Mandana Fallahpour

PERCEIVED PARTICIPATIoN AND AuToNoMY: ASPECTS oF FuNCTIoNING AND CoNTEXTuAL FACToRS PREDICTING PARTICIPATIoN AFTER STRoKE

OBJECTIVE To describe perceived participation and autonomy among a sample of persons with stroke in Iran and to identify different aspects of functioning and contextual factors predicting participation after stroke. DESIGN A cross-sectional study. SUBJECTS A total of 102 persons, between 27 and 75 years of age, diagnosed with first-ever stroke. METHODS Participants were assessed for different aspects of functioning, contextual factors and health conditions. Participation was assessed using the Persian version of the Impact on Participation and Autonomy questionnaire. RESULTS This study demonstrated that the majority of the study population perceived their participation and autonomy to be good to fair in the different domains of their participation, but not with respect to the autonomy outdoors domain. In addition, physical function was found to be the most important variable predicting performance-based participation, whereas mood state was the most important variable predicting social-based participation. CONCLUSION The results emphasize the importance of physical function, mood state and access to caregiving services as predictors of participation in everyday life after stroke. Whilst there are two dimensions of participation in this Persian sample of persons with stroke, the factors explaining participation seem to be the same across the cultures.

Impact on Participation and Autonomy (IPA): Psychometric evaluation of the Persian version to use for persons with stroke

Abstract The aim of this study was to evaluate the psychometric properties of the Persian version of the Impact on Participation and Autonomy questionnaire (IPA-P) to use for persons with stroke. A total of 102 persons diagnosed with first-ever stroke participated in this cross-sectional study. The psychometric properties were evaluated using a Rasch rating scale model. The results showed that IPA-P could not measure perceived participation as one unidimensional construct according to the criteria, but supported two different but related constructs. Performance-based participation consisted of 19 items including three IPA domains: autonomy indoors, family role, and autonomy outdoors. Social-based participation consisted of seven items from the social relations domain. The results provided evidence of internal scale validity, person response validity, and sensitivity for each of the two constructs of IPA-P. In conclusion, the results supported the psychometric properties of two constructs of perceived participation in the Persian sample tested. However further evaluation of psychometric properties of the IPA is needed in a variety of diagnoses and in other cultural backgrounds.

Perceived difficulty in use of everyday technology in persons with acquired brain injury of different severity: a comparison with controls.

OBJECTIVE To compare the perceived difficulty in use of everyday technology in persons with acquired brain injury with different levels of severity of disability with that of controls. METHODS This comparison study recruited 2 samples of persons with acquired brain injury and controls, comprising a total of 161 participants, age range 18-64 years. The long and short versions of the Everyday Technology Use Questionnaire and the Extended Glasgow Outcome Scale were used to evaluate participants. RESULTS Persons with acquired brain injury demonstrated lower mean levels of perceived ability in use of everyday technology than controls (F = 21.84, degrees of freedom = 1, p < 0.001). Further analysis showed a statistically significant mean difference in perceived difficulty in use of everyday technology between persons with severe disability and good recovery, between persons with severe disability and controls, and between persons with moderate disability and controls. No significant mean difference was found between persons with severe disability and moderate disability, between persons with moderate disability and good recovery, and between persons with good recovery and controls. CONCLUSION Perceived difficulty in using everyday technology is significantly increased among persons with acquired brain injury with severe to moderate disability compared with controls. Rehabilitation services should consider the use of everyday technology in order to increase participation in everyday activities after acquired brain injury.

Participation after acquired brain injury: Associations with everyday technology and activities in daily life

Abstract Background: The development of the information society has led to increased use of everyday technology and changed the conditions for participation. Enabling participation in everyday life situations is an important rehabilitation goal after acquired brain injury (ABI). Identifying factors associated with individuals’ experienced participation and problems therein is therefore essential. Objective: This study aimed at exploring the relationship between perceived difficulty in everyday technology use, perceived ability in the activities of daily living (ADL), and perceived participation, and participation problems in persons with ABI. Methods: Eighty-one persons with ABI participated in the study and were assessed by the Impact on Participation and Autonomy questionnaire, the Everyday Technology Use Questionnaire, and the ADL taxonomy. Results: Findings showed that the combined model of difficulty in everyday technology (ET) use, ADL ability, and the interaction between them explained both participation in various domains of everyday life, and also overall level of perceived participation and the perceived problems. Conclusions: The findings underscore the importance of evaluating individuals’ ability in both ET use and ADL after ABI to increase the probability of explaining these persons’ participation in desired everyday life situations and, also, for rehabilitation design.

Skill clusters of ability to manage everyday technology among people with and without cognitive impairment, dementia and acquired brain injury

Abstract Background: In order to develop supporting interventions for people demonstrating problems ET use, a detailed level of description of strengths and deficits is needed. Aims: To explore clusters of specific performance skill required when using ET, and to evaluate if and in what way such clusters are associated with age, gender, diagnosis, and types of ETs managed. Materials and methods: A secondary analysis of 661 data records from 203 heterogeneous samples of participants using the Management of Everyday Technology Assessment (META) was used. Ward’s method and a hierarchical tree cluster analysis were used to determine and define the skill clusters. Results: Four distinct clusters of performance skill item profiles were found, across the 661 data records. These were then, based on each individuals’ cluster profiles in managing ET, categorized into two groups. The two groups were associated with, diagnosis and type of ETs managed. Conclusions and significance: The findings support a more dyadic person-ET approach in evaluation of ET management. The information from the skill clusters can be used to develop targeted intervention guides for occupational therapy and healthcare.