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Gepubliceerd in: Quality of Life Research 10/2017

25-04-2017

Relationships between environmental factors and participation in adults with traumatic brain injury, stroke, and spinal cord injury: a cross-sectional multi-center study

Auteurs: Alex W. K. Wong, Sheryl Ng, Jessica Dashner, M. Carolyn Baum, Joy Hammel, Susan Magasi, Jin-Shei Lai, Noelle E. Carlozzi, David S. Tulsky, Ana Miskovic, Arielle Goldsmith, Allen W. Heinemann

Gepubliceerd in: Quality of Life Research | Uitgave 10/2017

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Abstract

Purpose

To develop and evaluate a model of environmental factors-participation relationships for persons with traumatic brain injury (TBI), stroke, and spinal cord injury (SCI), and test whether this model differed across three diagnostic groups, as well as other demographic and clinical characteristics.

Methods

A cross-sectional observational study included 545 community-dwelling adults with neurological disorders (TBI = 166; stroke = 189; SCI = 190) recruited at three academic medical centers. Participants completed patient-reported measures of environmental factors and participation.

Results

The final structural equation model had acceptable fit to the data (CFI = 0.923; TLI = 0.898; RMSEA = 0.085; SRMR = 0.053), explaining 63% of the variance in participation in social roles and activities. Systems, services, and policies had an indirect influence on participation and this relation was mediated by social attitudes and the built and natural environment. Access to information and technology was associated with the built and natural environment which in turn influence on participation (ps < 0.001). The model was consistent across sex, diagnosis, severity/type of injury, education, race, age, marital status, years since injury, wheelchairs use, insurance coverage, personal or household income, and crystallized cognition.

Conclusions

Social and physical environments appear to mediate the influence of systems, services, and policies on participation after acquired neurological disorders. These relations are stable across three diagnostic groups and many personal and clinical factors. Our findings inform health and disability policy, and provide guidance for implementing the initiatives in Healthy People 2020 in particular for people with acquired neurological disorders.

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Metagegevens
Titel
Relationships between environmental factors and participation in adults with traumatic brain injury, stroke, and spinal cord injury: a cross-sectional multi-center study
Auteurs
Alex W. K. Wong
Sheryl Ng
Jessica Dashner
M. Carolyn Baum
Joy Hammel
Susan Magasi
Jin-Shei Lai
Noelle E. Carlozzi
David S. Tulsky
Ana Miskovic
Arielle Goldsmith
Allen W. Heinemann
Publicatiedatum
25-04-2017
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 10/2017
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-017-1586-5