Factors affecting activities and participation in persons with disabilities - informing models and measures
Wee, Joy Yenn May
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Purpose- The World Health Organization describes ‘activities’ as what one does, and ‘participation’ as life situations or roles. This thesis explores and describes important influencers of activities and participation from the perspective of persons with disabilities. It also suggests how to include such information when reporting results of tools measuring activities and participation, so that health professionals working with persons with disabilities might collaborate and communicate more effectively with each other and the people they serve. Method- The World Health Organization framework of the International Classification of Functioning, Disability and Health (ICF) was used. Participants with mobility problems living in the community with their disability for a least 1 year were involved in this mixed methods study to gain a broad understanding of how persons with disabilities perceive and experience factors that affect their general and specific activities and participation. Semi-structured interviews guided by categories contained in two standard measures, the Barthel Index (BI), and the Participation Scale (P-scale) were employed, and grounded theory methods were used. From their responses, relationships between important concepts were used to inform a theoretical model. Upon this framework, relevant important shared factors, derived through combining several methods, were incorporated into reporting tools. Results- 24 participants identified 258 individual factors. Grounded theory analysis resulted in The Successful Adaptation Model, describing relationships amongst factors and activities and participation. For the BI, devices, home modifications, and treatments were most contributory. For the P-scale, personality, community and home accessibility, level of impairment, mobility aids, and transportation were among the most influential factors. Conclusion- This study incorporates perspectives of persons with disability into the Successful Adaptation Model, describing factors affecting activities and participation and their interactions. It also suggests a method of reporting important factors in conjunction with standardized measures of activities and participation.