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Barradell S, Scholten I. How, and to what end, is the WHO-ICF framework represented in physiotherapy? Insights from a qualitative research synthesis. Physiother Theory Pract 2024:1-18. [PMID: 38938207 DOI: 10.1080/09593985.2024.2370345] [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: 11/13/2023] [Accepted: 06/14/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND It has been two decades since the World Health Organization's endorsement of the International Classification of Functioning, Disability and Health (ICF). It is timely to undertake a rigorous search that analyzes the discourses around the ICF's conceptual framework within physiotherapy, the kinds of enquiry to date and the professional areas where this is happening and how. PURPOSE The aim of this research is to synthesize the literature related to how the physiotherapy profession (practice, research and education) thinks about and puts to use the WHO ICF. RESULTS A final sample of 37 papers was agreed. Five overarching third-order interpretations were derived: (i) A way of thinking and practicing, (ii) Endorsed but not embedded, (iii) Striking a balance, (iv) Power of participation and (v) Moving forward. Together, these themes illustrate the evolving role of the ICF in physiotherapy over the previous two decades. They highlight the ICF's potential for shaping the future of physiotherapy practice, education and research. CONCLUSIONS Work is needed to connect existing literature about the ICF and related models and embed the ICF, its language and philosophy across physiotherapy education and practice. Re-representation of the model might help address misinterpretation of the ICF, but fundamentally, embedding the ICF in entry-level curriculum is likely to be the most significant driver of change in practice.
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Affiliation(s)
- Sarah Barradell
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Ingrid Scholten
- Speech Pathology & Audiology, Flinders University, Adelaide, SA, Australia
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van Klaveren LM, Geukers V, de Vos R. Care complexity, perceptions of complexity and preferences for interprofessional collaboration: an analysis of relationships and social networks in paediatrics. BMC MEDICAL EDUCATION 2024; 24:334. [PMID: 38528513 DOI: 10.1186/s12909-024-05304-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND In the context of increasingly intricate healthcare systems, professionals are compelled to collaborate within dynamically changing interprofessional teams. Moreover, they must adapt these collaborative processes to effectively and efficiently manage the evolving complexity of care needs. It remains unclear how professionals determine care complexity and relate this complexity to their preferences for interprofessional collaboration (IPC). This study investigated the relationships between care complexity, professionals' perceived complexity and IPC preferences, and examined the variation in individual and team characteristics of IPC-practices across different levels of complexity in paediatric care. METHODS In an online questionnaire, 123 healthcare professionals working at an academic tertiary children's hospital scored their perceptions of complexity and preferences for IPC. They also selected family and various professions as members of the interprofessional (IP-) team based on thirteen patient cases. We employed conjoint analysis to systematically model the complexity of case descriptions across the five domains of the International Classification of Functioning, Disability and Health (ICF). Additionally, we applied social network analysis to identify important professions, crucial connectors and influential professions in the IP-team, and to describe the cohesiveness of IP-teams. RESULTS Modelled case complexity, professionals' perceived complexity and IPC preferences were positively associated. We found large inter-individual variations in the degree of these associations. Social network analysis revealed that the importance and influence of professions was more equally distributed when case complexity increased. Depending on the context and complexity of the case, different professions (e.g. medical doctors, social professionals, extramural professionals) were considered to be more crucial connectors within the IP-team. Furthermore, team cohesion was positively associated with modelled and perceived care complexity. CONCLUSIONS In conclusion, our study contributes to the existing knowledge by integrating task-specific insights and broadening the use of conjoint and social network analysis in the context of IPC. The findings substantiate the contingency theory that relates characteristics of IPC to care complexity, offering quantified insights into how IP-teams adapt to situational needs. This understanding of relationships and variations within IPC holds crucial implications for designing targeted interventions in both clinical and health profession education contexts. Consequently, it contributes to advancements in healthcare systems.
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Affiliation(s)
- Lisa-Maria van Klaveren
- Institute for Education and Training, Amsterdam Universities Medical Centres location University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
| | - Vincent Geukers
- Emma Children's Hospital, Amsterdam Universities Medical Centres location University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands
| | - Rien de Vos
- Institute for Education and Training, Amsterdam Universities Medical Centres location University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands
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Plener J, Mior S, Atkinson-Graham M, Hogg-Johnson S, Côté P, Ammendolia C. Information is power: a qualitative study exploring the lived experiences of patients with degenerative cervical radiculopathy. Pain 2024; 165:347-356. [PMID: 37625188 PMCID: PMC10785052 DOI: 10.1097/j.pain.0000000000003019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 08/27/2023]
Abstract
ABSTRACT Degenerative cervical radiculopathy (DCR) can lead to severe pain, paraesthesia, and/or motor weakness, resulting in significant morbidity, disability, and reduced quality of life. Typically, individuals suffer from prolonged symptoms, with time to complete recovery spanning months to years. Little is known about the impact DCR has on peoples' lives. Therefore, this study aimed to explore the everyday experiences of individuals living with DCR. A qualitative study was conducted through an interpretivist lens exploring the experiences of participants. Participants were purposefully recruited and interviewed with 2 research team members. Transcripts were independently analyzed by 2 reviewers and coding was finalized by consensus. Analysis was performed using an interpretative phenomenological approach, with emergent themes mapped onto the 5 domains of the International Classification of Functioning, Disability and Health framework. Eleven participants were interviewed between December 2021 and April 2022. Three themes emerged: the biopsychosocial impact of DCR, role of the health care provider, and uncertainty surrounding DCR. Pain and paraesthesia were the most common symptoms experienced by participants, leading to significant psychological distress and impact to daily activities, most notably driving, housecleaning, sleep, and ability to work. Participants described the uncertainty they experienced as a result of the unpredictable nature of DCR and the important role that health care providers play in their journey with DCR. Health care providers were seen acting as either a facilitator or a barrier to their recovery. The findings from this study can be used by clinicians providing patient-centered care to better understand the experiences of people with DCR.
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Affiliation(s)
- Joshua Plener
- Division of Graduate Education, Canadian Memorial Chiropractic College, Toronto, Canada
- Department of Medicine, Mount Sinai Hospital, Toronto, Canada
| | - Silvano Mior
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
- Institute for Disability and Rehabilitation Research, Oshawa, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Melissa Atkinson-Graham
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Sheilah Hogg-Johnson
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
- Institute for Disability and Rehabilitation Research, Oshawa, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Pierre Côté
- Institute for Disability and Rehabilitation Research, Oshawa, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Carlo Ammendolia
- Department of Medicine, Mount Sinai Hospital, Toronto, Canada
- Department of Surgery, University of Toronto, Toronto, Canada
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Fréz AR, Alouche SR, Binda AC, Nunes Cabral CM. Content validity of the International Classification of Functioning, Disability and Health core set for knee dysfunction: a Delphi study. Physiother Theory Pract 2024; 40:110-117. [PMID: 35837751 DOI: 10.1080/09593985.2022.2101037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To assess the content validity of the preliminary core set for knee dysfunction based on the opinion of experts. DESIGN A panel of 180 experts in knee disorders or on the use of the International Classification of Functioning, Disability, and Health for musculoskeletal conditions was invited for this Delphi study. The experts gave their opinion on whether to include the categories of the preliminary core set for knee dysfunction in a more comprehensive core set, using a six-item Likert scale. Kappa coefficient was used to analyze the agreement between the experts, and a consensus of 75% among responses was considered acceptable. RESULTS Nineteen experts participated in all rounds. Of the 24 categories from the preliminary core set for knee dysfunction, 15 remained in the comprehensive core set and one category was further detailed into three new categories. Seven new categories were included. Thus, the comprehensive core set for knee dysfunction was composed of 25 categories with an agreement of 81.5% among responses and a Kappa value of 0.63. CONCLUSION After validation by experts, the comprehensive core set for knee dysfunction was composed of 25 categories that can be used to assess the functioning of patients with knee dysfunction.
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Affiliation(s)
- Andersom Ricardo Fréz
- Physical Therapy Department, Universidade Estadual do Centro-Oeste, Guarapuava, Brazil
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Sandra Regina Alouche
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Aline Cristiane Binda
- Physical Therapy Department, Universidade Estadual do Centro-Oeste, Guarapuava, Brazil
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
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Hoyle M, Meredith P, Ownsworth T, Khan A, Gustafsson L. Associations between participation and personal factors in community-dwelling adults post-stroke. BRAIN IMPAIR 2023; 24:456-473. [PMID: 38167356 DOI: 10.1017/brimp.2022.31] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To examine associations between post-stroke participation and personal factors, including demographic characteristics, self- and threat appraisals, and personality variables. METHODS An exploratory cross-sectional study with purpose-designed survey was completed online or via mail. The survey was comprised of demographic and health-related questions and multiple questionnaires, including the Stroke Impact Scale Version 3.0 (SISv3) (participation/perceived recovery), Community Integration Questionnaire (CIQ) (participation), Head Injury Semantic Differential III (pre- vs post-stroke self-concept/self-discrepancy), Appraisal of Threat and Avoidance Questionnaire (threat appraisal), Life Orientation Test - Revised (optimism) and Relationships Questionnaire (adult attachment style) that measured variables of interest. Sixty-two participants, aged 24-96 years who had experienced a stroke (one or multiple events) and had returned to community living, completed the survey. Associations were examined using correlations, and univariate and multiple linear regression analyses. RESULTS Regression analysis showed that greater participation, measured using the CIQ, was associated with younger age, female gender, lower self-discrepancy and higher perceived recovery, explaining 69% of the variability in CIQ participation. Further, greater participation on the SISv3 was associated with lower self-discrepancy and higher perceived recovery, explaining 64% of the variability in SISv3 participation. CONCLUSIONS Results indicate that personal factors, particularly self-appraisals like self-concept/self-discrepancy, in combination with perceived recovery may be important in explaining a large portion of variance in post-stroke participation. Specifically, findings highlight the interrelatedness of self-concept change, perceived recovery and post-stroke participation. Further longitudinal research is needed to clarify the directionality of these associations throughout the hospital-to-home transition.
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Affiliation(s)
- Melanie Hoyle
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Pamela Meredith
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia
| | - Tamara Ownsworth
- School of Applied Psychology, Griffith University, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
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Anne Sinnott Jerram K, Dunn JA, Smaill RP, Middleton JW. International Classification of Function, Disability and Health (ICF) Word Mapping to Determine the Human Functioning Associated with Upper Extremity Surgery for Tetraplegia. J Patient Exp 2023; 10:23743735231211886. [PMID: 38026063 PMCID: PMC10631323 DOI: 10.1177/23743735231211886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Understanding human functioning and disablement, the contributing factors and their interactions in individuals with tetraplegia is important since elective upper extremity (UE) reconstructive surgery is now offered earlier after injury prior to full recognition of what lies ahead. Qualitative and quantitative data were available from a prior series of mixed methods studies, including a case series design capturing the patients' lived-experience perspectives of nerve or tendon transfer surgery, or not as the case may be. The objective of this study was to perform secondary data analysis to determine whether the recommended outcome tools being used by clinicians reflect the all important domains of functioning identified by people with tetraplegia who were considering UE reconstructive procedures. The original 18 candidate themes derived from qualitative analysis were reviewed in retrospect, along with a content analysis of the tools' questions, undertaking word mapping links to the ICF taxonomy. The outcomes tools included in the content analysis were the Canadian Occupational Performance Measure, the Capabilities of Upper Extremity Questionnaire, The Personal Wellbeing Index, and the Grasp and Release Test. Comparison between clinical outcomes tools and the patient lived-experience data uniquely identified links to Chapter1 (b) Mental functions, which include consciousness, orientation, temperament/personality, energy/drive, and higher-level cognition.
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Affiliation(s)
- K Anne Sinnott Jerram
- John Walsh Centre for Rehabilitation Research, Kolling Institute, St Leonards, NSW, Australia
- Sydney Medical School-Northern, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Burwood Academy of Trust, Christchurch, New Zealand
| | - Jennifer A Dunn
- Department of Orthopedic Surgery & Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | | | - James W Middleton
- John Walsh Centre for Rehabilitation Research, Kolling Institute, St Leonards, NSW, Australia
- Sydney Medical School-Northern, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Simone de Souza Vasconcelos K, de Carvalho Bastone A, Alvarenga Vieira R, Cristina de Souza Andrade A, Correa Dias R, Domingues Dias JM, Rodrigues Perracini M, Oliveira Guerra R, de Souza Moreira B. Examining the factors associated with functional capacity of community-dwelling older adults using the ICF framework: a cross-sectional study from the Frailty in Brazilian Older Adults Study (FIBRA). Physiother Theory Pract 2023; 39:2454-2469. [PMID: 35659442 DOI: 10.1080/09593985.2022.2079574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND There are many factors associated with functioning and disability in older adults and these relationships are not clear. OBJECTIVE To explore the factors associated with functional capacity of older adults using the framework of the International Classification of Functioning, Disability, and Health (ICF). METHODS This is a cross-sectional study with a dataset from a survey of 1 377 community-dwelling older adults (≥ 65 years) in a middle-income country. Three functional outcomes were selected to represent the functioning domains: 1) muscle strength for body function; 2) walking speed for activity; and 3) advanced activities of daily living (ADL) for participation. Demographic, clinical, and social information was selected to represent the domains of health conditions and contextual factors (i.e. personal and environmental factors). Multivariate models tested the impact of these factors on each outcome. RESULTS Depressive symptoms, age, and physical activity were associated with the three outcomes. Muscle strength was also associated with urinary incontinence, visual deficits, female sex, and employment. Walking speed was also associated with urinary incontinence, obesity, fractures due to falls, female sex, health professionals' visits, and walking aid devices. Advanced ADL were also associated with stroke, visual deficits, education, employment, health perception, social support, and walking aid devices. CONCLUSION Functional capacity of older adults is associated with some non-modifiable factors, such as age and sex. The modifiable factors must be addressed by health professionals and policymakers in the geriatric area, especially depression, obesity, physical inactivity, and social support.
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Affiliation(s)
- Karina Simone de Souza Vasconcelos
- Postgraduate Program in Rehabilitation Science, School of Physical Education, Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Alessandra de Carvalho Bastone
- Postgraduate Program in Rehabilitation and Functional Performance, Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Renata Alvarenga Vieira
- Department of Physical Therapy, School of Physical Therapy, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | | | - Rosângela Correa Dias
- Postgraduate Program in Rehabilitation Science, School of Physical Education, Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - João Marcos Domingues Dias
- Postgraduate Program in Rehabilitation Science, School of Physical Education, Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Mônica Rodrigues Perracini
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Ricardo Oliveira Guerra
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte (UFRN), Natal, Brazil
| | - Bruno de Souza Moreira
- Center for Studies in Public Health and Aging, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Joncic G, Jain M, Chattu VK, Gohar B, Nowrouzi-Kia B. Examining the health and functioning status of medical laboratory professionals in Ontario, Canada: an exploratory study during the COVID-19 pandemic. BMJ Open 2023; 13:e074384. [PMID: 37914309 PMCID: PMC10626828 DOI: 10.1136/bmjopen-2023-074384] [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: 04/05/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVES This study aims to explore the overall and specific aspects of the functioning of medical laboratory professionals (MLPs) in Ontario, Canada during the COVID-19 pandemic. DESIGN A cross-sectional analysis where a questionnaire was used to assess the mental status of MLPs. SETTING An online questionnaire administered in Ontario, Canada. PARTICIPANTS 632 MLPs (medical laboratory technologists, technicians and assistants) were included. MAIN OUTCOME MEASURES We employed the WHO Disability Assessment Schedule V.2.0 (WHODAS V.2.0) Questionnaire to assess functioning/disability and Copenhagen Psychosocial Questionnaire, third edition for psychosocial workplace factors. Multiple regression analysis examined the relationship between overall and specific domain functioning scores and psychosocial workplace factors. RESULTS Of the total 632 participants, the majority were female gender and Caucasian. It was found that health (β=2.25, p<0.001, CI: 1.77 to 2.73), management of environmental conditions (β=0.65, p<0.001, CI: 0.33 to 0.98), fear of unemployment (β=-0.72, p<0.001, CI: -1.09 to -0.35) and frequency of stress (β=-1.86, p<0.001, CI: -2.33 to -1.40), in addition to bullying exposure (β=0.56, p<0.01, CI: 0.15 to 0.98) and threats of violence exposure (β=0.90, p<0.01, CI: 0.25 to 1.54), significantly decreased functioning overall and within the specific WHODAS V.2.0 functioning domains. CONCLUSION This study provides preliminary evidence of the overall and specific aspects of functioning among the MLPs during the COVID-19 pandemic. Besides, these findings can support and guide the improvement of workplace practices and policies among MLPs in the future.
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Affiliation(s)
- Genavieve Joncic
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mahika Jain
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vijay Kumar Chattu
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Basem Gohar
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
- Centre for Research in Occupational Safety & Health, Laurentian University, Sudbury, Ontario, Canada
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Centre for Research in Occupational Safety & Health, Laurentian University, Sudbury, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Lampart P, Häusler F, Langewitz W, Rubinelli S, Sigrist-Nix D, Scheel-Sailer A. Patients' experiences with goal setting during initial rehabilitation after newly acquired spinal cord injury: A pilot qualitative interview study. J Spinal Cord Med 2023; 46:837-847. [PMID: 35867389 PMCID: PMC10446827 DOI: 10.1080/10790268.2022.2095496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To explore patients' experiences with goal setting during initial rehabilitation after newly acquired spinal cord injury/disorder (SCI/D). DESIGN Qualitative design with semi-structured interviews and purposively sampled participants. Interviews were transcribed verbatim. Transcripts were analyzed for qualitative content analysis using the Mayring method. SETTING Specialized acute care and rehabilitation center for SCI/D-patients. PARTICIPANTS Patients in initial rehabilitation after a newly acquired SCI/D. INTERVENTIONS n.a. OUTCOME MEASURES n.a. RESULTS Ten participants were interviewed in the post-acute phase after a newly acquired SCI/D. Participants described individual patient characteristics as well as organizational elements influencing their experience with goal setting. Organizational elements comprised structural elements (e.g. ward rounds, rehabilitation meetings, etc.) and interaction with and among the interprofessional teams. Perspectives from various health care professionals (HCPs) were perceived as increasing adequate goal setting and motivation. Furthermore, the participants described their own involvement and motivation as crucial for goal achievement. The main point of the critique was the standardization of the goal setting process. Interviewees would have preferred individualized goal setting embedded in a clearly foreseeable rehabilitation plan. CONCLUSION Organization and collaboration with and among the HCPs should be geared towards identifying specific patient needs during the course of rehabilitation and deriving individually tailored goals from them. Communication plays an important role in the individual goal setting.
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Affiliation(s)
- Patricia Lampart
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Florin Häusler
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Sara Rubinelli
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | | | - Anke Scheel-Sailer
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Mol T, Scholten E, van Bennekom C, Post M. Development of the self-regulation assessment and content validation using cognitive interviews in a multicultural post-rehabilitation population. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1085658. [PMID: 37275402 PMCID: PMC10237367 DOI: 10.3389/fresc.2023.1085658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/17/2023] [Indexed: 06/07/2023]
Abstract
Aim Self-regulation is one of the main goals of medical rehabilitation. Four themes of self-regulation were identified by former patients and rehabilitation physicians in a previous study. Based on these themes, a measure for self-regulation, the self-regulation assessment (SeRA), was developed. This study aimed to establish the content validity of the SeRA in a multicultural and multi-diagnostic post-rehabilitation population. Methods The Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology was applied. First, cognitive interviews were held with eight former rehabilitation patients. Feedback was obtained on relevance, comprehensibility, and comprehensiveness of the items. Items with problems were revised. Then, a second series of cognitive interviews was held with 16 former rehabilitation patients with non-Western migration backgrounds. Again, feedback was obtained on relevance, comprehensibility, and comprehensiveness of the items. Results The first series of cognitive interviews revealed good comprehensiveness, and also comprehensibility or relevance problems with 12 of the 25 items. These items were revised or deleted. Two missing concepts were identified and these were added. There was no need to revise the items based on the results of the second series of cognitive interviews. Conclusion The final version of the SeRA demonstrated content validity for the studied population. The measure is ready for psychometric analyses in subsequent validation studies.
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Affiliation(s)
- Tanja Mol
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, Netherlands
| | - Eline Scholten
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, Utrecht, Netherlands
| | - Coen van Bennekom
- Department of Research and Development, Rehabilitation Centre Heliomare, Wijk aan Zee, Netherlands
- Department of Public and Occupational Health, VU Medical Center, Amsterdam, Netherlands
| | - Marcel Post
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, Netherlands
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Sinnott Jerram KA, Dunn J, Smaill R, Middleton J. A Mixed Methods Approach as a Channel to Interpret Outcomes Research and Lived Experience Enquiry of Upper Extremity Elective Surgery for Tetraplegia. J Pers Med 2023; 13:394. [PMID: 36983576 PMCID: PMC10058672 DOI: 10.3390/jpm13030394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/07/2023] [Accepted: 02/21/2023] [Indexed: 02/26/2023] Open
Abstract
Cervical spinal cord injury (SCI) causing tetraplegia is extremely disabling. In such circumstances, restoration of upper extremity (UE) function is considered the highest priority. The advent of early nerve transfer (NT) procedures, in addition to more traditional tendon transfers (TT), warranted in-depth consideration given the time-limited nature of NT procedures. Potential surgery candidates may not yet have come to terms with the permanence of their disability. A mixed methods convergent design was utilized for concurrent analysis of the Aotearoa/New Zealand upper limb registry data from the clinical assessments of all individuals considering UE surgery, regardless of their final decision. The International Classification of Functioning, Disability and Health (ICF) taxonomy guided data interpretation during the three-phased study series. It was the integration of the findings using the Stewart Model of care drawn from palliative health that enabled the interpretation of higher order messages. It is clear the clinical assessment and selection processes in use require reconsideration given the complexities individuals face following onset of SCI. We draw attention to the higher order cognitive demands placed on individuals, the requirement for SCI peer involvement in decision making and the need for acknowledgment of interdependence as a relational construct when living with tetraplegia.
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Affiliation(s)
- K. Anne Sinnott Jerram
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
- Faculty of Medicine and Health, Sydney Medical School-Northern, The University of Sydney, Camperdown, NSW 2006, Australia
- Burwood Academy Trust, Christchurch 8083, New Zealand
| | - Jennifer Dunn
- Department of Orthopedic Surgery & Musculoskeletal Medicine, University of Otago, Christchurch 8011, New Zealand
| | | | - James Middleton
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
- Faculty of Medicine and Health, Sydney Medical School-Northern, The University of Sydney, Camperdown, NSW 2006, Australia
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Otte T, Decuman S, Gelade W, Duyver C. Perceptions of medical advisers on ICF core-sets’ use for evaluating work incapacity related to back pain in French-speaking Belgium. Work 2022; 74:1401-1418. [PMID: 36502361 DOI: 10.3233/wor-210247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND: There is willingness in Europe to implement the use of a biopsychosocial model such as the International Classification of Functioning, Disability and Health (ICF) for assessing work incapacity. OBJECTIVE: A preliminary study was conducted to investigate the perceptions of medical advisers on the value of structuring clients’ biopsychosocial information in an ICF-based report. METHOD: A sample (n = 101) received a perception questionnaire after watching two comparative videos based on a clinical case. Questions relating to work incapacity were also asked. The data was analysed using quantitative methods. Comments were also collected. RESULTS: Before knowing the ICF-based report, 61.96% of the respondents believed a return to work seems possible by providing adapted work or a different job. There is an increase of 8.69 pp (p-value: 0.077) after reading the report. Opening up the initial sample to more insurance physicians (n = 119), the difference is more significant (p-value: 0.012). Also, 71.9% of respondents believe they have a better view of the client’s biopsychosocial situation after reading the report. Respondents recognise the clinical and diagnostic relevance of ICF but say it cannot be used at the moment for various reasons, such as the time required or the need for a multidisciplinary team and effective coordination. Older respondents are less enthusiastic about the appropriateness of using ICF. CONCLUSION: The respondents identify an added value in having a biopsychosocial based-report. After learning about the report, more physicians see opportunities for professional re-integration than before. The medical advisers and their team must be strengthened and receive a clear role in order to empower them.
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Affiliation(s)
- Thomas Otte
- Department of Disability Benefits, Belgian National Institute for Health and Disability Insurance, Brussels, Belgium
| | - Saskia Decuman
- Department of Disability Benefits, Belgian National Institute for Health and Disability Insurance, Brussels, Belgium
| | - Wouter Gelade
- Center for Research in the Economics of Development, University of Namur, Namur, Belgium
| | - Corentin Duyver
- Centre Académique de Médecine Générale, Université catholique de Louvain, Brussels, Belgium
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Hammond LD, Farrington AP, Sivan M. Verification of the Integrative Model of Adjustment to Chronic Conditions by Mapping it Onto the World Health Organization's International Classification of Function, Disability and Health. Rehabil Process Outcome 2022; 11:11795727221126891. [PMID: 36278118 PMCID: PMC9583227 DOI: 10.1177/11795727221126891] [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: 04/21/2022] [Accepted: 08/31/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose Literature regarding the WHO's International Classification of Function, Disability and Health (ICF) has called for research into psychosocial adjustment processes. This project aims to establish the relevance of the Integrative Model of Adjustment to Chronic Conditions (IMACC) as a framework for research and a clinical tool in rehabilitation by linking it with the ICF. Methods The study employed secondary analysis of data from the original IMACC grounded theory study, where 8 women and 2 men with type 2 diabetes mellitus participated. IMACC consists of 3 interconnected parts comprising a total of 13 components. Datasets used for the study consisted of the qualitative data underpinning each IMACC component. Meaningful concepts from each dataset were linked to ICF categories using the updated ICF linking rules. Results Results showed that all 13 IMACC components accommodate ICF category codes from all health and health related ICF components in patterns consistent with the theoretical conceptualisation of each separate IMACC component. Conclusion IMACC maps comprehensively to the ICF framework and provides a framework that may be useful for future ICF related research into biopsychosocial processes in psychosocial adjustment. IMACC provides a clinically applicable intervention for people with psychosocial adjustment difficulties consistent with the ICF framework.
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Affiliation(s)
| | - Alexander Paul Farrington
- Psychology Department, School of Social
Sciences, Humanities and Law, Teesside University, Middlesbrough, Tees Valley,
UK
| | - Manoj Sivan
- Academic Department of Rehabilitation
Medicine (ADRM), University of Leeds, Leeds, UK
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14
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van der Veen S, Evans N, Huisman M, Welch Saleeby P, Widdershoven G. Toward a paradigm shift in healthcare: using the International Classification of Functioning, Disability and Health (ICF) and the capability approach (CA) jointly in theory and practice. Disabil Rehabil 2022:1-8. [PMID: 35732595 DOI: 10.1080/09638288.2022.2089737] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Over the past two decades, healthcare systems have shifted to adopt a more holistic, patient-centered care system. However, operationalization in practice remains challenging. Two frameworks have contributed substantially to the transformation toward more holistic and patient-centered care: the International Classification of Functioning, Disability and Health (ICF) and the capability approach (CA). Using these frameworks jointly can contribute to improved patient-centered care in clinical practice. METHODS This article explores the strengths and weaknesses of the use of the two frameworks in care and investigates whether using them jointly might contribute to more appropriate and patient-centered care. We will present a practical example of this integration in the form of a novel e-health application. RESULTS The exploration indicated that if the frameworks are used jointly, the individual weaknesses can be overcome. The application, used to exemplify the joint use of the frameworks, contains all categories of the ICF. It offers a unique tool that allows a person to self-assess, record, and evaluate their functioning and capabilities and formulate related goals. CONCLUSIONS Using the ICF jointly with the CA can foster holistic, patient-centered care. The e-health application provides a concrete example of how the frameworks can be used jointly. Implications for rehabilitationUsing the International Classification of Functioning, Disability and Health jointly with the capability approach can foster holistic, patient-centered care.The joint use of the frameworks is demonstrated by an e-health application which enables users to evaluate their functioning in relation to their own goals, provides them with the opportunity to increase control over their health and have a more active role in their care.Tools to record both functioning and goals from a patient's perspective can support professionals in offering patient-centered care in daily practice.Individual recording, monitoring and evaluation of functioning, capabilities and goals regarding functioning can provide a basis for research and quality improvement.
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Affiliation(s)
- Sabina van der Veen
- Department of Ethics, Law and Humanities, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Natalie Evans
- Department of Ethics, Law and Humanities, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Patricia Welch Saleeby
- Department of Sociology, Criminology and Social Work, Bradley University, Peoria, IL, USA
| | - Guy Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands
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15
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Exploring the Intensity, Frequency, and Duration of Pediatric Constraint Induced Movement Therapy Published Research: A Content Analysis. CHILDREN 2022; 9:children9050700. [PMID: 35626877 PMCID: PMC9139668 DOI: 10.3390/children9050700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/27/2022] [Accepted: 05/05/2022] [Indexed: 11/20/2022]
Abstract
Constraint Induced Movement Therapy (CIMT) utilizes a behavioral approach to neurorehabilitation involving constraint of an unaffected upper extremity which forces the use of the affected extremity. There is substantial evidence supporting the effectiveness of CIMT among both children and adults. The purpose of this study was to explore the frequency, intensity, and duration parameters across the published clinical outcomes related to pediatric CIMT (pCIMT) among children and youth populations. A content analysis approach was used to search the following databases Google Scholar, OT seeker, American Occupational Therapy Association special interest section, Medline, EbscoHost, and Cinhal. A total of 141 studies were identified via the initial search, with 51 studies meeting inclusion criteria. The findings revealed that 100% of the studies included restraint of the non-affected upper extremity, 73% incorporated repetitive task-oriented training, but less than half prescribed home practice strategies. Further, only 34% of the studies reviewed included all three components of CIMT. Outpatient hospital clinics and home-based settings were the most utilized settings for research studies. The mean minutes per session was M = 205.53, SD = 164.99. As part of the plan of care, the duration and frequency of therapy both had similar means (~M = 3.60) and standard deviations (~SD = 1.65). There was a significant variance of hours during (SD = 139.54) and outside of therapy (SD = 130.06). The results of this study, together with other emerging evidence, can assist practitioners in prescribing dosages dependent on the setting, the pediatric client, and their current functional status.
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16
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Karhula ME, Kanelisto K, Hämäläinen P, Ruutiainen J, Era P, Häkkinen A, Salminen AL. Self-reported Reasons for Changes in Performance of Daily Activities During a 2-Year Multidisciplinary Multiple Sclerosis Rehabilitation. Int J MS Care 2022; 24:110-116. [PMID: 35645629 PMCID: PMC9135369 DOI: 10.7224/1537-2073.2020-061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
Background Few multidisciplinary rehabilitation studies with a heterogeneous design have focused on individuals with multiple sclerosis (MS). This study compared subjective-reported changes in performance and satisfaction with daily activities among moderately and severely disabled individuals with MS during a 2-year, multidisciplinary, group-based, outpatient rehabilitation program comprising education in self-management and compensatory techniques, exercise, and guided peer support. Methods Thirty-eight adults with moderate disability (Expanded Disability Status Scale [EDSS] score of 4.0-5.5, 74% women, mean age of 48) and 41 individuals with severe disability (EDSS 6.0-8.5, 63% women, mean age of 48) were assessed at baseline and after 12 and 21 months of outpatient rehabilitation using the Canadian Occupational Performance Measure (COPM). Group × time interactions were analyzed using mixed analysis of variance. Participants' explanations of reasons for changes in activity performance were collected via semistructured interviews and analyzed content. Results Statistically significant improvements in COPM performance and satisfaction scores were reported in both groups from baseline to 21 months of rehabilitation. No significant between-group differences in improvement were observed. The self-reported reasons for improvement were mainly linked to environmental factors. Conclusions The outpatient rehabilitation program, including 4 themes-cognition, mood, energy conservation, and body control-improved the self-reported performance of patients with MS with moderate and severe disabilities. Environmental factors warrant consideration during rehabilitation.
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Affiliation(s)
- Maarit E. Karhula
- From the GeroCenter Foundation for Aging Research and Development (MEK, KK, PE), University of Jyväskylä, Jyväskylä, Finland
- From the South-Eastern Finland University of Applied Sciences, Mikkeli, Finland (MEK)
| | - Katja Kanelisto
- From the GeroCenter Foundation for Aging Research and Development (MEK, KK, PE), University of Jyväskylä, Jyväskylä, Finland
| | - Päivi Hämäläinen
- From the Masku Neurological Rehabilitation Centre, Masku, Finland (PH)
- From the Finnish Neuro Society, Masku, Finland (PH, JR)
- From the University of Turku, Turku, Finland (PH, JR)
| | - Juhani Ruutiainen
- From the Finnish Neuro Society, Masku, Finland (PH, JR)
- From the University of Turku, Turku, Finland (PH, JR)
| | - Pertti Era
- From the GeroCenter Foundation for Aging Research and Development (MEK, KK, PE), University of Jyväskylä, Jyväskylä, Finland
| | - Arja Häkkinen
- From the Faculty of Sport and Health Sciences (AH), University of Jyväskylä, Jyväskylä, Finland
- From the Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyvaskyla, Finland (AH)
| | - Anna-Liisa Salminen
- From the Research Department, Social Insurance Institution of Finland, Helsinki, Finland (A-LS)
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17
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Mol TI, van Bennekom CAM, Scholten EWM, Post MWM. Measures of self-regulation used in adult rehabilitation populations: A systematic review and content screening. Clin Rehabil 2022; 36:1120-1138. [PMID: 35473388 PMCID: PMC9284405 DOI: 10.1177/02692155221091510] [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] [Indexed: 02/04/2023]
Abstract
Objective We aimed to identify generic measures of self-regulation and to examine the
degree to which these measures fit a recently developed conceptual model of
self-regulation in a rehabilitation context. Data sources Pubmed, Embase, PsycInfo, and CINAHL were searched. Review methods Articles were included if they were published between January 2015 and August
2020 and reported on empirical studies (trials and observational studies)
using a measure of self-regulation or a related concept, in an adult
rehabilitation population. Main content was analysed by linking all items of
the selected measures to one or more of the six sub-themes of
self-regulation: (1) insight into physical and cognitive impairments, (2)
insight into the consequences of the impairments, (3) insight into
abilities, (4) to be able to communicate limitations, (5) trust in body and
functioning, and (6) make use of abilities. Results Two reviewers independently screened 7808 abstracts, resulting in the
inclusion of 236 articles. In these articles, 80 different measures were
used to assess self-regulation or related concept. Nineteen of these
measures met the inclusion criteria and were included for the content
analyses. Nine of these were self-efficacy measures. No measures covered
four or more of the six sub-themes of self-regulation. The three sub-themes
on gaining insights were covered less compared to the sub-domains ‘trust’
and ‘make use of abilities’. Conclusions Many measures on self-regulation exist None of these measures cover all six
sub-themes of self-regulation considered important to measure
self-regulation as a rehabilitation outcome.
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Affiliation(s)
- T I Mol
- Center of Excellence for Rehabilitation Medicine, 526115UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,84792Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - C A M van Bennekom
- 100506Heliomare Rehabilitation Center, Research and Development, Wijk aan Zee, the Netherlands.,522567Amsterdam University Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam, the Netherlands
| | - E W M Scholten
- Center of Excellence for Rehabilitation Medicine, 526115UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - M W M Post
- Center of Excellence for Rehabilitation Medicine, 526115UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,84792Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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18
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Teo JL, Zheng Z, Bird SR. Identifying the factors affecting 'patient engagement' in exercise rehabilitation. BMC Sports Sci Med Rehabil 2022; 14:18. [PMID: 35130940 PMCID: PMC8819209 DOI: 10.1186/s13102-022-00407-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022]
Abstract
Background Despite the proven benefits of exercise rehabilitation for numerous health conditions, musculoskeletal injuries and recovery from surgery, patient adherence to such programs is reported to often be less than 35%. Increasing patient engagement therefore has the potential to improve patient health outcomes, benefiting the patient, their carers and the services that support them. The aims of this review were to identify the factors that contribute to ‘patient’ engagement in prescribed exercise rehabilitation using the COM-B (capability, opportunity, motivation-behaviour) framework of behavioural analysis. Methods Five electronic databases (PubMed, Embase, Cochrane, Web of Science, and ClinicalTrials.gov) were searched. ‘COM-B’ was the key word searched for specifically within titles and abstracts, combined with either ‘physical activity’ OR ‘exercise’ included using the ‘AND’ operation. Records were then filtered and excluded following full-text screening based on the predetermined eligibility criteria. Results Twenty studies were included in the review. The main COM-B themes highlighted for improving patient engagement were: capability—improving patient knowledge and cognitive skills for behavioural regulation, such as ‘action planning’ and ‘action control’, which could also benefit time-management; opportunity—a balanced life situation that enabled time to be devoted to the exercise program, social support, easily accessible and affordable resources and services; and motivation—increasing patient levels of self-efficacy and autonomous motivation, which were noted to be influenced by levels of perceived ‘capability’, additionally ‘motivation’ was noted to be influenced by patients perceiving the benefits of the exercise, and adherence to the program was promoted by ‘goal-setting’. Other issues in the ‘capability’ domain included a fear and/or dislike of exercise. Conclusion Patient engagement behavior has been shown to be influenced by both external (opportunity) and intrapersonal variables (capability and motivation). Those prescribing exercises within a rehabilitation program need to discuss these factors with their patients and co-design the exercise rehabilitation program in partnership with the patient, since this is likely to improve patient engagement, and thereby result in superior health outcomes. Furthermore, these factors need to be a consideration in clinical trials, if the findings from such trials are to translate into mainstream healthcare settings. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-022-00407-3.
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Affiliation(s)
- Junsheng L Teo
- School of Health and Biomedical Sciences, RMIT University, Melbourne, 3083, Australia
| | - Zhen Zheng
- School of Health and Biomedical Sciences, RMIT University, Melbourne, 3083, Australia
| | - Stephen R Bird
- School of Health and Biomedical Sciences, RMIT University, Melbourne, 3083, Australia.
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19
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Jaiswal A, Aldersey H, Wittich W, Mirza M, Finlayson M. Factors that influence the participation of individuals with deafblindness: A qualitative study with rehabilitation service providers in India. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2022. [DOI: 10.1177/0264619620941886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Evidence to inform rehabilitation service delivery for individuals with deafblindness, especially in the Indian context, is inadequate. Rehabilitation professionals often find it challenging to design rehabilitation interventions that promote participation for those with deafblindness. Therefore, our purpose was to understand the contextual factors that influence the participation of individuals with deafblindness in India from the perspectives of those who are involved in providing rehabilitation services to them. Using the International Classification of Functioning, Disability, and Health (ICF) as a framework, we conducted two focus group discussions with 16 rehabilitation service providers in India. We used a content analysis approach to examine the data. Rehabilitation service providers perceived participation barriers to be linked primarily to the social environment. Specifically, participants identified four major factors acting as barriers, including (a) lack of awareness about deafblindness; (b) negative attitudes and stigma associated with disability; (c) lack of access to resources such as assistive technology and interpreter support; and (d) communication challenges associated with severe impairments. Facilitators include accessibility of the built environment for multisensory impairments, affordable technology, provision of an interpreter and personal support worker, and training on deafblindness for professionals. The participation of individuals with deafblindness could be enhanced by identifying and removing environmental barriers and improving knowledge about deafblindness among rehabilitation professionals for proper identification, assessment, and access to rehabilitation services.
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20
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Kiltz U, Boonen A, van der Heijde D, Bautista-Molano W, Vargas RB, Chiowchanwisawakit P, El-Zorkany B, Gaydukova I, Geher P, Gossec L, Gilio M, Grazio S, Gu J, Khan MA, Kim TJ, Maksymowych WP, Marzo-Ortega H, Navarro-Compán V, Ozgocmen S, Patrikos D, Pimentel-Santos FM, Reveille J, Schirmer M, Stebbings S, Van den Bosch F, Weber U, Braun J. Development of an environmental contextual factor item set relevant to global functioning and health in patients with axial Spondyloarthritis. Rheumatology (Oxford) 2021; 61:2054-2062. [PMID: 34534275 DOI: 10.1093/rheumatology/keab653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/28/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To describe the development of an Environmental contextual factors (EF) Item Set (EFIS) accompanying the disease specific Assessment of SpondyloArthritis international Society Health Index (ASAS HI). METHOD First, a candidate item pool was developed by linking items from existing questionnaires to 13 EF previously selected for the ICF/ASAS Core Set. Second, using data from two international surveys, which contained the EF item pool as well as the items from the ASAS HI, the number of EF-items was reduced based on the correlation between the item and the ASAS HI sum score combined with expert opinion. Third, the final English EFIS was translated into 15 languages and cross-culturally validated. RESULTS The initial item pool contained 53 EF addressing 4 ICF EF-chapters: products and technology (e1), support and relationship (e3), attitudes (e4) and health services (e5). Based on 1754 responses of axial spondyloarthritis patients in an international survey, 44 of 53 initial items were removed based on low correlations to the ASAS HI or redundancy combined with expert opinion. 9 items of the initial item pool (range correlation 0.21-0.49) form the final EFIS. The EFIS was translated into 15 languages and field tested in 24 countries. CONCLUSIONS An EFIS is available complementing the ASAS HI and helps to interpret the ASAS HI results by gaining an understanding of the interaction between a health condition and contextual factors. The EFIS emphasizes the importance of support and relationships, as well as attitudes of the patient and health services in relation to self-reported health.
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Affiliation(s)
- Uta Kiltz
- Rheumazentrum Ruhrgebiet, Herne Germany; and.,Ruhr-Universität Bochum, Germany
| | - Annelies Boonen
- Department of Internal MedicineDivision of Rheumatology, Maastricht University Medical Center, the Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, the Netherlands
| | | | - Wilson Bautista-Molano
- University Hospital Fundación Santa Fe de Bogotá, and Universidad El Bosque, Bogotá, Colombia
| | | | | | | | | | - Pal Geher
- Semmelweis University, Budapest, Hungary
| | - Laure Gossec
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris France.,Pitié-Salpêtrière hospital, AP-HP Sorbonne Université, Rheumatology department, Paris, France
| | - Michele Gilio
- Department of Internal Medicine - "San Carlo" Hospital Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy
| | - Simeon Grazio
- Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | | | - Muhammad Asim Khan
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Tae-Jong Kim
- Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | | | - Helena Marzo-Ortega
- NIHR Leeds Biomedical Research Centre, Chapel Allerton Hospital, Leeds, and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | | | - Salih Ozgocmen
- Department of RheumatologyIstinye University, Medicalpark Gaziosmanpasa Hospital, Istanbul, Turkey
| | | | | | - John Reveille
- Department of Internal MedicineUniversity of Texas Health Science Center at Houston, USA
| | - Michael Schirmer
- Innsbruck Medical University, Department of Internal Medicine, Clinic IIAustria
| | - Simon Stebbings
- University of Otago, Dunedin School of Medicine, Dunedin, New Zealand
| | - Filip Van den Bosch
- VIB Center for Inflammation Research, Ghent, Belgium.,Department of Rheumatology Ghent University Hospital, Ghent, Belgium
| | - Ulrich Weber
- Practice Buchsbaum, Rheumatology, Schaffhausen, Switzerland
| | - Juergen Braun
- Rheumazentrum Ruhrgebiet, Herne Germany; and.,Ruhr-Universität Bochum, Germany
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21
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Reitzel M, Letts L, Di Rezze B, Phoenix M. Critically Examining the Person–Environment Relationship and Implications of Intersectionality for Participation in Children's Rehabilitation Services. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:709977. [PMID: 36188778 PMCID: PMC9397911 DOI: 10.3389/fresc.2021.709977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/16/2021] [Indexed: 01/03/2023]
Abstract
Participation of children in rehabilitation services is associated with positive functional and developmental outcomes for children with disabilities. Participation in therapy is at risk when the personal and environmental contexts of a child create barriers to accessing services. The International Classification of Functioning, Disability and Health (ICF) provides a framework for conceptualizing the personal and environmental factors linked to a child. However, it does not facilitate critical examination of the person–environment relationship and its impact on participation in children's rehabilitation. This perspective study proposes the use of intersectionality theory as a critical framework in complement with the ICF to examine the impact of systemic inequities on the participation in therapy for children with disabilities. Clinicians are called to be critical allies working alongside children and families to advocate for inclusive participation in children's rehabilitation by identifying and transforming systemic inequities in service delivery.
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Affiliation(s)
- Meaghan Reitzel
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- *Correspondence: Meaghan Reitzel
| | - Lori Letts
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Briano Di Rezze
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Bloorview Research Institute, Toronto, ON, Canada
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22
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Phoenix M, Reitzel M, Martens R, Lebsack J. Reconceptualizing the Family to Improve Inclusion in Childhood Disability Research and Practice. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:710580. [PMID: 36188823 PMCID: PMC9397813 DOI: 10.3389/fresc.2021.710580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/16/2021] [Indexed: 11/26/2022]
Abstract
The World Health Organization's International Classification of Functioning, Disability and Health recognizes that environmental factors impact well-being and life participation for children with disabilities. A primary environment in which children grow and learn is the family. The importance of family has long been recognized in family-centered practice and family-centered research. Although family-centered services and research have been critically explored, the concept of family has received less critical attention in rehabilitation literature. The family construct is due for an updated conceptualization with careful consideration of the implications for childhood disability rehabilitation practice and research. Interrogating the family construct asks questions such as: who is included as a part of the family? Which family structures are prioritized and valued? What is the potential harm when some families are ignored or underrepresented in childhood disability practice and research? What implications could a modern rethinking of the concept of family have on the future of childhood rehabilitation practice and research? This perspective article raises these critical questions from the authors' perspectives as parents of children with disabilities, child focused rehabilitation professionals, and researchers that focus on service delivery in children's rehabilitation and family engagement in research. A critical reflection is presented, focused on how the construct of family affects children's rehabilitation practice and research, integrating concepts of equity, inclusion and human rights. Practical suggestions for children's rehabilitation service providers and researchers are provided to aid in inclusive practices, critical reflection, and advocacy.
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Affiliation(s)
- Michelle Phoenix
- CanChild, McMaster University, Hamilton, ON, Canada
- Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- *Correspondence: Michelle Phoenix
| | - Meaghan Reitzel
- CanChild, McMaster University, Hamilton, ON, Canada
- Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | | | - Jeanine Lebsack
- IWK Strongest Families Research Institute, Halifax, NS, Canada
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Kuzu D, Troost JP, Carlozzi NE, Ehde DM, Molton IR, Kratz AL. How Do Fluctuations in Pain, Fatigue, Anxiety, Depressed Mood, and Perceived Cognitive Function Relate to Same-Day Social Participation in Individuals With Spinal Cord Injury? Arch Phys Med Rehabil 2021; 103:385-393. [PMID: 34454899 DOI: 10.1016/j.apmr.2021.07.809] [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: 01/06/2021] [Revised: 06/02/2021] [Accepted: 07/24/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This study aimed to examine same-day associations of pain, fatigue, depressed mood, anxiety, and perceived cognitive function with social participation in the daily lives of adults with spinal cord injury (SCI). DESIGN Observational study used a combination of baseline surveys and 7 end-of-day (EOD) diaries. SETTING General community. PARTICIPANTS Individuals with SCI (N=168; mean age, 49.8y; 63% male, 37% female). MAIN OUTCOME MEASURES Patient-Reported Outcomes Measurement Information System short form measures (Ability to Participate in Social Roles and Activities, Pain Intensity, Depression, Anxiety, Cognitive Function Abilities) were adapted for daily administrations as EOD diaries. RESULT Results of multivariable model showed that daily increases in fatigue (B=-0.10; P=.004) and depressive symptoms (B=-0.25; P=<.001) and decreases in perceived cognitive function (B=0.11; P=<.001) were significantly related to worse same-day social participation. Daily fluctuations in anxiety and pain were unrelated to same-day social participation. CONCLUSIONS This is the first study that shows within-person associations of common SCI symptoms with social participation in the daily lives of adults with SCI. Results from the current study may help to develop more effective individualized treatments of symptoms and symptom effect aimed at improving social participation.
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Affiliation(s)
- Duygu Kuzu
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
| | - Jonathan P Troost
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MI
| | - Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| | - Ivan R Molton
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| | - Anna L Kratz
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
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Karhula M, Saukkonen S, Xiong E, Kinnunen A, Heiskanen T, Anttila H. ICF Personal Factors Strengthen Commitment to Person-Centered Rehabilitation – A Scoping Review. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:709682. [PMID: 36188794 PMCID: PMC9397796 DOI: 10.3389/fresc.2021.709682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/15/2021] [Indexed: 12/03/2022]
Abstract
Background: The International Classification of Functioning, Disability and Health (ICF) classification is a biopsychosocial frame of reference that contributes to a holistic understanding of the functioning of a client and the factors involved. Personal factors (PFs) are not currently classified in the ICF due to large societal and cultural diversity and lack of clarity in the scope of such factors. Aims: To ascertain which factors in the ICF classification have been defined as PFs in different studies and what conclusions have been drawn on their role in the ICF classification. Methods: The study was a scoping review. A systematic search for articles published in 2010–2020 was performed on the Cinahl, Pubmed, ScienceDirect, and Sport Discus databases. The PFs specified in the articles were classified according to the seven categories proposed by Geyh et al. socio-demographic factors; position in the immediate social and physical context; personal history and biography; feelings; thoughts and beliefs; motives; and general patterns of experience and behavior. Results: The search yielded 1,988 studies, of which 226 met the inclusion criteria. The studies had addressed a wide variety of PFs that were linked to all seven categories defined by Geyh et al. Some studies had also defined PFs that were linkable to other components of the ICF or that did not describe functioning. Approximately 22% (51) of the studies discussed the role of PFs in rehabilitation. Conclusions: The range of PFs in the ICF classification addressed in the reviewed studies is wide. PFs play an important role in rehabilitation. However, according to the reviewed studies, a more precise coding of PFs is not yet warranted.
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Affiliation(s)
- Maarit Karhula
- Sustainable Well-being, Research and Development Department, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
- Kela Research, Social Insurance Institution of Finland, Helsinki, Finland
- *Correspondence: Maarit Karhula
| | - Sari Saukkonen
- Sustainable Well-being, Research and Development Department, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
| | - Essi Xiong
- Social Services and Health Care, Oulu University of Applied Sciences, Oulu, Finland
| | - Anu Kinnunen
- Social Services and Health Care, Savonia University of Applied Sciences, Kuopio, Finland
| | - Tuija Heiskanen
- Kela Research, Social Insurance Institution of Finland, Helsinki, Finland
| | - Heidi Anttila
- Public Health and Welfare Department, Knowledge Management and Co-Creation Unit, Functioning and Service Needs Team, Finnish Institute for Health and Welfare, Helsinki, Finland
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25
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van Leeuwen LM, Pronk M, Merkus P, Goverts ST, Terwee CB, Kramer SE. Operationalization of the Brief ICF Core Set for Hearing Loss: An ICF-Based e-Intake Tool in Clinical Otology and Audiology Practice. Ear Hear 2021; 41:1533-1544. [PMID: 33136629 PMCID: PMC7722460 DOI: 10.1097/aud.0000000000000867] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 01/15/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES According to the International Classification of Functioning, Disability and Health (ICF), functioning reflects the interplay between an individual's body structures and functions, activities, participation, environmental, and personal factors. To be useful in clinical practice, these concepts need to be operationalized into a practical and integral instrument. The Brief ICF Core Set for Hearing Loss (CSHL) provides a minimum standard for the assessment of functioning in adults with hearing loss. The objective of the present study was to operationalize the Brief CSHL into a digital intake tool that could be used in the otology-audiology practice for adults with ear and hearing problems as part of their intake assessment. DESIGN A three-step approach was followed: (1) Selecting and formulating questionnaire items and response formats, using the 27 categories of the Brief CSHL as a basis. Additional categories were selected based on relevant literature and clinical expertise. Items were selected from existing, commonly used disease-specific questionnaires, generic questionnaires, or the WHO's official descriptions of ICF categories. The response format was based on the existing item's response categories or on the ICF qualifiers. (2) Carrying out an expert survey and a pilot study (using the three-step test interview. Relevant stakeholders and patients were asked to comment on the relevance, comprehensiveness, and comprehensibility of the items. Results were discussed in the project group, and items were modified based on consensus. (3) Integration of the intake tool into a computer-based system for use in clinical routine. RESULTS The Brief CSHL was operationalized into 62 items, clustered into six domains: (1) general information, including reason for visit, sociodemographic, and medical background; (2) general body functions; (3) ear and hearing structures and functions; (4) activities and participation (A&P); (5) environmental factors (EF); and (6) personal factors (mastery and coping). Based on stakeholders' responses, the instructions of the items on A&P and EF were adapted. The three-step test interview showed that the tool had sufficient content validity but that some items on EF were redundant. Overall, the stakeholders and patients indicated that the intake tool was relevant and had a logical and clear structure. The tool was integrated in an online portal. CONCLUSIONS In the current study, an ICF-based e-intake tool was developed that aims to screen self-reported functioning problems in adults with an ear/hearing problem. The relevance, comprehensiveness, and comprehensibility of the originally proposed item list was supported, although the stakeholder and patient feedback resulted into some changes of the tool on item-level. Ultimately, the functioning information obtained with the tool could be used to promote patient-centered ear and hearing care taking a biopsychosocial perspective into account.
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Affiliation(s)
- Lisette M. van Leeuwen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health, Amsterdam, Netherlands
| | - Marieke Pronk
- Amsterdam UMC, Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health, Amsterdam, Netherlands
| | - Paul Merkus
- Amsterdam UMC, Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health, Amsterdam, Netherlands
| | - S. Theo Goverts
- Amsterdam UMC, Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health, Amsterdam, Netherlands
| | - Caroline B. Terwee
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health, Amsterdam, Netherlands
| | - Sophia E. Kramer
- Amsterdam UMC, Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health, Amsterdam, Netherlands
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26
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Ahmad Ainuddin H, Romli MH, Hamid TA, Salim MSF, Mackenzie L. Stroke Rehabilitation for Falls and Risk of Falls in Southeast Asia: A Scoping Review With Stakeholders' Consultation. Front Public Health 2021; 9:611793. [PMID: 33748063 PMCID: PMC7965966 DOI: 10.3389/fpubh.2021.611793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Research on rehabilitation for falls after stroke is warranted. However, published evidence on fall interventions with stroke survivors is limited and these are mainly international studies that may be less relevant for Southeast Asia. Objective: This review aims to systematically identify literature related to stroke rehabilitation for falls and risk of falls in Southeast Asia. Methods: A scoping review with stakeholders' consultation was implemented. An electronic search was conducted up to December 2020 on 4 databases (Medline, CINAHL, Scopus, ASEAN Citation Index). Only original studies conducted in Southeast Asia were selected. Results: The initial search yielded 3,112 articles, however, only 26 were selected in the final analysis. Most of the articles focused on physical rehabilitation and implemented conventional therapies. While the literature may reflect practice in Southeast Asia, stakeholders perceived that the literature was inadequate to show true practice, was not informative and missed several aspects such as functional, cognitive, and psychological interventions in managing falls. Individual-centric interventions dominated the review while community-based and environmental-focused studies were limited. Majority of the articles were written by physiotherapists while others were from physicians, occupational therapists, and an engineer but few from other healthcare practitioners (i.e., speech therapists, psychologists) or disciplines interested in falls. Conclusions: Falls prevention among stroke survivors has received a lack of attention and is perceived as an indirect goal in stroke rehabilitation in Southeast Asia. More innovative research adopted from falls research with older people is needed to advance falls prevention and intervention practice with stroke survivors.
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Affiliation(s)
- Husna Ahmad Ainuddin
- Center of Occupational Therapy Studies, Faculty of Health Sciences, Universiti Teknologi MARA Selangor, Selangor, Malaysia
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Muhammad Hibatullah Romli
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Malaysia
| | - Tengku Aizan Hamid
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Malaysia
| | - Mazatulfazura S. F. Salim
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, Faculty of Medicine and Health, School of Health Sciences, University of Sydney, Sydney, NSW, Australia
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McNaughton H, Weatherall M, McPherson K, Fu V, Taylor WJ, McRae A, Thomson T, Gommans J, Green G, Harwood M, Ranta A, Hanger C, Riley J. The effect of the Take Charge intervention on mood, motivation, activation and risk factor management: Analysis of secondary data from the Taking Charge after Stroke (TaCAS) trial. Clin Rehabil 2021; 35:1021-1031. [PMID: 33586474 DOI: 10.1177/0269215521993648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To use secondary data from the Taking Charge after Stroke study to explore mechanisms for the positive effect of the Take Charge intervention on physical health, advanced activities of daily living and independence for people after acute stroke. DESIGN An open, parallel-group, randomised trial with two active and one control intervention and blinded outcome assessment. SETTING Community. PARTICIPANTS Adults (n = 400) discharged to community, non-institutional living following acute stroke. INTERVENTIONS One, two, or zero sessions of the Take Charge intervention, a self-directed rehabilitation intervention which helps a person with stroke take charge of their own recovery. MEASURES Twelve months after stroke: Mood (Patient Health Questionnaire-2, Mental Component Summary of the Short Form 36); 'ability to Take Charge' using a novel measure, the Autonomy-Mastery-Purpose-Connectedness (AMP-C) score; activation (Patient Activation Measure); body mass index (BMI), blood pressure (BP) and medication adherence (Medication Adherence Questionnaire). RESULTS Follow-up was near-complete (388/390 (99.5%)) of survivors at 12 months. Mean age (SD) was 72.0 (12.5) years. There were no significant differences in mood, activation, 'ability to Take Charge', medication adherence, BMI or BP by randomised group at 12 months. There was a significant positive association between baseline AMP-C scores and 12-month outcome for control participants (1.73 (95%CI 0.90 to 2.56)) but not for the Take Charge groups combined (0.34 (95%CI -0.17 to 0.85)). CONCLUSION The mechanism by which Take Charge is effective remains uncertain. However, our findings support a hypothesis that baseline variability in motivation, mastery and connectedness may be modified by the Take Charge intervention.
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Affiliation(s)
- Harry McNaughton
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Mark Weatherall
- Department of Medicine, University of Otago, Wellington, New Zealand
| | | | - Vivian Fu
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - William J Taylor
- Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand
| | - Anna McRae
- Auckland District Health Board, Auckland, New Zealand
| | - Tom Thomson
- Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - John Gommans
- Hawkes Bay District Health Board, Hastings, New Zealand
| | - Geoff Green
- Counties-Manukau District Health Board, Auckland, New Zealand
| | - Matire Harwood
- Te Kupenga Hauora Māori, University of Auckland, Auckland, New Zealand
| | - Annemarei Ranta
- Department of Medicine, University of Otago, Wellington, New Zealand
| | - Carl Hanger
- Canterbury District Health Board, Christchurch, New Zealand
| | - Judith Riley
- Medical Research Institute of New Zealand, Wellington, New Zealand
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Meyer T, Tilly C. Reporting of patients' characteristics in rehabilitation trials: an analysis of publications of RCTs in major clinical rehabilitation journals. Eur J Phys Rehabil Med 2020; 56:829-835. [PMID: 33215907 DOI: 10.23736/s1973-9087.20.06710-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The reporting of patients' characteristics in randomized-controlled trials (RCTs) is one important dimension to improve the clinical replicability or transferability of study results into clinical practice. AIM Based on a previously developed framework for reporting on patient characteristics, the aim of this study was to determine whether and how patients' characteristics are presented in RCTs of major rehabilitation journals. DESIGN A literature search in eight high-impact medical rehabilitation journals was conducted. SETTING Any setting. POPULATION A rehabilitation patient group. METHODS Papers were included if they presented results on a RCT on rehabilitation patients. We excluded pilot or feasibility studies. We extracted information related to the description of personal, clinical and diagnosis-specific characteristics, comorbidities, and functioning according to the ICF (body functions and structures, activities and participation and context personal/environmental factors). RESULTS From a total of 129 papers initially identified we finally included 100 papers. Patient groups were almost exclusively defined by clinical diagnostic groups. Age and gender were the most prominent persons' characteristics (100% / 99% reported), followed by marital (22%), educational (15%) and occupational status (14%). Clinical characteristics usually relate to the respective diagnosis; general characteristics were reported on the duration of illness or symptoms (62%), to a lesser degree on BMI (45%) and/or weight (32%) and height (27%). One out of five papers report on comorbidities of the patients (20%). Information of body functions were present in almost every paper (98%), and nearly two third reported at least some aspect of activities and participation at baseline (63%). CONCLUSIONS The present analysis shows that there is a need to further the development of appropriate standards for the reporting of patient characteristics in rehabilitation trials. CLINICAL REHABILITATION IMPACT In future it should help rehabilitation practitioners to decide whether the patients in a study and their own patients share features similar enough to allow for transferability of results.
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Affiliation(s)
- Thorsten Meyer
- Research Unit Rehabilitation Sciences, Health Services Research in Rehabilitation, School of Public Health, Bielefeld University, Bielefeld, Germany -
| | - Christiane Tilly
- Research Unit Rehabilitation Sciences, Health Services Research in Rehabilitation, School of Public Health, Bielefeld University, Bielefeld, Germany
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29
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Perin C, Bolis M, Limonta M, Meroni R, Ostasiewicz K, Cornaggia CM, Alouche SR, da Silva Matuti G, Cerri CG, Piscitelli D. Differences in Rehabilitation Needs after Stroke: A Similarity Analysis on the ICF Core Set for Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124291. [PMID: 32560129 PMCID: PMC7345505 DOI: 10.3390/ijerph17124291] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 11/16/2022]
Abstract
Background: Successful rehabilitation is associated with physical, psychological, environmental, social, and personal factors based on the International Classification of Functioning, Disability and Health (ICF) framework. The influence of age has been suggested as crucial personal factors that may affect rehabilitation needs in post-stroke survivors. The aim of this study was to investigate the qualifiers of the ICF core set for stroke to detect differences in rehabilitation needs and goals between older (O, >65 years old) and younger (Y, ≤65 years old,) post-stroke individuals. Materials and methods: In this observational study, the comprehensive core set for stroke was filled during the rehabilitation period. Patient information was obtained using disability scales was translated into certain ICF categories using linking rules. Frequency, similarity, and linear regression analyses were performed for ICF qualifier profiles among Y and O patients. Results: Forty-eight ICF variables were significantly different between Y (n = 35, 46.17 ± 11.27 years old) and O (n = 35, 76.43 ± 6.77 years old) patients. Frequency analysis showed that activity of daily living and basic needs were more prevalent in O patients, whereas regaining of social role and social life were more prevalent in Y patients. The average Jaccard Index result (similarity analysis) was more homogeneous in O than in Y patients. Conclusions: ICF qualifiers are useful to design patient-centered care. Y patients have more heterogeneous needs and require more personalized program than O patients.
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Affiliation(s)
- Cecilia Perin
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy; (C.M.C.); (C.G.C.); (D.P.)
- Correspondence: ; Tel.: +39-03-6298-6446; Fax: +39-03-6298-6439
| | - Marta Bolis
- Casa di cura Beato Palazzolo, 24122 Bergamo, Italy;
| | - Marco Limonta
- Istituti Clinici Zucchi, 20841 Carate Brianza, Italy;
| | - Roberto Meroni
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, 4671 Differdange, Luxembourg;
| | | | - Cesare Maria Cornaggia
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy; (C.M.C.); (C.G.C.); (D.P.)
| | - Sandra Regina Alouche
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo 03071-000, Brazil;
| | - Gabriela da Silva Matuti
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo 03071-000, Brazil;
- Associação de Assistência à Criança Deficiente (AACD), 04027-000 São Paulo, Brazil;
| | - Cesare Giuseppe Cerri
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy; (C.M.C.); (C.G.C.); (D.P.)
| | - Daniele Piscitelli
- School of Medicine and Surgery, University of Milano Bicocca, 20126 Milano, Italy; (C.M.C.); (C.G.C.); (D.P.)
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
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30
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Cronin A, McLeod S, Verdon S. Applying the ICF-CY to Specialist Speech-Language Pathologists’ Practice With Toddlers With Cleft Palate Speech. Cleft Palate Craniofac J 2020; 57:1105-1116. [DOI: 10.1177/1055665620918799] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To evaluate how the practice of specialist speech-language pathologists (SLPs) working with young children with cleft palate ± cleft lip (CP±L) maps onto the International Classification of Functioning, Disability, and Health – Children and Youth version (ICF-CY) and consider the functionality of the categories of the ICF-CY for this specialist area of practice. Design: Cross-sectional, qualitative study. Setting: Semistructured face-to-face interviews were conducted with SLPs working in tertiary-level hospitals, universities, and public clinics. Participants: Six specialist SLPs with 17 to 39 years of experience working with young children with CP±L as researchers and clinicians in Australia, Brazil, Denmark, Ireland, New Zealand, and the United States. Main Outcome Measure(s): Specialists’ practices were captured using in-depth, semistructured interviews. Data collected were analyzed by directed content analysis applying the ICF-CY as a coding schema. Results: In total, 4077 data points were coded. Most mapped onto Body Structures (684, 16.8%), Body Functions (906, 22.2%), and Environmental Factors (1626, 39.9%) with less emphasis on Activities and Participation (560, 13.7%). A “best fit” approach was taken to topics that did not map exactly onto categories of the ICF-CY (eg, velopharyngeal insufficiency [VPI]); however, there was not always an ideally suitable category available. Conclusions: The current study revealed strengths and challenges in categorizing practice within the ICF-CY for children with CP±L, including collaboration with parents and significant others, specificity around speech, language, and articulation, and the different types of VPI. Therefore, future discussion around how best to use the framework with children with CP±L is needed.
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Affiliation(s)
- Anna Cronin
- School of Teacher Education, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Sharynne McLeod
- School of Teacher Education, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Sarah Verdon
- School of Community Health, Charles Sturt University, Albury, New South Wales, Australia
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31
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Lorca LA, Sacomori C, Benavente P, Mallea M, Fernández L, Plasser J. [Identification of ICF categories representative of functioning problems in adult cancer patients at hospital discharge: National expert consensus]. Rehabilitacion (Madr) 2019; 53:222-231. [PMID: 31813419 DOI: 10.1016/j.rh.2019.06.007] [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: 12/03/2018] [Revised: 04/26/2019] [Accepted: 06/25/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The International Classification of Functioning, Disability and Health (ICF) provides a standardised language and conceptual framework for health and health-related conditions, aiming to unify communication between different disciplines. OBJECTIVE To describe the process of selecting (through national expert consensus) ICF categories representative of functioning problems in cancer patients at hospital discharge. METHOD We conducted a descriptive qualitative and quantitative study that used the expert consensus method to design a clinical instrument. The study included 21 experts, consisting of 2 patients and 19 health professionals from different disciplines. A total of 208 ICF categories obtained in a previous stage through a systematic review and linking process were evaluated in 3 rounds. Participants evaluated each code and classified it as: highly relevant, relevant, slightly relevant, and not relevant at all. Only those codes assessed as «highly relevant» by more than 50% of the experts were included (cut off). In addition, another 143 ICF categories were evaluated in the second round. RESULTS In all, 24 ICF categories were obtained: 10 corresponded to the body function component, 11 to activities and participation, and 3 to environmental factors. CONCLUSIONS Consensus using the common language of the ICF resulted in the selection of 24 representative categories of the main health problems related to functioning at hospital discharge in adults treated for cancer.
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Affiliation(s)
- L A Lorca
- Hospital del Salvador, Santiago de Chile, Chile
| | - C Sacomori
- Escuela de Kinesiología, Universidad Bernardo O'Higgins, Santiago de Chile, Chile.
| | - P Benavente
- Hospital del Salvador, Santiago de Chile, Chile
| | - M Mallea
- Escuela de Terapia Ocupacional, Universidad Mayor, Santiago de Chile, Chile
| | - L Fernández
- Instituto Oncológico, Fundación Arturo López Pérez, Santiago de Chile, Chile
| | - J Plasser
- Hospital del Salvador, Santiago de Chile, Chile; Instituto Oncológico, Fundación Arturo López Pérez, Santiago de Chile, Chile
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32
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Della Vecchia C, Viprey M, Haesebaert J, Termoz A, Giroudon C, Dima A, Rode G, Préau M, Schott AM. Contextual determinants of participation after stroke: a systematic review of quantitative and qualitative studies. Disabil Rehabil 2019; 43:1786-1798. [PMID: 31646906 DOI: 10.1080/09638288.2019.1679897] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE From a patient's perspective, participation is a major determinant of quality of life. We aimed to review contextual factors, both personal and environmental, potentially associated with post-stroke participation. METHODS PubMed, PsycINFO, and Web of Science were searched for original quantitative and qualitative studies that investigated contextual factors of post-stroke participation, measured participation as the primary outcome, and met inclusion criteria. RESULTS Socio-demographic determinants were mostly unrelated with participation or showed discordant and inconclusive results. Although less investigated, psychosocial/psychological factors, particularly self-esteem and acceptance, were associated with participation in most studies. Motivation was found in qualitative studies, but discordant in quantitative ones. Environmental factors were even less investigated and mainly in qualitative studies among patients with communication disabilities. Among these, social support and attitude of others appeared to be major determinants of participation as well as physical environment and societal environment (services and polices). CONCLUSIONS Personal factors, particularly psychological and psychosocial factors, were identified as positively associated with post-stroke participation. Environmental factors such as support, relationships, and positive attitudes towards patients were major facilitators of participation as well as physical environment and accessibility to appropriate services. Most of these factors are modifiable and should be addressed to improve patient participation.Implications for RehabilitationPsychosocial factors (motivational aspects, acceptance of a new condition, self-esteem) and environmental factors (social support, attitudes towards the patient, physical environment, access to health, social services and policies) were identified as determinants of post-stroke participation.A structured evaluation of determinants of participation may be used in clinical practice to propose appropriate support and then improve patients' recoveryPrograms to improve patients' psychosocial skills such as self-esteem, acceptance, motivation should be tested and implemented, and policies to develop appropriate services accessibility should be encouraged.
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Affiliation(s)
- Claire Della Vecchia
- Université Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Social Psychology Research Group (EA 4163 GRePS), Lyon 2 University, Bron, France
| | - Marie Viprey
- Université Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Julie Haesebaert
- Université Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Anne Termoz
- Université Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Caroline Giroudon
- Central Documentation Department, Hospices Civils de Lyon, Lyon, France
| | - Alexandra Dima
- Université Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Gilles Rode
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon (CRNL), Equipe ImpAct, Bron, France.,Service de Médecine Physique et Réadaptation, Hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Marie Préau
- Social Psychology Research Group (EA 4163 GRePS), Lyon 2 University, Bron, France.,INSERM UMR 912 SESSTIM, Aix-Marseille Université, Marseille, France
| | - Anne-Marie Schott
- Université Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
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Comparing the International Classification of Functioning, Disability, and Health Core Sets for Hearing Loss and Otorhinolaryngology/Audiology Intake Documentation at Mayo Clinic. Ear Hear 2019; 40:858-869. [DOI: 10.1097/aud.0000000000000662] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Grantham W, Jespersen E, Płaszewski M. The end of being a straight child: an autoethnography of coping with adolescent idiopathic scoliosis. Disabil Rehabil 2019; 43:362-369. [PMID: 31211926 DOI: 10.1080/09638288.2019.1624989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE In the field of research on adolescent idiopathic scoliosis, the personal dimension is undervalued. Even the most comprehensive and current recommendations focus on biomedical issues and are entirely based on quantitative studies. Reports and narratives presenting people's preferences, values, views, and opinions, especially of those affected by this health condition, are not considered in those reports. This article's aim is to present personal experiences of scoliosis screening, diagnosis, and treatment, to contribute to the discussion. METHODS This is an evocative narrative autoethnography study, which allows focusing on the personal story of the author's experiences of adolescent idiopathic scoliosis management, connecting it to the rehabilitation context. RESULTS Experiences of non-person-centred rehabilitation resulted in stigmatisation, distress, and emotional upset, including anxiety and fear. In contrast, person-centred therapeutic relationship involved more positive outcomes of care, such as becoming an engaged co-responsible and active partner in rehabilitation. CONCLUSIONS It is strongly suggested to promote biographical research into the personal experiences of all aspects of adolescent idiopathic scoliosis, to identify patients' preferences and values more clearly. Furthermore, screening, diagnosis and treatment processes should be reviewed in terms of person-centredness, to ensure they are responsive to young people's needs in the vulnerable time of puberty. IMPLICATIONS FOR REHABILITATION Adolescent idiopathic scoliosis, including the treatment, and even the diagnosis, may be stigmatising and may lead to emotional and psychosocial harms Adolescent idiopathic scoliosis screening, diagnosis and treatment processes need to be person-centred, recognising young people's needs for privacy and support in the vulnerable time of puberty Emotional support from therapists ought to be part of the professional relationship based upon being with another person An explication of experiences of living with adolescent idiopathic scoliosis should be considered as a legitimate contribution to the practical and scientific understanding of this health condition.
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Affiliation(s)
- Weronika Grantham
- Faculty of Physical Education and Sport in Biała Podlaska, Józef Piłsudski University of Physical Education, Warsaw, Poland
| | - Ejgil Jespersen
- Faculty of Health Sciences in Biała Podlaska, Józef Piłsudski University of Physical Education, Warsaw, Poland
| | - Maciej Płaszewski
- Faculty of Health Sciences in Biała Podlaska, Józef Piłsudski University of Physical Education, Warsaw, Poland
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Convery E, Keidser G, Hickson L, Meyer C. The Relationship Between Hearing Loss Self-Management and Hearing Aid Benefit and Satisfaction. Am J Audiol 2019; 28:274-284. [PMID: 31184964 DOI: 10.1044/2018_aja-18-0130] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction. Method Thirty-seven adults with hearing loss, all of whom were current users of bilateral hearing aids, participated in this observational study. The participants completed self-report inventories probing their hearing loss self-management and hearing aid benefit and satisfaction. Correlation analysis was used to investigate the relationship between individual domains of hearing loss self-management and hearing aid benefit and satisfaction. Results Participants who reported better self-management of the effects of their hearing loss on their emotional well-being and social participation were more likely to report less aided listening difficulty in noisy and reverberant environments and greater satisfaction with the effect of their hearing aids on their self-image. Participants who reported better self-management in the areas of adhering to treatment, participating in shared decision making, accessing services and resources, attending appointments, and monitoring for changes in their hearing and functional status were more likely to report greater satisfaction with the sound quality and performance of their hearing aids. Conclusion Study findings highlight the potential for using information about a patient's hearing loss self-management in different domains as part of clinical decision making and management planning.
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Affiliation(s)
- Elizabeth Convery
- HEARing Cooperative Research Centre, Melbourne, Victoria, Australia
- National Acoustic Laboratories, Sydney, New South Wales, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Australia
| | - Gitte Keidser
- HEARing Cooperative Research Centre, Melbourne, Victoria, Australia
- National Acoustic Laboratories, Sydney, New South Wales, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Australia
| | - Louise Hickson
- HEARing Cooperative Research Centre, Melbourne, Victoria, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Australia
| | - Carly Meyer
- HEARing Cooperative Research Centre, Melbourne, Victoria, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Australia
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36
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Phoenix M, Jack SM, Rosenbaum PL, Missiuna C. A grounded theory of parents’ attendance, participation and engagement in children’s developmental rehabilitation services: Part 2. The journey to child health and happiness. Disabil Rehabil 2019; 42:2151-2160. [DOI: 10.1080/09638288.2018.1555618] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Michelle Phoenix
- CanChild, McMaster University, Hamilton, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Susan M. Jack
- School of Nursing, McMaster University, Hamilton, Canada
| | - Peter L. Rosenbaum
- CanChild, McMaster University, Hamilton, Canada
- Department of Paediatrics, McMaster University, Hamilton, Canada
| | - Cheryl Missiuna
- CanChild, McMaster University, Hamilton, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
- John & Margaret Lillie Chair in Childhood Disability Research, McMaster University, Hamilton, Canada
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Xu Q, Li S, Yang L. Perceived social support and mental health for college students in mainland China: the mediating effects of self-concept. PSYCHOL HEALTH MED 2018; 24:595-604. [PMID: 30451537 DOI: 10.1080/13548506.2018.1549744] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Previous studies revealed that both self-concept and social support were associated with mental health in college students. Very few studies have explored the ways these two variables work on mental health, particularly in mainland China. In the present study, 411 college students in northwest China were assessed using the School and Society Situations Scale (which includes a social support sub-scale and self-concept sub-scale) and Self-report Symptom Checklist 90. The results showed that a positive self-concept was positively correlated with individual perceived social support from parents, teachers, and peers, and that both self-concept and perceived social support were negatively associated with mental health problems. Moreover, structural equation modeling analyses showed that self-concept fully mediated the role of perceived social support in individuals' mental health. These results suggested that all kinds of perceived support from the social environment may help the college student form a positive self-concept, and the positive self-concept may help them resist and effectively cope with the risk factors related to mental health. These results also have implications in interventions to improve mental health in college students.
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Affiliation(s)
- QiongYing Xu
- a School of Psychology, Northwest Normal University , Lanzhou , China.,b Key Laboratory of Behavioral and Mental Health , Lanzhou , Gansu , China
| | - ShiFeng Li
- a School of Psychology, Northwest Normal University , Lanzhou , China.,b Key Laboratory of Behavioral and Mental Health , Lanzhou , Gansu , China
| | - Ling Yang
- a School of Psychology, Northwest Normal University , Lanzhou , China.,b Key Laboratory of Behavioral and Mental Health , Lanzhou , Gansu , China
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Rapidi CA, Tederko P, Moslavac S, Popa D, Branco CA, Kiekens C, Varela Donoso E, Christodoulou N. Evidence-based position paper on Physical and Rehabilitation Medicine (PRM) professional practice for persons with spinal cord injury. The European PRM position (UEMS PRM Section). Eur J Phys Rehabil Med 2018; 54:797-807. [PMID: 29952157 DOI: 10.23736/s1973-9087.18.05374-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Spinal cord injury (SCI) is a devastating condition and a challenge for every health system and every society. This EBPP represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians for people with SCI. The aim of the paper was to improve Physical and Rehabilitation Medicine (PRM) physicians' professional practice for persons with SCI in order to improve their functionality, social and community reintegration, and to overcome activity limitations and/or participation restrictions. EVIDENCE ACQUISITION A systematic review of the literature and a consensus procedure by means of a Delphi process have been performed involving the delegates of all European countries represented in the UEMS PRM Section. EVIDENCE SYNTHESIS The systematic literature review is reported together with thirty-eight recommendations resulting from the Delphi procedure. CONCLUSIONS The professional role of PRM physicians who have expertise in the rehabilitation of SCI is to run rehabilitation programmes in multi-professional teams, working in an interdisciplinary way in a variety of settings to improve the functioning of people with SCI.
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Affiliation(s)
| | - Piotr Tederko
- Department of Rehabilitation, Medical University of Warsaw, Warsaw, Poland
| | - Sasa Moslavac
- Department of Physical and Rehabilitation Medicine, Special Hospital for Medical Rehabilitation, Varaždinske Toplice, Croatia
| | - Daiana Popa
- Clinical Rehabilitation Hospital Felix-Spa Bihor County, Oradea, Romania
| | - Catarina A Branco
- Department of Physical and Rehabilitation Medicine, Centro Hospitalar de Entre o Douro e Vouga E.P.E, Porto, Portugal
| | - Carlotte Kiekens
- Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Enrique Varela Donoso
- Physical and Rehabilitation Medicine Department, Complutense University School of Medicine, Madrid, Spain
| | - Nicolas Christodoulou
- Medical School, European University Cyprus, Nicosia, Cyprus.,UEMS PRM Section, Brussels, Belgium
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Gee BM, Gerber LD, Butikofer R, Covington N, Lloyd K. Exploring the parameters of intensity, frequency, and duration within the constraint induced movement therapy published research: A content analysis. NeuroRehabilitation 2018; 42:167-172. [PMID: 29562553 DOI: 10.3233/nre-172233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Neurological rehabilitation specialists must determine appropriate dosage, consisting of frequency, intensity, and duration of specified treatments. OBJECTIVE The objective of this study was to perform a content analysis of the current literature related to dosage (duration, frequency and intensity) for constraint-induced movement therapy (CIMT) in the adult population. METHODS A content analysis was conducted which yielded 62 scholarly articles. RESULTS The frequency of CIMT ranged from 1 to 7 days per week with the average frequency being 4.98 days. The duration of CIMT, ranged from 2 to 10 weeks with the average duration 3.14 weeks. All three components of dosage were reported collectively in outcomes studies conducted in inpatient settings and rehabilitation clinics. CONCLUSIONS The findings provide a groundwork for evidence based practice for clinician in the application of CIMT dosage with consideration of settings and CIMT components.
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Affiliation(s)
- Bryan M Gee
- Department of Physical and Occupational Therapy, Idaho State University, Pocatello, ID, USA
| | - L Derek Gerber
- Department of Physical and Occupational Therapy, Idaho State University, Pocatello, ID, USA
| | - Rebecca Butikofer
- Department of Physical and Occupational Therapy, Idaho State University, Pocatello, ID, USA
| | - Nicole Covington
- Department of Physical and Occupational Therapy, Idaho State University, Pocatello, ID, USA
| | - Kimberly Lloyd
- Department of Physical and Occupational Therapy, Idaho State University, Pocatello, ID, USA
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Geyh S, Schwegler U, Peter C, Müller R. Representing and organizing information to describe the lived experience of health from a personal factors perspective in the light of the International Classification of Functioning, Disability and Health (ICF): a discussion paper. Disabil Rehabil 2018; 41:1727-1738. [PMID: 29509044 DOI: 10.1080/09638288.2018.1445302] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To discuss the representation and organization of information describing persons' lived experience of health from a personal factors perspective in the light of the International Classification of Functioning, Disability and Health, using spinal cord injury as a case in point for disability. METHODS The scientific literature was reviewed, discussion rounds conducted, and qualitative secondary analyses of data carried out using an iterative inductive-deductive approach. RESULTS Conceptual considerations are explicated that distinguish the personal factors perspective from other components of the International Classification of Functioning, Disability and Health. A representation structure is developed that organizes health-related concepts describing the internal context of functioning. Concepts are organized as individual facts, subjective experiences, and recurrent patterns of experience and behavior specifying 7 areas and 211 concept groups. CONCLUSIONS The article calls for further scientific debate on the perspective of personal factors in the light of the International Classification of Functioning, Disability and Health. A structure that organizes concepts in relation to a personal factors perspective can enhance the comprehensiveness, transparency and standardization of health information, and contribute to the empowerment of persons with disabilities. Implications for rehabilitation The present study collected data from scientific literature reviews, discussion rounds and qualitative secondary analyses in order to develop a representation and organization of information describing persons' lived experience of health from a personal factors perspective in the light of the International Classification of Functioning, Disability and Health. The following representation structure for health-related information from a personal factors perspective was developed: (i) Individuals facts (i.e., socio-demographical factors, position in the immediate social and physical context, personal history and biography), (ii) subjective experience (i.e., feelings, thoughts and beliefs, motives), and (iii) recurrent patterns of experience (i.e., feelings, thoughts and beliefs) and behavior. With this study, we aim to stimulate further scientific discussion about the personal factors component in the International Classification of Functioning, Disability and Health, including its application and subsequent validation for potential implementation into clinical practice.
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Affiliation(s)
- Szilvia Geyh
- a Swiss Paraplegic Research (SPF) , Nottwil , Switzerland.,b Department of Health Sciences and Health Policy , University of Lucerne , Nottwil , Switzerland
| | - Urban Schwegler
- a Swiss Paraplegic Research (SPF) , Nottwil , Switzerland.,b Department of Health Sciences and Health Policy , University of Lucerne , Nottwil , Switzerland
| | - Claudio Peter
- a Swiss Paraplegic Research (SPF) , Nottwil , Switzerland.,b Department of Health Sciences and Health Policy , University of Lucerne , Nottwil , Switzerland
| | - Rachel Müller
- a Swiss Paraplegic Research (SPF) , Nottwil , Switzerland.,b Department of Health Sciences and Health Policy , University of Lucerne , Nottwil , Switzerland
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Madden RH, Bundy A. The ICF has made a difference to functioning and disability measurement and statistics. Disabil Rehabil 2018; 41:1450-1462. [PMID: 29433362 DOI: 10.1080/09638288.2018.1431812] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS Fifteen years after the publication of the International Classification of Functioning, Disability and Health (ICF), we investigated: How ICF applications align with ICF aims, contents and principles, and how the ICF has been used to improve measurement of functioning and related statistics. METHODS In a scoping review, we investigated research published 2001-2015 relating to measurement and statistics for evidence of: a change in thinking; alignment of applications with ICF specifications and philosophy; and the emergence of new knowledge. RESULTS The ICF is used in diverse applications, settings and countries, with processes largely aligned with the ICF and intended to improve measurement and statistics: new national surveys, information systems and ICF-based instruments; and international efforts to improve disability data. Knowledge is growing about the components and interactions of the ICF model, the diverse effects of the environment on functioning, and the meaning and measurement of participation. CONCLUSION The ICF provides specificity and a common language in the complex world of functioning and disability and is stimulating new thinking, new applications in measurement and statistics, and the assembling of new knowledge. Nevertheless, the field needs to mature. Identified gaps suggest ways to improve measurement and statistics to underpin policies, services and outcomes. Implications for Rehabilitation The ICF offers a conceptualization of functioning and disability that can underpin assessment and documentation in rehabilitation, with a growing body of experience to draw on for guidance. Experience with the ICF reminds practitioners to consider all the domains of participation, the effect of the environment on participation and the importance of involving clients/patients in assessment and service planning. Understanding the variability of functioning within everyday environments and designing interventions for removing barriers in various environments is a vital part of rehabilitation planning.
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Affiliation(s)
- Rosamond H Madden
- a Faculty of Health Sciences , University of Sydney , Sydney , Australia
| | - Anita Bundy
- a Faculty of Health Sciences , University of Sydney , Sydney , Australia.,b Department of Occupational Therapy , Colorado State University , Fort Collins , CO , USA
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42
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Fehrmann E, Kotulla S, Fischer L, Kienbacher T, Tuechler K, Mair P, Ebenbichler G, Paul B. The impact of age and gender on the ICF-based assessment of chronic low back pain. Disabil Rehabil 2018; 41:1190-1199. [DOI: 10.1080/09638288.2018.1424950] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Elisabeth Fehrmann
- Karl Landsteiner Institute, Institute for Outpatient Rehabilitation Research, Vienna, Austria
- Department of Psychology, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Simone Kotulla
- Essen University Hospital, Institute of Medical Psychology and Behavioral Immunobiology, Essen, Germany
| | - Linda Fischer
- Karl Landsteiner Institute, Institute for Outpatient Rehabilitation Research, Vienna, Austria
| | - Thomas Kienbacher
- Karl Landsteiner Institute, Institute for Outpatient Rehabilitation Research, Vienna, Austria
| | - Kerstin Tuechler
- Karl Landsteiner Institute, Institute for Outpatient Rehabilitation Research, Vienna, Austria
| | - Patrick Mair
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Gerold Ebenbichler
- Department of Physical Medicine and Rehabilitation, Medical University Vienna, Vienna, Austria
| | - Birgit Paul
- Karl Landsteiner Institute, Institute for Outpatient Rehabilitation Research, Vienna, Austria
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Sivan M, Gallagher J, Holt R, Weightman A, O'Connor R, Levesley M. Employing the International Classification of Functioning, Disability and Health framework to capture user feedback in the design and testing stage of development of home-based arm rehabilitation technology. Assist Technol 2018; 28:175-82. [PMID: 26852630 DOI: 10.1080/10400435.2016.1140689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The purpose of this study was to evaluate the International Classification of Functioning, Disability and Health (ICF) as a framework to ensure that key aspects of user feedback are identified in the design and testing stages of development of a home-based upper limb rehabilitation system. Seventeen stroke survivors with residual upper limb weakness, and seven healthcare professionals with expertise in stroke rehabilitation, were enrolled in the user-centered design process. Through semi-structured interviews, they provided feedback on the hardware, software and impact of a home-based rehabilitation device to facilitate self-managed arm exercise. Members of the multidisciplinary clinical and engineering research team, based on previous experience and existing literature in user-centred design, developed the topic list for the interviews. Meaningful concepts were extracted from participants' interviews based on existing ICF linking rules and matched to categories within the ICF Comprehensive Core Set for stroke. Most of the interview concepts (except personal factors) matched the existing ICF Comprehensive Core Set categories. Personal factors that emerged from interviews e.g. gender, age, interest, compliance, motivation, choice and convenience that might determine device usability are yet to be categorised within the ICF framework and hence could not be matched to a specific Core Set category.
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Affiliation(s)
- Manoj Sivan
- a Academic Department of Rehabilitation Medicine , University of Leeds , Leeds , UK.,b Institute of Brain, Behaviour and Mental Health, University of Manchester , Manchester, UK
| | - Justin Gallagher
- c School of Mechanical Engineering , University of Leeds , Leeds, UK
| | - Ray Holt
- c School of Mechanical Engineering , University of Leeds , Leeds, UK
| | - Andrew Weightman
- a Academic Department of Rehabilitation Medicine , University of Leeds , Leeds , UK.,d School of Mechanical, Aerospace and Civil Engineering , University of Manchester , Manchester , UK
| | - Rory O'Connor
- a Academic Department of Rehabilitation Medicine , University of Leeds , Leeds , UK
| | - Martin Levesley
- c School of Mechanical Engineering , University of Leeds , Leeds, UK
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Mahdi S, Viljoen M, Yee T, Selb M, Singhal N, Almodayfer O, Granlund M, de Vries PJ, Zwaigenbaum L, Bölte S. An international qualitative study of functioning in autism spectrum disorder using the World Health Organization international classification of functioning, disability and health framework. Autism Res 2017; 11:463-475. [PMID: 29226604 PMCID: PMC5900830 DOI: 10.1002/aur.1905] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 11/23/2017] [Accepted: 11/25/2017] [Indexed: 01/30/2023]
Abstract
This is the third in a series of four empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The present study aimed to describe functioning in ASD (as operationalized by the ICF) derived from the perspectives of diagnosed individuals, family members, and professionals. A qualitative study using focus groups and semi-structured interviews were conducted with 19 stakeholder groups (N = 90) from Canada, India, Saudi Arabia, South Africa, and Sweden. Meaningful concepts from the focus groups and individual interviews were linked to ICF categories using a deductive qualitative approach with standardized linking procedures. The deductive qualitative content analysis yielded meaningful functioning concepts that were linked to 110 ICF categories across all four ICF components. Broad variation of environmental factors and activities and participation categories were identified in this study, while body functions consisted mainly of mental functions. Body structures were sparsely mentioned by the participants. Positive aspects of ASD included honesty, attention to detail, and memory. The experiences provided by international stakeholders support the need to understand individuals with ASD in a broader perspective, extending beyond diagnostic criteria into many areas of functioning and environmental domains. This study is part of a larger systematic effort that will provide the basis to define ICF Core Sets for ASD, from which assessment tools can be generated for use in clinical practice, research, and health care policy making. Autism Res 2018, 11: 463-475. © 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. LAY SUMMARY The study findings support the need to understand the living experiences of individuals with Autism Spectrum Disorder (ASD) from a broader perspective, taking into account many areas of an individual's functioning and environment. The ICF can serve as foundation for exploring these living experiences more extensively by offering tools that enable wide variety of individual difficulties and strengths to be captured along with important environmental influences. As such, these tools can facilitate interventions that meet the needs and goals of the individual.
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Affiliation(s)
- Soheil Mahdi
- Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Marisa Viljoen
- Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Tamara Yee
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Melissa Selb
- ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Nidhi Singhal
- Action for Autism, The National Centre for Autism, New Delhi, India
| | - Omar Almodayfer
- Mental Health Department, KAMC-R, MNGHA, Riyadh, Saudi Arabia
| | - Mats Granlund
- CHILD, SIDR, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Petrus J de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | | | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
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Physical activity, body functions and disability among middle-aged and older Spanish adults. BMC Geriatr 2017; 17:150. [PMID: 28720075 PMCID: PMC5516319 DOI: 10.1186/s12877-017-0551-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 07/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity (PA) is a health determinant among middle-aged and older adults. In contrast, poor health is expected to have a negative impact on PA. This study sought to assess to what extent specific International Classification of Functioning, Disability and Health (ICF) health components were associated with PA among older adults. METHODS We used a sample of 864 persons aged ≥50 years, positively screened for disability or cognition in a cross-sectional community survey in Spain. Weekly energy expenditure during PA was measured with the Yale Physical Activity Survey (YPAS) scale. The associations between body function impairment, health conditions or World Health Organization Disability Assessment Schedule (WHODAS 2.0) disability scores and energy expenditure were quantified using negative-binomial regression, and expressed in terms of adjusted mean ratios (aMRs). RESULTS Mean energy expenditure was 4542 Kcal/week. A lower weekly energy expenditure was associated with: severe/extreme impairment of mental functions, aMR 0.38, 95% confidence interval, CI (0.21-0.68), and neuromusculoskeletal and movement functions, aMR 0.50 (0.35-0.72); WHODAS 2.0 disability, aMR 0.55 (0.34-0.91); dementia, aMR 0.45 (0.31-0.66); and heart failure, aMR 0.54 (0.34-0.87). In contrast, people with arthritis/osteoarthritis had a higher energy expenditure, aMR 1.27 (1.07-1.51). CONCLUSION Our results suggest that there is a strong relationship between selected body function impairments, mainly mental, and PA. Although more research is needed to fully understand causal relationships, strategies to improve PA among the elderly may require targeting mental, neuromusculoskeletal and movement functions, disability determinants (including barriers), and specific approaches for persons with dementia or heart failure.
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Heerkens YF, de Brouwer CP, Engels JA, van der Gulden JW, Kant IJ. Elaboration of the contextual factors of the ICF for Occupational Health Care. Work 2017; 57:187-204. [DOI: 10.3233/wor-172546] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Yvonne F. Heerkens
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Dutch Institute of Allied Health Care, Amersfoort, The Netherlands
| | | | - Josephine A. Engels
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Joost W.J. van der Gulden
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - IJmert Kant
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
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Correlates of self-reported physical function in individuals with spinal cord injuries and disorders: does self-efficacy matter? Spinal Cord 2017; 55:1096-1102. [DOI: 10.1038/sc.2017.35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 03/01/2017] [Accepted: 03/07/2017] [Indexed: 11/08/2022]
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Abstract
OBJECTIVE The Learning Health System for Spinal Cord Injury (LHS-SCI) is an initiative embedded in the World Health Organization's (WHO's) Global Disability Plan and requires the statistical collection of data on the lived experience of persons with SCI to consequently formulate recommendations and policies. The International Spinal Cord Injury (InSCI) community survey has been developed as an initial step to gain information about the lived experience of persons with SCI within and across diverse nations. DESIGN InSCI is a multinational community survey based on the International Classification of Functioning, Disability and Health Core Sets for SCI and involves 28 countries from all six WHO regions. The study will be implemented in 2017. Overall aims, guiding principles on sampling strategies, data collection modes, and reminder management are described. CONCLUSIONS InSCI will be the first survey to be conducted simultaneously in many countries and in all six WHO world regions that identifies the factors associated with functioning, health, and well-being of persons living with SCI. Expected results of the survey will be used for the basis of conducting stakeholder dialogs for policy reforms designed to improve the functioning, health maintenance, and well-being of persons with SCI.
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Finger M, de Bie R, Selb M, Escorpizo R. An examination of concepts in vocational rehabilitation that could not be linked to the ICF based on an analysis of secondary data. Work 2017; 53:775-92. [PMID: 26890591 DOI: 10.3233/wor-152251] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND In the last few years the International Classification of Functioning, Disability and Health (ICF) has become a widely known and useful reference classification in vocational rehabilitation. It would be equally important to know which aspects of work-related health information cannot be assigned to distinct ICF categories. OBJECTIVE The objective of this study is to examine the concepts derived from three studies conducted within the ICF Core Set for vocational rehabilitation project, which could not be linked to distinct ICF codes in order to complement the current understanding of functioning in vocational rehabilitation. METHODS Secondary data analysis of the concepts from the systematic literature review, expert survey and patient focus group study of the ICF Core Set for vocational rehabilitation project that were marked as nd = not definable, nc = not covered or pf = personal factor. Nd-concepts were assigned to the biopsychosocial model of the ICF; additional ICF categories were formulated where needed. Nc-concepts were grouped into common themes not covered by the ICF. Pf-categories were linked to a proposed personal factors classification. RESULTS 1093 nd-concepts were matched to overarching terms in the ICF, and "other specified"-categories were detailed. 1924 pf-concepts were linked to 31 second level categories of a proposed personal factors classification. 441 nc-concepts were grouped into six themes including the concept of well-being and attributes related to processes and time. CONCLUSIONS With concepts that emerged from the secondary analysis of data gathered during the vocational rehabilitation ICF Core Set project, we have enriched the ICF model with constructs specific to vocational rehabilitation. However, additional research is needed to further explore personal factors specific to vocational rehabilitation. The influence of themes complementary to the ICF such as well-being and quality of life on return-to-work should be further investigated.
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Affiliation(s)
- Monika Finger
- Swiss Paraplegic Research (SPF), Nottwil, Switzerland.,ICF Research Branch in cooperation with the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland.,Caphri Research School, Maastricht University, Maastricht, The Netherlands
| | - Robert de Bie
- Caphri Research School, Maastricht University, Maastricht, The Netherlands.,Department of Epidemiology and Institute for Education, Maastricht University, Maastricht, The Netherlands
| | - Melissa Selb
- Swiss Paraplegic Research (SPF), Nottwil, Switzerland.,ICF Research Branch in cooperation with the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland
| | - Reuben Escorpizo
- Swiss Paraplegic Research (SPF), Nottwil, Switzerland.,ICF Research Branch in cooperation with the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland.,Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
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Bjørnshave Noe B, Bjerrum M, Angel S. The influence of clarification and threats on life situation: patients' experiences 1 year after TSCI. Spinal Cord Ser Cases 2017; 3:17006. [PMID: 28435741 DOI: 10.1038/scsandc.2017.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 12/22/2016] [Accepted: 01/10/2017] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The study was conducted at the Spinal Cord Injury Centre of Western Denmark (VCR). The aim of the study was to explore patients' experiences following traumatic spinal cord injury and to identify characteristics of positive versus negative life situation 1 year post discharge from hospital rehabilitation. This was a qualitative study conducted using inductive content analysis. CASE PRESENTATION In this qualitative study seven patients were interviewed one year after discharge from initial rehabilitation at the VCR. The interviews were analysed using inductive content analysis. DISCUSSION We found that two categories condensed the patients' experiences of their life situation 1 year post discharge: 'clarification in relation to overall life situation' and 'threat to core competences'. The transversal analysis across the derived categories identified different combinations of clarification and threats to core competences explaining the patients' experiences: high degree of clarification combined with low degree of threat to core competences was indicative of positive life situation. Also, positive life situation was seen when a high degree of clarification compensated for high degree of threats on core competencies. In contrast, an overall stressful and negative life situation was influenced by poor clarification combined with a high degree of threat to core competences. However, when core competences can be transformed into new skills, threats were manageable. This study revealed that clarification related to overall life situation in combination with threat to core competences may explain traumatic spinal cord injury patients' overall life situation 1 year post discharge. An appropriate balance characterises a positive life situation. There might be a need to pay attention to patients who are challenged by low degree of clarification and high degree of threats on core competencies 1 year post discharge as this may influence the life situation negatively.
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Affiliation(s)
- Bodil Bjørnshave Noe
- Section of Nursing, Institute of Public Health, Health, Aarhus University, Aarhus, Denmark
| | - Merete Bjerrum
- Section of Nursing, Institute of Public Health, Health, Aarhus University, Aarhus, Denmark
| | - Sanne Angel
- Section of Nursing, Institute of Public Health, Health, Aarhus University, Aarhus, Denmark
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