While the findings support a growing consensus that participation in leisure activities might significantly contribute to prevention of dementia, it also identifies major hindrances to progress. Important limitations detected include a lack of theoretical underpinnings, and little consensus and standardisation in the measured key variables. The study reinforces the critical need to overcome these limitations to enable health care professionals (e.g. occupational therapists) to make evidence-based recommendations for increased participation in activities as a means of promoting health and preventing cognitive decline.

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.

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Enabling participation after stroke within a client-centred paradigm in this socio-cultural context requires consideration of the essential meaning of this concept as characterized by the dynamic process between the characteristics of "doing", "identity", and "living life". The study highlights how the provision of efficient rehabilitation services in this Eastern context requires attention to both "doing" and to "identity" in rehabilitation interventions, in order to enable individuals to adapt to their new lives after stroke and to "live their lives".

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.

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.

The general aim of this thesis was to explore and describe perceived participation in everyday occupations, and the factors associated with participation among persons with stroke in a sample from Iran. Furthermore, the aim was to describe and understand the lived experience of participation in everyday occupations following stroke. This thesis was based on four studies. The first three studies were performed using quantitative methods and the last study used a qualitative method. In Study I the focus was on producing the Persian version of the Impact on Participation and Autonomy (IPA) questionnaire and the psychometric evaluation of the translated version to be used for persons with stroke. In Study II perceived participation and autonomy was described among persons with stroke, and different aspects of functioning and contextual factors associated with participation after stroke were explored and identified in the sample. In Study III the Persian translated version of the Occupational Gaps Questionnaire (OGQ) and the LiSat-11 checklist were produced and psychometrically evaluated to use for persons with stroke. Moreover, this study focused on describing occupational gaps after stroke and exploring their relation to different aspects of functioning and perceived life satisfaction. In Study IV the lived experience of participation in everyday occupations was explored among persons with stroke using the phenomenological approach.

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.