbidity; testing the measurement properties of the Dutch Keele Assessment of Participation. BMJ Open 2013; 3:e003181. [PMID: 23975101 PMCID: PMC3753519 DOI: 10.1136/bmjopen-2013-003181] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The Keele Assessment of Participation (KAP) questionnaire measures person-perceived participation in 11 aspects of life. Participation allows fulfilment of valued life activities and social roles, which are important to older adults. Since we aimed to use the KAP in a larger Dutch cohort, we examined the measurement properties of KAP in a Dutch sample of older adults with joint pain and comorbidity. DESIGN Cohort study. SETTING A community-based sample in Amsterdam, the Netherlands and North Staffordshire, UK. PARTICIPANTS Participants were aged 65 years and over, had at least two chronic diseases (identified through general practice consultation) and reported joint pain on most days (questionnaire). The Dutch cohort provided baseline data (n=407), follow-up data at 6 months (n=364) and test-retest data 2 weeks after 6 months (n=122). The UK cohort provided comparable data (n=404). OUTCOME MEASURES The primary outcome was person-perceived participation, as measured with the KAP. The measurement properties examined were the following: structural validity (factor analysis), internal consistency (Cronbach's α), reliability (intraclass correlation coefficients; ICC), construct validity (hypothesis testing), responsiveness (hypothesis testing and area under the curve) and cross-cultural validity (differential item functioning; DIF). RESULTS Factor analysis revealed two domains: KAPd1: 'participation in basic activities' and KAPd2: 'participation in complex activities', with Cronbach's α of 0.74 and 0.57 and moderate test-retest reliability: ICC of 0.63 and 0.57, respectively. Further analyses of KAPd1 showed poor construct validity and responsiveness. Despite the uniform DIF in item 'interpersonal relations', the total KAPd1 score seemed comparable between the Dutch and UK sample. CONCLUSIONS Only KAP domain 'participation in basic activities' showed good internal consistency and sufficient reliability. KAPd2 lacks sufficient measurement properties for application in studies, although items may be used as single items. Further development of the concept 'participation' may help the development and validation of instruments to measure participation.
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Affiliation(s)
- Lotte A H Hermsen
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Stephanie S Leone
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Babette van der Zwaard
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Martin Smalbrugge
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Joost Dekker
- Department of Rehabilitation Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Henriëtte E van der Horst
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Ross Wilkie
- Arthritis Research UK Primary Care Centre, Keele University, Staffordshire, UK
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Cicerone KD. Participation After Multidisciplinary Rehabilitation for Moderate to Severe Traumatic Brain Injury in Adults. Arch Phys Med Rehabil 2013; 94:1421-3. [DOI: 10.1016/j.apmr.2013.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 04/10/2013] [Accepted: 04/12/2013] [Indexed: 10/26/2022]
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Suttiwong J, Vongsirinavarat M, Vachalathiti R, Chaiyawat P. Impact on participation and autonomy questionnaire: psychometric properties of the thai version. J Phys Ther Sci 2013; 25:769-74. [PMID: 24259849 PMCID: PMC3820408 DOI: 10.1589/jpts.25.769] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 03/01/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The present study aimed to cross-culturally translate and evaluate the reliability and validity of the Thai version of the Impact on Participation and Autonomy (IPA) in persons with spinal cord injury (SCI). [Subjects] One hundred and thirty-nine persons with SCI who lived in the community were recruited for this study. [Methods] The IPA was translated following the guideline for cross-cultural adaptation of self-report measures. The reliability and validity was examined in 139 persons with SCI. For the test-retest reliability, 30 participants completed the Thai version of the IPA twice with a 2-week interval. [Results] The translated questionnaire and its items had moderate to good reliability, with the ICC(3,1) ranging from 0.76 to 0.93. The internal consistency for all domains was high, with Cronbach's alpha ranging from 0.86 to 0.90. The convergent validity, discriminant validity, and construct validity were supported. [Conclusion] The Thai version of the IPA is a reliable and valid instrument for assessing the level of community participation in Thai persons with spinal cord injury.
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van der Zee CH, Baars-Elsinga A, Visser-Meily JMA, Post MWM. Responsiveness of two participation measures in an outpatient rehabilitation setting. Scand J Occup Ther 2013; 20:201-8. [PMID: 23312022 DOI: 10.3109/11038128.2012.754491] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The responsiveness of a new participation measure, the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) was compared with that of the Impact on Particpation and Autonomy (IPA). Furthermore, the concurrent validity of these two measures was assessed. METHOD Participants were patients with brain injury or neuromuscular disease, who received occupational therapy as part of a multidisciplinary outpatient rehabilitation programme. They completed the IPA and the USER-Participation at the start and end of the programme, and at three-month follow-up. Responsiveness was analysed using the effect size (ES) and the standardized response mean (SRM). RESULTS Responsiveness figures were small to moderate (-0.4 to 0.5) and similar for the IPA and the USER-Participation. The USER-Participation showed a consistent result, with Frequency scores declining and Restriction and Satisfaction scores inclining over time, and the IPA showed mixed results, with the different domain scores both inclining and declining over time. Correlations between IPA and USER-Participation scales were all significant, but by far strongest for the USER-Participation Satisfaction scale (-0.64 to -0.81). CONCLUSION The USER-Participation was at least as responsive as the IPA. Further, satisfaction with participation as measured with the USER-Participation is highly similar to the concept of autonomy in participation as measured with the IPA.
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Affiliation(s)
- Carlijn H van der Zee
- Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
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Holtslag I, van Wijk I, Hartog H, van der Molen AM, van der Sluis C. Long-term functional outcome of patients with longitudinal radial deficiency: cross-sectional evaluation of function, activity and participation. Disabil Rehabil 2012; 35:1401-7. [PMID: 23167292 DOI: 10.3109/09638288.2012.737086] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate all functional aspects of patients with longitudinal radial dysplasia and to clarify the relationship between body functions on the one hand and limitations in activity and participation on the other hand. METHODS Thirty-one arms of seventeen adult patients with longitudinal radial dysplasia were analysed. Body function was assessed by measuring grip and pinch strength and active range of motion (ROM) of the hand. Activities were measured using the "Sequential Occupational Dexterity Assessment ", to measure perceived restrictions in participation the "Impact on Participation and Autonomy questionnaire" was used. Relationships between severity of dysplasia, body function, participation and activity were determined. RESULTS Patients with a severe type scored significantly lower in body function scores than patients with a mild form. Patients with limited active finger joint motion performed worse on activities. We found no significant differences in activity and participation between mild or severe types and found no correlation in participation scores. CONCLUSION Although considerable restrictions in joint mobility and strength were revealed, little or no limitations on the activity and participation level were found. Limitations in body functions hardly influenced capacity on activity level and did not influence participation in societal roles.
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Affiliation(s)
- Irene Holtslag
- Department of Rehabilitation Medicine, University Medical Centre of Utrecht, Utrecht, The Netherlands
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Tse T, Douglas J, Lentin P, Carey L. Measuring participation after stroke: a review of frequently used tools. Arch Phys Med Rehabil 2012; 94:177-92. [PMID: 22982555 DOI: 10.1016/j.apmr.2012.09.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 08/29/2012] [Accepted: 09/02/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To identify and critique the measures currently used to assess participation in clinical stroke studies. DATA SOURCES Relevant articles published between January 2001 and April 2012 identified through Medline, CINAHL, and ProQuest Central databases. STUDY SELECTION Published articles involving poststroke assessment of participation. Case studies, cohort studies, and randomized controlled trials were included. DATA EXTRACTION The most frequently used measures were identified and the psychometric properties evaluated. Three raters independently evaluated each measure relative to the first and second coding levels of the International Classification of Functioning, Disability and Health (ICF) Activities and Participation domain categories. DATA SYNTHESIS Thirty-six measures were identified. The Stroke Impact Scale (SIS), London Handicap Scale, Assessment of Life Habits (LIFE-H), Frenchay Activities Index, and Activity Card Sort (ACS) were used most frequently. No single measure met criteria across all psychometric indices, and not one covered all 9 of the ICF Activities and Participation domains. The SIS, LIFE-H, and ACS covered the widest range. The domains covered most frequently were Community, Social and Civic Life, Domestic Life, and Mobility. Learning and Applying Knowledge, General Tasks and Demands, and Communication were the domains less frequently covered. CONCLUSIONS This review identified and evaluated the most frequently used participation measures in clinical stroke studies. The SIS, LIFE-H, and ACS covered the ICF Activities and Participation domain categories most comprehensively. However, none of the measures covered all the ICF Activities and Participation domain categories. The information provided in this systematic review can be used to guide the selection of participation measures to meet specific clinical and research purposes.
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Affiliation(s)
- Tamara Tse
- The Florey Institute of Neuroscience and Mental Health, Neurorehabilitation and Recovery, Stroke Division, Heidelberg, Victoria, Australia.
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Lantz K, Marcusson J, Wressle E. Perceived Participation and Health-Related Quality of Life in 85 Year Olds in Sweden. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2012. [DOI: 10.3928/15394492-20120316-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study explores how 85 year olds in Sweden perceive participation and autonomy in their life situations in relation to health-related quality of life and gender. A postal questionnaire included questions on sociodemographics, social network, assistive technology, community assistance, and the EQ-5D. During a home visit, an occupational therapist evaluated perceived participation and autonomy using the Impact on Participation and Autonomy Questionnaire. Most perceived their participation as sufficient. Women had greater limitations than men in indoor and outdoor autonomy. Only a few individuals reported many or severe problems with participation, mainly in mobility and leisure. Not having friends nearby, no close contact with neighbors, and living in community housing increased the risk of perceived problems. Sufficient participation was positively associated with higher health-related quality of life, and facilitating participation is an area of interest for occupational therapists.
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Stevelink SAM, Hoekstra T, Nardi SMT, van der Zee CH, Banstola N, Premkumar R, Nicholls PG, van Brakel WH. Development and structural validation of a shortened version of the Participation Scale. Disabil Rehabil 2012; 34:1596-607. [PMID: 22372970 DOI: 10.3109/09638288.2012.656793] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- S A M Stevelink
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, the Netherlands.
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Hitzig SL, Romero Escobar EM, Noreau L, Craven BC. Validation of the Reintegration to Normal Living Index for community-dwelling persons with chronic spinal cord injury. Arch Phys Med Rehabil 2012; 93:108-14. [PMID: 22200389 DOI: 10.1016/j.apmr.2011.07.200] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 07/21/2011] [Accepted: 07/22/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the validity (construct, concurrent) of the Reintegration to Normal Living (RNL) Index for measurement of community participation in adults with chronic spinal cord injury (SCI). DESIGN Cross-sectional telephone survey. SETTING Rehabilitation institute. PARTICIPANTS Community-dwelling adult men and women (N=617) with SCI who were at least 1 year postinjury. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES RNL Index and Satisfaction With Life Scale (SWLS). RESULTS Reliability of the RNL Index was determined by using Cronbach α, and construct validity was established through confirmatory factor analysis (CFA). In addition, general linear models to predict RNL Index scores were conducted to establish concurrent validity. The RNL Index is a reliable measure of community participation (α=.87). CFA analyses suggested that the RNL Index loads onto a 2-factor solution and is distinct from the SWLS. Significant predictors of RNL Index score included years post-injury, impairment, ambulatory status, employment, and poor health, which yielded R(2)=.26 (P<.001). CONCLUSIONS The RNL Index is a valid and reliable measure of community participation for persons with chronic SCI of traumatic cause.
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Affiliation(s)
- Sander L Hitzig
- Lyndhurst Centre, Toronto Rehabilitation Institute, Toronto, Ontario, Canada.
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Wilkie R, Jordan JL, Muller S, Nicholls E, Healey EL, van der Windt DA. Measures of social function and participation in musculoskeletal populations: Impact on Participation and Autonomy (IPA), Keele Assessment of Participation (KAP), Participation Measure for Post-Acute Care (PM-PAC), Participation Objective, Participation S. Arthritis Care Res (Hoboken) 2011; 63 Suppl 11:S325-36. [DOI: 10.1002/acr.20641] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Domain Sets and Measurement Instruments on Participation and Environmental Factors in Spinal Cord Injury Research. Am J Phys Med Rehabil 2011; 90:S66-78. [DOI: 10.1097/phm.0b013e318230fbf9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fairhall N, Sherrington C, Clemson L, Cameron ID. Do exercise interventions designed to prevent falls affect participation in life roles? A systematic review and meta-analysis. Age Ageing 2011; 40:666-74. [PMID: 21764816 DOI: 10.1093/ageing/afr077] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND the World Health Organization describes individuals' functioning at a societal level as 'participation'. Despite being a key component of functioning and an important goal of rehabilitation, participation is not measured consistently in ageing research. The aim was to evaluate the extent to which measurement of participation has been reported in trials of fall prevention interventions and to determine the effect of exercise interventions on participation in life roles. METHODS systematic review with meta-analysis. Randomised controlled trials of exercise interventions that aimed to reduce falls in older people (60+) in community, aged care facilities or hospital settings were included. The outcome of interest was participation in life roles. Trials that measured participation at two time-points were included in the meta-analysis. RESULTS ninety-six trials met the review inclusion criteria. Participation was measured in 19 of these trials (20%). Nine instruments were used to measure participation. Fifteen trials, involving 3,616 participants, were included in the meta-analysis. The pooled estimate of the effect of interventions including exercise indicated a small improvement in participation (Hedges' g = 0.16, 95% confidence interval = 0.04-0.27, P = 0.006). Meta-regression showed multifactorial intervention with an exercise component had a larger effect than exercise intervention alone, but the difference was not statistically significant (effect on Hedges' g = 0.22, 95% CI = -0.05 to 0.50, P = 0.10). CONCLUSION interventions including exercise may improve participation in life roles in older people. The International Classification of Functioning, Disability and Health may be a useful framework for understanding the broader impact of falls prevention interventions. SYSTEMATIC REVIEW REGISTRATION ACTRN12610000862044.
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Affiliation(s)
- Nicola Fairhall
- Musculoskeletal Division, The George Institute for Global Health, The University of Sydney, NSW, Australia.
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Adolfsson M, Malmqvist J, Pless M, Granuld M. Identifying child functioning from an ICF-CY perspective: Everyday life situations explored in measures of participation. Disabil Rehabil 2011; 33:1230-44. [DOI: 10.3109/09638288.2010.526163] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Brehm M, Bus SA, Harlaar J, Nollet F. A candidate core set of outcome measures based on the International Classification of Functioning, Disability and Health for clinical studies on lower limb orthoses. Prosthet Orthot Int 2011; 35:269-77. [PMID: 21937572 DOI: 10.1177/0309364611413496] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although many core sets of measurement concepts have been published in the literature, this has not been done for the field of lower limb orthoses. OBJECTIVES This paper provides an overview of the measurement concepts that are relevant in lower limb orthotic evaluations, and it proposes a candidate Core Set of outcome measures to be used in clinical studies on ankle-foot orthoses (AFOs) and knee-ankle-foot orthoses (KAFOs). STUDY DESIGN Literature review. METHODS The International Classification of Functioning, Disability and Health (ICF) was used as framework to select relevant concepts. RESULTS AND CONCLUSION Measurement concepts covering all ICF levels of functioning were identified as relevant for the Core Set, including functions of the joints and bones (b710-b729), muscle functions (b730-b749), gait pattern functions (b770), walking (b450), moving around in different locations (d460), and daily-life functioning (d5-d9). Further validation of this candidate Core Set through a formal decision-making process is needed to obtain consensus among experts in the field. Based on such a consensus, the next step will be to systematically review the literature and identify those measurement instruments that are best suited to assess the proposed concepts, based on their psychometric properties in a given sample and context. Thereafter, we suggest that this ICF Core Set of measurement instruments should be applied in orthotic studies on AFOs and KAFOs in ambulatory patients with gait problems. CLINICAL RELEVANCE Although many ICF Core Sets have been published, this has not been done for the field of lower limb orthoses. We feel that such a Core Set is urgently needed, to enable comparison of results, and establish evidence on the efficacy of orthotic treatment, which will improve patient care.
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Affiliation(s)
- Merel Brehm
- Department of Rehabilitation Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
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Bogner JA, Whiteneck GG, Corrigan JD, Lai JS, Dijkers MP, Heinemann AW. Comparison of Scoring Methods for the Participation Assessment With Recombined Tools–Objective. Arch Phys Med Rehabil 2011; 92:552-63. [DOI: 10.1016/j.apmr.2010.11.014] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 10/25/2010] [Accepted: 11/10/2010] [Indexed: 11/25/2022]
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Mayo NE, Moriello C, Asano M, van der Spuy S, Finch L. The extent to which common health-related quality of life indices capture constructs beyond symptoms and function. Qual Life Res 2010; 20:621-7. [PMID: 21108008 DOI: 10.1007/s11136-010-9801-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2010] [Indexed: 11/28/2022]
Abstract
PURPOSE This study proposes to identify for 5 widely used generic HRQL and QOL measures the extent to which function and global feelings of well-being are represented in their content. METHODS The 5 indices were the EQ-5D, the HUI, the SF-36, SF-12, and the WHOQOL-Bref. A total of 15 raters with a variety of health and research backgrounds mapped the items. Raters independently identified all codes that could possibly map to the item and indicated the code that best reflected the underlying intent of the item, using the standardized mapping rules and methodology. A Delphi process aided consensus for each of the items. The consensus rounds involved reconsideration of item codes for which 70% of raters did not agree on the "best" code. These consensus rounds were terminated when item codes reached the threshold of 70% agreement or when it became evident from that consensus would not be reached. RESULTS Function was a predominant construct for the 5 indices, with the proportion of items capturing function ranging from a low of 27% for the WHOQOL-Bref to a high of 92% for the SF-12. Less than 50% of items within the indices mapped to the granularity of function as described by the ICF. CONCLUSIONS This paper demonstrates an additional method to validate the content of health-related indices to supplement the qualitative methods of consulting with experts and patients.
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Affiliation(s)
- Nancy E Mayo
- Division of Clinical Epidemiology, Royal Victoria Hospital Site, 687 Pine Ave. W, Montreal, Quebec, Canada.
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Magasi S, Post MW. A Comparative Review of Contemporary Participation Measures' Psychometric Properties and Content Coverage. Arch Phys Med Rehabil 2010; 91:S17-28. [PMID: 20801275 DOI: 10.1016/j.apmr.2010.07.011] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 07/15/2010] [Indexed: 10/19/2022]
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Hollingsworth H, Gray DB. Structural equation modeling of the relationships between participation in leisure activities and community environments by people with mobility impairments. Arch Phys Med Rehabil 2010; 91:1174-81. [PMID: 20684897 DOI: 10.1016/j.apmr.2010.04.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Revised: 04/20/2010] [Accepted: 04/21/2010] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the linkages between the constructs of participation and the environment for a set of leisure activities (attending concerts, attending movies, attending sporting events). DESIGN Self-report surveys of the influence of the environment on participation were analyzed using structural equation modeling. Temporal, evaluative, and health-related aspects of leisure activities were selected as latent variables associated with participation. The environmental construct consisted of the latent variables of the influence on participation of the natural, interpersonal, built, background, and supportive environments. SETTING Midwestern United States. PARTICIPANTS A purposive sample of people (N=604) with mobility limitations. INTERVENTION None. MAIN OUTCOME MEASURES Measures of relationships between participation in leisure activities and the environment of people with mobility limitations. RESULTS Structural equation modeling can be an important tool for empirically examining the contributions of the component latent variables of participation and the environment. CONCLUSIONS A model that fits participation by people with disabling conditions in their environment can provide guidance for community-based interventions and person-based therapies.
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Affiliation(s)
- Holly Hollingsworth
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO, USA.
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