Ingela Petersson

Longitudinal changes in everyday life after home modifications for people aging with disabilities

Objective: To investigate longitudinal impacts of home modifications on the difficulty of performing everyday life tasks for people aging with disabilities, and to investigate whether other factors had any additional impacts on difficulty in everyday life tasks for people receiving home modifications. Methods: The sample consisted of 103 persons aging with disabilities and in need of home modifications, divided into an intervention group and a comparison group. The data were first subjected to Rasch analysis and a random coefficient model was used. Results: Participants in the intervention group reported a significantly lower level of difficulty in everyday life tasks compared with those in the comparison group. One confounding factor, number of months waiting for home modification, had an impact on difficulty in everyday life. Conclusion: Home modifications are effective in decreasing difficulty in performing everyday life tasks up to six months after the installation. Furthermore, to be effective home modifications need to be installed in a timely fashion. For each consecutive month the person waited for their home modification the difficulty of performing everyday life tasks increased. Therefore, it is important that home modifications be installed as soon as possible after the need has been identified.

Performance of activities of daily living in a sample of applicants for home modification services

Home modification services are provided to support persons with functional limitations to live independently at home. It is not well known what causes individuals to apply for home modifications, or in what kind of life situation this need appears. The aim of this study was to examine the relationship between performance of activities of daily living, housing and living situation, and the home modification applied for in a sample of home modification applicants. Further, the aim was to examine differences in performance of activities of daily living between subgroups with different social support. A total of 102 participants were included in the study. Data on performance of activities of daily living was collected through interviews in the participants’ homes, using structured instruments. The participants reported high levels of independence in activities of daily living, and were using assistive devices to a large extent. However, the applicants clearly experienced difficulties in performing activities related to the applied home modification. The study indicates that the main reason for applying for Home Modification Grants was perceived difficulties in performance of activities of daily living. This stresses the importance of including other aspects besides independence when trying to understand persons’ activity performance and planning for occupational therapy interventions.

Psychometric evaluation of an assessment of awareness using two different Rasch models

Abstract Objective: The aim of this study was to evaluate the psychometric properties of the Assessment of Awareness of Disability (AAD), applied to a sample of clients with a variety of diagnoses, using two different Rasch models. Methods: The sample consisted of 245 clients admitted to occupational therapy services in Sweden. The psychometric properties of the AAD measures were analysed and compared using both Rasch partial credit (PCM) and rating scale (RSM) models. Results: In relation to rating scale properties and person response validity, the RSM yielded better results. However, the PCM demonstrated better item goodness-of-fit statistics than the RSM, supporting the internal scale validity of the AAD. Some systematic indications of sample-dependent misfit were also found in the data. Conclusion: The results support the validity of the AAD in a sample of clients with various diagnoses, although some limitations of the tool are addressed. The outcomes also demonstrate the importance of making cautious choices when selecting a Rasch model for investigating psychometric properties, as the choice has a substantial impact on the interpretation of the findings.

Leisure repertoire among persons with a spinal cord injury: Interests, performance, and well-being

Abstract Objective To explore and describe the leisure repertoire of persons with traumatic spinal cord injury (SCI) and how the repertoire is related to interest, performance, and well-being. Design Cross-sectional study. Setting A total of 97 persons with traumatic SCI were recruited from the non-profit national organization, RG Active Rehabilitation in Sweden. Outcome measure Data were collected through a two-part postal survey. The first comprised of questions investigating socio-demographic variables and injury characteristics; the second part included an interest checklist with 20 areas of leisure activities. Results The participants were mostly interested in, performed, and experienced well-being from social and culture activities and TV/DVD/movies. The areas of leisure activities in which they had most likely experienced changes after the SCI were outdoor activities, exercise, and gardening. Sex, age, and to some extent, time since injury were related to interest, performance, well-being, and changed performance. Conclusions The results provided an explanation and limited description of a changed leisure repertoire among persons after a traumatic SCI. The study showed that sex, age, and time since injury were more closely related to the choice of leisure activities to include in the leisure repertoire than the level of injury. This knowledge can be of importance when professionals in the field of rehabilitation are planning and implementing interventions concerning leisure activities for persons with SCI.

The assessment of awareness of ability (A3) in a Japanese context: A Rasch model application

Abstract The overall aim of this study was to evaluate the validity of the Assessment of Awareness of Ability (A3) in a Japanese context. The A3 (formerly known as the Assessment of Awareness of Disability, AAD) is a standardized 11-question interview used to explore the discrepancy between observed strengths and limitations in the performance of activities of daily living (ADL) according to the Assessment of Motor and Process Skills (AMPS) and the limitations described by the client. In this study, 259 matched Swedish and Japanese A3 data records were analyzed using a Rasch partial credit model (PCM). The analysis of rater consistency and items demonstrated acceptable goodness-of-fit according to the PCM, indicating rater consistency and internal scale validity. The A3 can help clients and therapists understand discrepancies between observed and self-reported performance aspects of various everyday tasks within Japanese and Swedish contexts.