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Bernard M, Hoffmann L, Richter M, Völlm C, Fink A, Dawal B. Participation of adolescents with and without physical disabilities and chronic diseases: A comprehensive conceptualization. Child Care Health Dev 2024; 50:e13240. [PMID: 38426628 DOI: 10.1111/cch.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/10/2024] [Accepted: 01/13/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND In 2001, the International Classification of Functioning and Disability (ICF) introduced participation as a main goal of rehabilitation processes. However, to date, a comprehensive concept of participation in the rehabilitative context is missing, particularly in German-speaking countries. We thus aimed to refine and extend the existing concepts of participation in this brief communication. METHODS In preceding studies, we conducted semi-structured interviews with adolescents who either had chronic diseases and/or physical disabilities or had no impairments and focus groups with parents and experts. Based on these diverse perspectives and findings, we refine the term participation. RESULTS Participation is a construct that is embedded in a social context and consists of objective (i.e., attendance) and subjective (i.e., satisfaction and involvement) dimensions. These dimensions are reflected in different domains and areas that are relevant to adolescents' lives. In addition, the subjective relevance of respective areas in life needs to be regarded as a weighing component when evaluating participation. CONCLUSION Our results reflect international models on participation, refine the existing concept, and underline the multidimensional character of participation. These findings are urgently needed to develop appropriate instruments, for example, for assessing whether rehabilitative processes are effective regarding the goal of participation.
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Affiliation(s)
- Marie Bernard
- Institute of Medical Sociology (IMS), Interdisciplinary Center for Health Sciences, Medical Faculty, Martin Luther University, Halle-Wittenberg, Germany
| | - Laura Hoffmann
- Institute of Medical Sociology (IMS), Interdisciplinary Center for Health Sciences, Medical Faculty, Martin Luther University, Halle-Wittenberg, Germany
- TUM School of Medicine and Health, Department Health and Sport Sciences, Chair of Social Determinants of Health, Technical University of Munich, Germany
| | - Matthias Richter
- Institute of Medical Sociology (IMS), Interdisciplinary Center for Health Sciences, Medical Faculty, Martin Luther University, Halle-Wittenberg, Germany
- TUM School of Medicine and Health, Department Health and Sport Sciences, Chair of Social Determinants of Health, Technical University of Munich, Germany
| | - Carina Völlm
- Health Department, City of Stuttgart, Stuttgart, Germany
| | - Astrid Fink
- Department of Health and Consumer Protection, Kreis Groß-Gerau, Groß-Gerau, Germany
| | - Britta Dawal
- Department of Educational-and Social Sciences, University of Applied Sciences Südwestfalen, Germany
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Krieger B, Ederer F, Amann R, Morgenthaler T, Schulze C, Dawal B. Translation and cross-cultural adaptation of the young children participation and environment measure for its use in Austria, Germany, and Switzerland. Front Pediatr 2024; 11:1258377. [PMID: 38239598 PMCID: PMC10794623 DOI: 10.3389/fped.2023.1258377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Background Concepts such as participation and environment may differ across cultures. Consequently, cultural equivalence must be assured when using a measure like the Young Children Participation and Environment Measure (YC-PEM) in other settings than the original English-speaking contexts. This study aimed to cross-culturally translate and adapt the YC-PEM into German as it is used in Germany, Austria, and Switzerland. Methods Following international guidelines, two translations were compared, and the research and expert team made the first adaptations. Twelve caregivers of children with and without disabilities from three German-speaking countries participated in two rounds of think-aloud interviews. Data were analyzed by content analysis to look for item, semantic, operational, conceptual, and measurement equivalence to reach a cultural equivalence version in German. Results Adaptations were needed in all fields but prominently in item, operational, and conceptual equivalence. Operational equivalence resulted in graphical adaptations in the instructions and questions to make the German version of YC-PEM, YC-PEM (G), more user-friendly. Conclusion This study presents a cross-cultural translation and adaptation process to develop a German version of the YC-PEM suitable for Germany, Austria, and Switzerland. A culturally adapted YC-PEM (G) is now available for research, practice, and further validation.
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Affiliation(s)
- Beate Krieger
- Institute of Occupational Therapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Friedrich Ederer
- Department of Economic and Social Sciences, Institute for Social Medicine, Rehabilitation Sciences and Health Services Research, Nordhausen University of Applied Sciences, Nordhausen, Germany
| | - Ruth Amann
- Department of Occupational Therapy, Graz University Clinic for Pediatrics and Adolescents Medicine, Graz, Austria
| | - Thomas Morgenthaler
- Institute of Occupational Therapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Christina Schulze
- Institute of Occupational Therapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Britta Dawal
- Department of Education and Social Sciences, South Westphalia University of Applied Sciences, Soest, Germany
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Hoffmann L, Völlm C, Bernard M, Fink A, Richter M, Dawal B. What does social participation mean? A qualitative study exploring the concept of participation from the perspectives of experts and parents. BMJ Open 2023; 13:e072684. [PMID: 37451711 PMCID: PMC10351295 DOI: 10.1136/bmjopen-2023-072684] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVES This study aimed to assess the theoretical framework regarding social participation from the perspectives of experts and parents of youth aged between 10 and 17 years, and therefore, provides new insights into the concept of social participation. DESIGN A qualitative study was conducted to understand the construct of social participation in more detail. Eight focus groups were held with experts (n=21) and parents (n=24) and analysed based on content analysis. PARTICIPANTS We used purposive and snowball sampling to obtain a comprehensive sample of (A) parents of adolescents with and without chronic and/or physical-motor impairments and (B) experts involved in participatory research and/or treatment of adolescents with chronic and/or physical-motor impairments. The final sample consisted of 3 focus groups with a total of 21 experts and 5 focus groups with 24 parents. This included 10 parents who had disabled children. RESULTS The concept of social participation consists of subjective and objective components. The focus from the experts' perspective is clearly on the subjective level; that is, revolving around the question 'Does the adolescent feel involved?' In contrast, the parents' focus is more on normative expectations. The possibility of participation in all areas of life through the adjustment of environmental factors was identified as a central factor. CONCLUSIONS The results underline the importance of the subjective feelings of adolescents, as well as the significance of normative requirements. To capture the subjective component of participation, suitable measurements are needed. TRIAL REGISTRATION NUMBER DRKS00014739.
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Affiliation(s)
- Laura Hoffmann
- Chair of Social Determinants of Health, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | | | - Marie Bernard
- Institute of Medical Sociology, Martin Luther University, Halle, Germany
| | - Astrid Fink
- Institute of Medical Sociology, Martin Luther University, Halle, Germany
- Department of Health and Consumer Protection, Kreis Groß-Gerau, Germany
| | - Matthias Richter
- Chair of Social Determinants of Health, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Britta Dawal
- Department of Education and Social Sciences, South Westphalia University of Applied Sciences, Soest, Germany
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Bärwalde T, Hoffmann L, Fink A, Völlm C, Martin O, Bernard M, Gebhard B, Richter M. The Adolescent Concept of Social Participation-A Qualitative Study on the Concept of Social Participation from Adolescents with and without Physical Disabilities. QUALITATIVE HEALTH RESEARCH 2023; 33:143-153. [PMID: 36527275 DOI: 10.1177/10497323221146414] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE The construct of social participation is still not clearly defined. To reach a better understanding of social participation, the perspectives of adolescents must be taken into account. This study explores the adolescent concept of social participation and expands knowledge of the meaning of subjective components of the term. METHODS Thirty-four semi-structured interviews were conducted with adolescents with and without physical disabilities or chronic diseases between the ages of 12 and 17 and analyzed according to grounded theory. RESULTS Adolescents describe social participation as involving reflexive interaction with their social environment. Furthermore, forming a social environment plays an important role. All components of the concept are embedded in a context that influences the ways adolescents participate. Adolescents differentiate between active and passive forms of social participation. The concept of reflexive interaction is situated within an interdependent structure of components such as the "feeling of belonging" and the feeling of "well-being" among adolescents. CONCLUSION The results expand the current state of knowledge regarding the theoretical differentiation of social participation by exploring subjective components of the term. This offers the possibility of supplementing the theoretical frameworks of social participation and supports the understanding of the critical importance of social participation for adolescents.
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Affiliation(s)
- Tim Bärwalde
- Department of Anesthesiology and Intensive Care Medicine, 14955Park-Klinik Weissensee, Berlin, Germany
| | - Laura Hoffmann
- Institute of Medical Sociology, 9176Martin Luther University Halle-Wittenberg, Germany
- TUM Department of Sport and Health Sciences, 9184Technical University of Munich, Germany
| | - Astrid Fink
- Department of Health and Consumer Protection, Kreis Groß-Gerau, Groß-Gerau, Germany
| | - Carina Völlm
- Department of Educational- and Social Sciences, South Westphalia University of Applied Sciences, Germany
| | - Olaf Martin
- Institute of Nursing Science and Interprofessional Learning, 60634University Medicine Greifswald, Germany
| | - Marie Bernard
- Institute of Medical Sociology, 9176Martin Luther University Halle-Wittenberg, Germany
| | - Britta Gebhard
- Department of Educational- and Social Sciences, South Westphalia University of Applied Sciences, Germany
| | - Matthias Richter
- TUM Department of Sport and Health Sciences, 9184Technical University of Munich, Germany
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Golos A, Weintraub N. The Psychometric Properties of the Structured Preschool Participation Observation (SPO). Phys Occup Ther Pediatr 2020; 40:582-594. [PMID: 31928286 DOI: 10.1080/01942638.2020.1711845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIMS To evaluate the validity and reliability of the Structured Preschool Participation Observation (SPO), based on the COnsensus-based-Standards for the selection of health Measurement INstruments. The SPO development was based on biopsychosocial and ecological models to evaluate children's participation in play, learning and social occupational areas. METHODS Following the establishment of content validity, construct validity using factor analysis and reliability were examined among 250 preschool children with typical development (TD). The known-groups procedure was used, comparing 88 children with developmental disabilities (DD), who attended special educational settings with the TD children. RESULTS Three factors accounted for 68% of the variance. High internal consistency (alpha>.812) was found, as well as a significant moderate-to-high inter-rater reliability in most areas. Children with TD scored significantly higher than children with DD with small to large effect sizes. CONCLUSIONS The SPO appears to be a suitable measure for assessing children's participation in preschool activities through structured observation. Further studies are needed to further establish its psychometric properties, along with using additional scales of enjoyment and/or involvement and self-care activities. The SPO may assist in generating intervention goals for children with limitations in participation and may complement information gathered from parents.
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Affiliation(s)
- Anat Golos
- Head of Environment and Participation in Community Laboratory; Head of Undergraduate Studies and Deputy Chair of School of Occupational Therapy, Hebrew University, Jerusalem, Israel
| | - Naomi Weintraub
- Head of the Neuro-Developmental Disabilities and Writing Research Laboratory, the School of Occupational Therapy, Hebrew University, Jerusalem, Israel
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Smits DW, van Gorp M, van Wely L, Verheijden J, Voorman J, Wintels S, van der Cruijsen J, Ketelaar M. Participation in Social Roles of Adolescents With Cerebral Palsy: Exploring Accomplishment and Satisfaction. Arch Rehabil Res Clin Transl 2019; 1:100021. [PMID: 33543052 PMCID: PMC7853369 DOI: 10.1016/j.arrct.2019.100021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective To explore participation in social roles of adolescents (aged 12-18y) with cerebral palsy (CP), in terms of satisfaction compared with accomplishment. Design Cohort study as part of a prospective longitudinal research program. Setting Clinic. Participants Participants were adolescents (N=45; 58% male, mean age 15y 6mo) with CP at levels I-II (88%) and III-IV-V (12%) of the Gross Motor Function Classification System. Interventions Not applicable. Main Outcome Measures Accomplishment (0-9 scale; with score <8 “having difficulties”) and satisfaction (1-5 scale; with score 3 “neutral”) were assessed using the Life-Habits questionnaire, on 6 domains (Responsibilities, Interpersonal relationships, Community life, Education, Employment, Recreation). Per domain, we analyzed scatterplots of accomplishment vs satisfaction. Additionally, we compared determinant-models (including factors of CP, activity, person, and environment) using regression analysis. Results For accomplishment, mean scores were <8.00 except for Interpersonal relationships. For satisfaction, mean scores varied between 3.85 and 4.34. Overall, individuals with similar levels of accomplishment showed large ranges in their levels of satisfaction, which was expressed by low explained variances, especially on Education (6%). Furthermore, different sets of determinants were found for accomplishment (predominantly CP factors) compared with satisfaction (predominantly environment factors). Conclusions This study revealed a dissociation between participation accomplishment and satisfaction with participation among adolescents with CP. For practice and research, we recommend not only to focus on accomplishment but also, if not mainly, on satisfaction.
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Key Words
- Adolescent
- CP, cerebral palsy
- Cerebral palsy
- GMFCS, Gross Motor Function Classification System
- GMFM, Gross Motor Function Measure
- ICF, International Classification of Functioning, Disability, and Health
- Life-H, Life Habits questionnaire
- MACS, Manual Ability Classification System
- PEDI, Pediatric Evaluation of Disability Inventory
- PERRIN, Pediatric Rehabilitation Research in the Netherlands
- Personal satisfaction
- PiP, Participation in Perspective
- Rehabilitation
- Social participation
- UCL, Utrecht Coping List
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Affiliation(s)
- Dirk-Wouter Smits
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marloes van Gorp
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Leontien van Wely
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Johannes Verheijden
- BOSK, Association of Persons with a Physical Disability, Utrecht, The Netherlands
| | - Jeanine Voorman
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sophie Wintels
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Joyce van der Cruijsen
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Corresponding author Marjolijn Ketelaar, PhD, Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Rembrandtkade 10, 3583 TM Utrecht, The Netherlands.
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