An exploratory study examining the relationships between the personal, environmental and activity participation variables and quality of life among young adults with disabilities (original) (raw)
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Journal of Vocational Rehabilitation, 2016
The aim of this study was to understand how the characteristics of self-determination (i.e., choice, problemsolving, goal setting) and factors associated with resilience (i.e., support and self-efficacy) relate to each other, including the relationship these variables have on quality-of-life (QoL) for individuals with disabilities. METHODS: Data were collected from 195 youth and young adults with disabilities. RESULTS: Results indicated self-efficacy as a critical skill, showing positive associations with behavior of choice and QoL. In addition, social support emerged as an important factor in the development of self-determination skills. The findings also indicated that an individual's financial situation assumed a mediator role between self-determination components and QoL. Through structural equations modeling (SEM), a model representing the relationships between these variables was designed.
International Journal of Physical Medicine & Rehabilitation, 2016
Background: Youth living with chronic disabilities face challenges in various life domains, and effective rehabilitation services are essential in providing the necessary support to optimize their participation in the community. To date, there has not been any systematic review summarizing rehabilitation intervention studies that targeted this vulnerable population and their participation in various societal domains. Aim: The purpose of this comprehensive review was to identify and critically appraise studies that aimed to improve participation outcome in young adults. Design: Systematic review Settings: Rehabilitation facilities, home, school, community, other Population: Young adults with disabilities Method: Systematic search in OVID MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Knowledge Social Sciences Index (2000 to 2013). The International Classification of Functioning, Disability and Health (ICF) was used to classify the focus and outcome of the interventions. Results: 104 multidisciplinary intervention studies were identified of which only 9 had a randomized design. Two of the randomized trials had a particular focus on young adults, one of which demonstrated a positive effect on the measured outcome as a result of the intervention. The review also revealed that studies targeting young adults often included subjects with multiple disabilities, had less focus on the ICF category "body functions" and evaluated a broader spectrum of participatory outcomes compared to studies including broader age categories. The majority of the studies did not explicitly illustrate the linkage between the applied interventions and the outcome measures or describe the processes of the interventions that might have affected the results. Furthermore, only 27% or the studies manipulated the environmental context as part of the interventions. Conclusions: In this review, only one third of the multidisciplinary intervention studies specifically targeted young adults, while the other studies included a wide age range. Very few studies were designed to be able to evaluate the outcome as a direct result of the applied intervention or described the specific elements involved in the interventions. This is of vital importance in the design and delivery of effective rehabilitation services and in enabling efficient transdisciplinary communication in this complex field. Clinical Rehabilitation Impact: The ICF framework was found to be useful in this review for the classification of the components and outcomes in intervention studies. This framework may also provide a common language for the
Community-Based Rehabilitation (CBR) and its Impact on Quality of Life (QoL) of Disabled Children
Review of Education, Administration & Law
Disability has a substantial impact on a person's Quality of Life (QoL). Rehabilitation, a process where measures are taken to improve the QoL of people with disabilities, uses a variety of techniques. Community-based rehabilitation (CBR) is one such technique. It was developed in response to the region's serious QoL as well as its poor accessibility to and availability of rehabilitation services. Therefore, the main goal of this study was to address the concerns facing impaired children and to create a reliable intervention (CBR) for handling those problems. A quantitative research method was applied in this study. Data was collected from 256 participants who were with mild disability i.e., Hearing Impaired, Visually Impaired, Mentally Retarded and Physically Handicapped along with their immediate families, concerned trained volunteers from five different schools. In-depth research was conducted on them by using instrument i.e., World Health Organization Quality of Life (WH...
Health and Quality of Life Outcomes, 2018
Background: Measurement of quality of life demands thoroughly developed and validated instruments. The development steps from theory to concepts and from empirical data to items are sparsely described in the literature of questionnaire development. Furthermore, there seems to be a need for an instrument measuring quality of life and participation in a population with diverse disabilities. The aim of this paper was to present and discuss the initial steps in the development of the Electronic Quality of Life questionnaire (EQOL). Methods: The development of EQOL included six steps: 1) Establishing conceptual understanding; 2) Development of interview guides which build on the conceptual understanding; 3) Qualitative interviews of 55 participants (10-40 years old) with different types and severities of disabilities; 4) Conceptualization of domains identified in the qualitative data through thematic analysis; 5) Operationalization of the identified domains into items and; 6) Evaluation of content validity of the first version of the EQOL-measure. Content validity was examined by cognitive interviews with participants in the target group as well as by continuous feedback from an advisory board. Results: We identified six domains (function and health, environment (physical and social), social network, wellbeing, occupation, and managing strategies) based on themes derived from the qualitative interviews and on conceptual discussions within the author group. These domains were incorporated in a conceptual model and items were generated to measure the content of each domain. Participants expressed satisfaction with EQOL but most participants felt that there were too many items. Conclusions: In total, 191 items were included in the questionnaire. Participants felt that the EQOL-questionnaire was relevant to their quality of life and participation. We have shown that it is possible to include quality of life and participation for people with various disabilities in one instrument. Although capturing less detail than a condition specific instrument, EQOL includes aspects perceived important for people with disabilities who are not included in general surveys. This is relevant when for example evaluating environmental adaptations and when comparing populations with various disabilities.
2013
The MHD-DCP is a conceptual model that enables one to identify and explains the causes and consequences of disease, trauma, and disruptions to the development of a person or a population. It demonstrates that social participation is not only the result of our identity, our choices, impairments to our organs, and our abilities and inabilities, but also of characteristics of our living environment. For example, an individual's preparing meals or going to regular school may be influenced by the reinforcement of that person's capabilities and alteration of his or her functional limitations through rehabilitation, as well as through the reduction of obstacles caused by prejudices, lack of assistance or resources, and absence of accessibility within the home, school or urban space. The original DCP model was developed based on the Quebec government's disability policy, "On Equal Terms," and on the recommendations of international experts, including the World Health Organization, the United Nations, Disabled Peoples' International, and the Council of Europe, at the Quebec Meeting on International Classification of Impairments, Disabilities, and Handicaps (ICIDH) in June 1987. By 1989, Patrick Fougeyrollas, a Canadian social anthropologist, and the Quebec Committee on ICIDH published a conceptual framework illustrating the person-environment interactive process of the construction of social participation or exclusion and denial of human rights. Throughout the 1990s, they improved the DCP framework and classification, known also as the Quebec model, and urged the WHO and international partners to revise the ICIDH and recognize the Environmental Factors as a full component of the Disability Creation Process. From 1993 to 2001, this innovative conceptualization and its scientific applications influenced the revision process that culminated in the WHO's adoption of the International Classification of Functioning, Disability, and Health (ICF).
Enabling participation for disabled young people: study protocol
BMC public health, 2018
Participation in community life is vital for health and wellbeing, promoting a sense of belonging, networks of social support and opportunities for physical activity. Disabled young people have lower levels of mobility and participation in recreational activities (physical, social and cultural), education and employment, than their peers without disabilities. This has implications for their health and wellbeing and life course opportunities. Previous research on the participation levels of disabled young people has primarily relied on parent/caregiver reports and been oriented to home and school environments. This study investigates how physical and social environmental factors cohere to support or restrict the everyday mobility and participation of disabled young people. The study is located in Auckland, Aotearoa/New Zealand (NZ). Participants comprise 35 young people aged 12-25 years with mobility, vision or hearing impairments. A mixed-methods research design combines objective (...
Community Participation, Supports, and Barriers of School-Age Children With and Without Disabilities
Archives of Physical Medicine and Rehabilitation, 2013
Objective: To examine patterns of community participation and environmental factors that affect community participation for school-age children with and without disabilities. Design: Cross-sectional, descriptive, and exploratory study. Setting: Parents from the United States and Canada completed the main outcome measure online in their homes or communities. Participants: Parents (NZ576) reported on their children aged 5 to 17 years with disabilities (nZ282) and without disabilities (nZ294). Interventions: Not applicable. Main Outcome Measure: Participation and Environment Measure for Children and Youth. Results: Group differences in summary scores and many items were significant (P<.001). Children with disabilities participated less frequently, were less involved, and had less environmental support in the community than children without disabilities. Parents of children with disabilities desired more change in their child's participation than parents of children without disabilities. Effect sizes for summary scores were moderate to very large (n 2 p from .11e.40), with the largest group difference found in environment scores. Overall, the largest group differences in participation were in "unstructured physical activities" and "getting together with other children"dalso the 2 areas where parents of children with disabilities most frequently desired change. The largest differences in environmental impact were in physical, social, and cognitive activity demands and availability/adequacy of programs and services. Conclusions: Results provide insights about where greater efforts are needed to support community participation of school-age children with disabilities. Further study with a more diverse sample in terms of race/ethnicity, family income/education levels, and geographic region is needed to determine the extent to which results may be generalized. Archives of Physical Medicine and Rehabilitation 2013;94:315-23 ª 2013 by the American Congress of Rehabilitation Medicine Participation in activities that provide a sense of accomplishment and enjoyment during childhood and youth helps to foster positive development into adulthood. 1-5 Participation has been shown to be an indicator of overall health and well-being across the lifespan and has been described as a key rehabilitation outcome. 5-8
Journal of Rehabilitation Medicine, 2004
Firstly to investigate the utility of the International Classification of Functioning, Disability and Health's (ICF's) participation dimension when items from extant questionnaires focusing on participation were assigned to ICF codes on an item-by-item basis; and, secondly, to conduct a preliminary investigation of the theoretical assumption expressed in ICF that ICF's environment component interacts with body function and participation components. Design: A person-based, descriptive study. Subjects: The sample comprised students with disabilities (n = 448), their parents/relatives (n = 414), their teachers/ managers (n = 418) and special education consultants (n = 110). Methods: Items from original surveys were used. Participation of students with disabilities: a survey of participation in school activities, The Arc's Self-Determination Scale, Perceived interaction-questionnaire, Environments survey, The Abilities Index. Data were analysed with the help of ANOVA, Scheffé pair-wise comparisons, correlation analysis and cluster analysis. Results: The study partly confirmed the utility of ICF participation dimension in assigning codes to items from extant instruments. Moderate statistical correlations between participation chapters and between items from different ICF dimensions were found. Cluster analysis resulted in groups with participation patterns not related to type of disability. Conclusion: Items from extant instruments can be assigned to ICF participation codes, but further item analyses and a more extensive questionnaire base are needed.