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Ringsten M, Ivanic B, Iwarsson S, Lexell EM. Interventions to improve outdoor mobility among people living with disabilities: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1407. [PMID: 38882933 PMCID: PMC11177337 DOI: 10.1002/cl2.1407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 06/18/2024]
Abstract
Background Around 15% of the global population live with some form of disabilities and experience worse health outcomes, less participation in the community and are part of fewer activities outside the home. Outdoor mobility interventions aim to improve the ability to move, travel and orient outside the home and could influence the number of activities outside the home, participation and quality of life. However, outdoor mobility interventions may also lead to harm like falls or injuries or have unforeseen effects which could lead to mortality or hospitalization. Objectives To assess the efficacy of interventions aiming to improve outdoor mobility for adults living with disabilities and to explore if the efficacy varies between different conditions and different intervention components. Search Methods Standard, extensive Campbell search methods were used, including a total of 12 databases searched during January 2023, including trial registries. Selection Criteria Only randomized controlled trials were included, focusing on people living with disabilities, comparing interventions to improve outdoor mobility to control interventions as well as comparing different types of interventions to improve outdoor mobility. Data Collection and Analysis Standard methodological procedures expected by Campbell were used. The following important outcomes were 1. Activity outside the home; 2. Engagement in everyday life activities; 3. Participation; 4. Health-related Quality of Life; 5. Major harms; 6. Minor harms. The impact of the interventions was evaluated in the shorter (≤6 months) and longer term (≥7 months) after starting the intervention. Results are presented using risk ratios (RR), risk difference (RD), and standardized mean differences (SMD), with the associated confidence intervals (CI). The risk of bias 2-tool and the GRADE-framework were used to assess the certainty of the evidence. Main Results The screening comprised of 12.894 studies and included 22 studies involving 2.675 people living with disabilities and identified 12 ongoing studies. All reported outcomes except one (reported in one study, some concerns of bias) had overall high risk of bias. Thirteen studies were conducted in participants with disabilities due to stroke, five studies with older adults living with disabilities, two studies with wheelchair users, one study in participants with disabilities after a hip fracture, and one study in participants with cognitive impairments. Skill training interventions versus control interventions (16 studies) The evidence is very uncertain about the benefits and harms of skill training interventions versus control interventions not aimed to improve outdoor mobility among all people living with disabilities both in the shorter term (≤6 months) and longer term (≥7 months) for Activity outside the home; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. Skill training interventions may improve engagement in everyday life activities among people with disabilities in the shorter term (RR: 1.46; 95% CI: 1.16 to 1.84; I 2 = 7%; RD: 0.15; 95% CI: -0.02 to 0.32; I 2 = 71%; 692 participants; three studies; low certainty evidence), but the evidence is very uncertain in the longer term, based on very low certainty evidence. Subgroup analysis of skill training interventions among people living with disabilities due to cognitive impairments suggests that such interventions may improve activity outside the home in the shorter term (SMD: 0.44; 95% CI: 0.07 to 0.81; I 2 = NA; 118 participants; one study; low certainty evidence). Subgroup analysis of skill training interventions among people living with cognitive impairments suggests that such interventions may improve health-related quality of life in the shorter term (SMD: 0.49; 95% CI: 0.12 to 0.88; I 2 = NA; 118 participants; one study; low certainty evidence). Physical training interventions versus control interventions (five studies) The evidence is very uncertain about the benefits and harms of physical training interventions versus control interventions not aimed to improve outdoor mobility in the shorter term (≤6 months) and longer term (≥7 months) for: Engagement in everyday life activities; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. Physical training interventions may improve activity outside the home in the shorter (SMD: 0.35; 95% CI: 0.08 to 0.61; I 2 = NA; 228 participants; one study; low certainty evidence) and longer term (≥7 months) (SMD: 0.27; 95% CI: 0.00 to 0.54; I 2 = NA; 216 participants; one study; low certainty evidence). Comparison of different outdoor mobility interventions (one study) The evidence is very uncertain about the benefits and harms of outdoor mobility interventions of different lengths in the shorter term (≤6 months) and longer term (≥7 months) for Activity outside the home; Engagement in everyday life activities; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. No studies explored the efficacy of other types of interventions. Authors’ Conclusions Twenty-two studies of interventions to improve outdoor mobility for people living with disabilities were identified, but the evidence still remains uncertain about most benefits and harms of these interventions, both in the short- and long term. This is primarily related to risk of bias, small underpowered studies and limited reporting of important outcomes for people living with disabilities. For people with disabilities, skill training interventions may improve engagement in everyday life in the short term, and improve activity outside the home and health-related quality of life for people with cognitive impairments in the short term. Still, this is based on low certainty evidence from few studies and should be interpreted with caution. One study with low certainty evidence suggests that physical training interventions may improve activity outside the home in the short term. In addition, the effect sizes across all outcomes were considered small or trivial, and could be of limited relevance to people living with disabilities. The evidence is currently uncertain if there are interventions that can improve outdoor mobility for people with disabilities, and can improve other important outcomes, while avoiding harms. To guide decisions about the use of interventions to improve outdoor mobility, future studies should use more rigorous design and report important outcomes for people with disabilities to reduce the current uncertainty.
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Affiliation(s)
- Martin Ringsten
- Cochrane Sweden, Research and Development Skåne University Hospital Lund Sweden
- Department of Health Sciences Lund University Lund Sweden
| | | | | | - Eva Månsson Lexell
- Department of Health Sciences Lund University Lund Sweden
- Department of Neurology, Rehabilitation Medicine, Cognitive Medicine and Geriatrics Skåne University Hospital Lund-Malmö Sweden
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van Biljon HM, van Niekerk L, Plastow NA, Swanepoel L. Out-of-home life spaces valued by urban older adults with limited income. Afr J Disabil 2023; 12:1177. [PMID: 37293267 PMCID: PMC10244872 DOI: 10.4102/ajod.v12i0.1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/27/2023] [Indexed: 06/10/2023] Open
Abstract
Background Access to, and occupational performance in, out-of-home-life-spaces is linked to health, wellbeing and quality of life for older adults. There is little evidence of how this relates to older adults with limited resources in an African urban context. Objectives To describe the out-of-home-life-spaces accessed and valued by older adults with limited resources, living in an urban South African setting. Method An exploratory concurrent mixed methods study saw 84 rehabilitation clinicians conduct 393 face-to-face interviews with older adults. Clinicians produced reflective field notes and participated in focus groups. Quantitative data were analysed using descriptive statistics with SPSS Version X. Qualitative data were analysed through inductive content analysis. Results Older adults walked, used mini-bus taxis or private vehicles to get to places of worship, medical facilities, shops, family and friends and special interest gatherings on a weekly or monthly frequency. Lack of funds was the main barrier. Older adults aspired to travel, go on holiday and to visit out-of-town family homes. Conclusion Exploring the daily lived experience of older, urban South Africans with limited resources brought to light the value they attribute to participation in activities that contribute to the wellbeing of their families and communities. Such activities are found in a variety of life spaces. Contribution Results could inform policy makers and service providers in their planning of community mobility, transportation services and health care, for older adults with limited resources.
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Affiliation(s)
- Hester M van Biljon
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lana van Niekerk
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nicola A Plastow
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lizette Swanepoel
- Department of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Bergström A, Fallahpour M, Vikström S. Occupational gaps reported by proxies for persons with dementia residing in a nursing home. Scand J Occup Ther 2023; 30:374-383. [PMID: 34932438 DOI: 10.1080/11038128.2021.2016947] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND In accordance with Swedish national dementia guidelines, persons with dementia residing in nursing homes should have the possibility to participate in everyday occupations. Securing choices and desires for participating in occupations is challenging due to the nature of dementia and is not evident in empirical studies regarding nursing home residents. AIM to describe gaps in participation in everyday occupations among persons with dementia living in a nursing home, as reported by a proxy respondent. METHOD To record the congruence or discrepancy between doing and wanting to do, the Occupational Gaps Questionnaire was used. Results were analysed with descriptive statistics. RESULTS The respondents scored that over half of the persons with dementia had two or more occupational gaps and one-fourth wanted to participate in minor shopping. However, less than two percent were deemed to do this activity. CONCLUSIONS Persons with dementia living in nursing homes risk restrictions in participation. Securing valuable information regarding individuals' choices and desires, adhering to the persons' inherent rights to expression, can be the first step in promoting participation in everyday occupations. SIGNIFICANCE Occupational therapists with their unique theoretical knowledge can facilitate participation in occupations, supporting the citizenship of nursing home residents.
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Affiliation(s)
- Aileen Bergström
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Mandana Fallahpour
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Sofia Vikström
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Ringsten M, Iwarsson S, Lexell EM. PROTOCOL: Interventions to improve outdoor mobility among adults with disability. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1280. [PMID: 36908835 PMCID: PMC9538711 DOI: 10.1002/cl2.1280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This is the protocol for a Campbell systematic review. The objectives are as follows: to assess the efficacy of interventions aiming to improve outdoor mobility for people with disability and to explore if the efficacy varies between different populations and different intervention components.
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Affiliation(s)
- Martin Ringsten
- Cochrane Sweden, Research and DevelopmentSkåne University HospitalLundSweden
- Department of Health SciencesLund UniversityLundSweden
| | | | - Eva Månsson Lexell
- Department of Health SciencesLund UniversityLundSweden
- Department of Neurology, Rehabilitation Medicine, Cognitive Medicine and GeriatricsSkåne University HospitalLund‐MalmöSweden
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van Biljon H, van Niekerk L, Margot-Cattin I, Adams F, Plastow N, Bellagamba D, Kottorp A, Patomella AH. The health equity characteristics of research exploring the unmet community mobility needs of older adults: a scoping review. BMC Geriatr 2022; 22:808. [PMID: 36266632 PMCID: PMC9585759 DOI: 10.1186/s12877-022-03492-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/26/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Unmet community mobility needs of older adults, published since the announcement of the UN sustainable development goals was synthesised to describe the health equity characteristics of research identifying unmet community mobility needs of older adults. METHODS Searches were conducted in March and April 2020, 2275 articles were screened and 100 identified for data extraction. RESULTS Findings showed underrepresentation of articles considering rural settings [9%] and originating in the global South [14%]. Gender, disability, education, and transport / driving were identified as key health equity characteristics and only 10 articles provided detail on all four of these. External factors inhibiting community mobility included built environments, service availability, and societal attitudes. Internal factors included finances, fear and apprehension, and functional limitations. CONCLUSIONS The need for standardised reporting of participant characteristics in the community mobility of older adults was highlighted. These characteristics are required by research consumers to judge equity dimensions, and the extent to which findings represent minority or marginalised groups. 15 after the UN pledge to reduce inequalities, peer reviewed primary research does not reflect a global drive to end discrimination, exclusion and reduce the inequalities and vulnerabilities that leave people behind.
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Affiliation(s)
- Hester van Biljon
- grid.11956.3a0000 0001 2214 904XStellenbosch University, Stellenbosch, South Africa
| | - Lana van Niekerk
- grid.11956.3a0000 0001 2214 904XStellenbosch University, Stellenbosch, South Africa
| | - Isabel Margot-Cattin
- grid.410380.e0000 0001 1497 8091University of Applied Sciences and Arts, Windisch, Switzerland
| | - Fasloen Adams
- grid.11956.3a0000 0001 2214 904XStellenbosch University, Stellenbosch, South Africa
| | - Nicola Plastow
- grid.11956.3a0000 0001 2214 904XStellenbosch University, Stellenbosch, South Africa
| | - David Bellagamba
- grid.410380.e0000 0001 1497 8091University of Applied Sciences and Arts, Windisch, Switzerland
| | - Anders Kottorp
- grid.32995.340000 0000 9961 9487Malmö University, Malmö, Sweden
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Gaber SN, Thalén L, Malinowsky CW, Margot-Cattin I, Seetharaman K, Chaudhury H, Cutchin M, Wallcook S, Kottorp A, Brorsson A, Biglieri S, Nygård L. Social Citizenship Through Out-of-Home Participation Among Older Adults With and Without Dementia. J Appl Gerontol 2022; 41:2362-2373. [PMID: 35773080 PMCID: PMC9561802 DOI: 10.1177/07334648221112425] [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] [Indexed: 11/15/2022] Open
Abstract
There is limited empirical knowledge about how older adults living with dementia enact their social citizenship through out-of-home participation. This study aimed: (a) to investigate out-of-home participation among older adults with and without dementia in four countries and (b) to compare aspects of stability or change in out-of-home participation. Using a cross-sectional design, older adults with mild-to-moderate dementia and without dementia, aged 55 years and over, were interviewed using the Participation in ACTivities and Places OUTside the Home questionnaire in Canada (n = 58), Sweden (n = 69), Switzerland (n = 70), and the United Kingdom (n = 128). Data were analyzed using descriptive statistics and a two-way analysis of variance. After adjustment for age, diagnosis of dementia and country of residence had significant effects on total out-of-home participation (p < .01). The results contribute to policies and development of programs to facilitate social citizenship by targeting specific activities and places.
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Affiliation(s)
- Sophie N Gaber
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, 27106Karolinska Institutet, Huddinge, Sweden.,Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden
| | - Liv Thalén
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, 27106Karolinska Institutet, Huddinge, Sweden
| | - Camilla W Malinowsky
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, 27106Karolinska Institutet, Huddinge, Sweden
| | - Isabel Margot-Cattin
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, 27106Karolinska Institutet, Huddinge, Sweden.,Department of Occupational Therapy, School of Social Work and Health, Lausanne (HETSL), 111832University of Applied Sciences and Arts of Western Switzerland (HES-SO) Delémont, Switzerland
| | | | - Habib Chaudhury
- Department of Gerontology, 1763Simon Fraser University, Burnaby, BC, Canada
| | - Malcolm Cutchin
- 144477Pacific Northwest University of Health Sciences, Yakima, WA, USA
| | - Sarah Wallcook
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, 27106Karolinska Institutet, Huddinge, Sweden
| | - Anders Kottorp
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, 27106Karolinska Institutet, Huddinge, Sweden.,Faculty of Health and Society, 59606Malmö University, Malmö, Sweden
| | - Anna Brorsson
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, 27106Karolinska Institutet, Huddinge, Sweden
| | - Samantha Biglieri
- School of Urban and Regional Planning, 7984Ryerson University, Toronto, ON, Canada
| | - Louise Nygård
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, 27106Karolinska Institutet, Huddinge, Sweden
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Thalén L, Malinowsky C, Margot-Cattin I, Gaber SN, Seetharaman K, Chaudhury H, Cutchin M, Wallcook S, Anders K, Brorsson A, Nygård L. Out-of-home participation among people living with dementia: A study in four countries. DEMENTIA 2022; 21:1636-1652. [PMID: 35435030 PMCID: PMC9243454 DOI: 10.1177/14713012221084173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Social participation in out-of-home activities is important for people living with
dementia, yet little is known about such participation. The aim of this study was to
explore and compare out-of-home participation among people living with dementia in four
countries by assessing different types of places of participation visited or no longer
visited. A cross-sectional design was used to gather self-reported experiences concerning
out-of-home participation among people with mild stage dementia living in Canada
(n = 29), Sweden (n = 35), Switzerland
(n = 35) and the UK (n = 64). Interviews were
conducted using the Participation in ACTivities and places OUTside the Home for
older adults (ACT-OUT) instrument. Participants still visited 16
(Median) places out of a possible total of 24, and they had abandoned 5
(Median) places. Neighbourhood was the place most participants still
visited, whereas 50% of them had stopped going to a Sports facility, with no significant
differences between country samples regarding how many participants had abandoned that
place (Fisher’s exact test, p > 0.01). There were significant
differences between country samples in the frequency of present participation and
abandonment of the Hospital, Dentist’s office, Cemetery, Garden, and Forest (Fisher’s
exact test, all p < 0.01). Although the participants still visited a
variety of places, they had stopped going to places previously visited, which indicates
reductions in participation, posing an inherent risk to well-being. The similarities and
differences across samples from the four countries suggest that healthcare services and
access to public transport may contribute to the complex interactional process of
out-of-home participation for people living with dementia. The findings highlight the need
for initiatives targeting specific types of places to support continued participation in
society, especially places at a higher risk of abandonment such as places for recreation
and physical activity.
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Affiliation(s)
- Liv Thalén
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Camilla Malinowsky
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Isabel Margot-Cattin
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Occupational Therapy, School of Social Work and Health, Lausanne (HETSL), University of Applied Sciences and Arts of Western Switzerland (HES-SO), Delémont, Switzerland
| | - Sophie N Gaber
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Ersta Sköndal Bräcke University College, Department of Health Care Sciences, and Uppsala University, Department of Women’s and Children’s Health, Clinical Psychology in Healthcare, Huddinge, Sweden
| | | | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Malcolm Cutchin
- Pacific Northwest University of Health Sciences, Yakima, WA, United States
| | - Sarah Wallcook
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Kottorp Anders
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden and Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Anna Brorsson
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Louise Nygård
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Margot-Cattin I, Berchtold A, Gaber S, Kuhne N, Nygård L, Malinowsky C. Associations between community participation and types of places visited among persons living with and without dementia: risks perception and socio-demographic aspects. BMC Geriatr 2022; 22:309. [PMID: 35397532 PMCID: PMC8994370 DOI: 10.1186/s12877-022-03015-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Increasingly, literature has focused on community participation in places visited by persons living with and without dementia. Earlier research indicates that multiple factors, including socio-demographic aspects and risk perception may influence community participation.
Aim and methods
This cross-sectional, explorative study aims to inquire into how places visited, socio-demographic aspects and risks perception are associated with self-rated community participation for persons living with and without dementia (n = 70) in Switzerland. Data was collected through face-to-face interviews with questionnaires (ACT-OUT, MoCA, sociodemographic). First, we investigated whether the number of places visited was correlated with self-rated participation; then we added socio-demographic and risks perception factors with a bivariate analysis; and searched for a model using multinomial logistic regressions.
Results
For the group of participants living with dementia, risks of falling (p = .014) and of getting lost (p = .037) were significantly associated with self-rated participation. For the group of participants living without dementia, visiting places outside the home was significantly associated with self-rated participation, especially visiting places in domain D/places for recreational and physical activities (p = .005).
Discussion and conclusions
The results of exploring multiple factors and searching for a model highlights the complexity of community participation as a construct. Risks and visiting places for recreational and physical activities seem to play a role in self-rated participation. Mobile interviews might be better suited to gain in-depth understanding on community participation for persons living with dementia.
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Margot-Cattin I, Kühne N, Öhman A, Brorsson A, Nygard L. Familiarity and participation outside home for persons living with dementia. DEMENTIA 2021; 20:2526-2541. [PMID: 33779330 PMCID: PMC8564230 DOI: 10.1177/14713012211002030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Familiarity is important for persons living with dementia who participate outside home.
When familiarity is challenged, such participation may be difficult. This ethnographic
study clarifies how familiarity is experienced by persons with dementia in performing
activities and visiting places, and how familiarity contributes to maintaining
participation outside home. Nine participants were interviewed in their home and while
visiting familiar places. Data were content analysed using a constant comparative method.
The findings suggest that persons with dementia experience familiarity as continuous and
whole, through occurrences that support personal territories. Landmarks and objects
enhance the experience of familiarity. Familiarity that is continuously challenged may
render participation outside home fragile.
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Affiliation(s)
- Isabel Margot-Cattin
- Department of Occupational Therapy, School of Social Work and Health - Lausanne (HETSL), University of Applied Sciences and Arts of Western Switzerland (HES-SO), Switzerland; Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), 27106Karolinska Institute, Stockholm, Sweden
| | - Nicolas Kühne
- Department of Occupational Therapy, School of Social Work and Health - Lausanne (HETSL), University of Applied Sciences and Arts of Western Switzerland (HES-SO), Switzerland
| | - Annika Öhman
- Unit of Occupational Therapy, Department of Health, Medicine and Caring Sciences, 4566Linköping University, Norrköping, Sweden
| | - Anna Brorsson
- Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), 27106Karolinska Institute, Stockholm, Sweden
| | - Louise Nygard
- Division of Occupational Therapy, Department of Neurobiology, Care Science and Society (NVS), 27106Karolinska Institute, Stockholm, Sweden
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