Relationships between environmental factors and participation in adults with traumatic brain injury, stroke, and spinal cord injury: a cross-sectional multi-center study.
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 characteri...
| Publicado en: | Quality of Life Research Vol. 26; no. 10; pp. 2633 - 2646 |
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| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Oct2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=125130488&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125130488 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09629343 GPQ jtl: Quality of Life Research issn: 09629343 maglogo: N pubinfo: dt: Oct2017 vid: 26 iid: 10 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 125130488 125130488 144192236 NLM28444554 125130488 10.1007/s11136-017-1586-5 NLM28444554 125130488 ppf: 2633 ppct: 13 formats: fmt: @attributes: type: P tig: atl: Relationships between environmental factors and participation in adults with traumatic brain injury, stroke, and spinal cord injury: a cross-sectional multi-center study. aug: au: Wong, Alex Ng, Sheryl Dashner, Jessica Baum, M. Hammel, Joy Magasi, Susan Lai, Jin-Shei Carlozzi, Noelle Tulsky, David Miskovic, Ana Goldsmith, Arielle Heinemann, Allen Wong, Alex W K Baum, M Carolyn Carlozzi, Noelle E Tulsky, David S Heinemann, Allen W affil: Program in Occupational Therapy and Department of Neurology , Washington University School of Medicine , St. Louis USA sug: subj: Quality of Life Psychosocial Factors Stroke Etiology Spinal Cord Injuries Etiology Environment Stroke Pathology Adult Human Female Male Cross Sectional Studies Middle Age Spinal Cord Injuries Pathology Validation Studies Comparative Studies Evaluation Research Multicenter Studies Funding Source Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: 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. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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