Domain Sets and Measurement Instruments on Participation and Environmental Factors in Spinal Cord Injury Research

Abstract

The understanding and measurement of participation and environmental context in spinal cord injury (SCI) is critically important. However, there is limited understanding of the environment-participation relationship in SCI research. There is little consensus on what is and on how to measure participation and its environmental determinants in the SCI. The objective of this article is to develop a set of International Classification of Functioning, Disability and Health (ICF)-based SCI Participation and Environment Domain Set and measurement instruments that intend to measure those domains. ICF categories from the ICF components of activities and participation and environmental factors based on the comprehensive ICF Core Set for SCI and the ICF Core Set for vocational rehabilitation were merged. Measurement instruments were selected based on published systematic reviews of measurement instruments in SCI. There were 128 ICF categories or domains in total (38 for environmental factors and 90 for activities and participation). There were six measurement instruments on environmental factors and six for participation based on existing systematic reviews. This article presents a domain set that is relevant to conducting research on the social and environmental perspectives, in an effort to understand and measure functioning in SCI (i.e., "SCI participation domain set" and "SCI environment domain set," respectively). The sample of SCI Participation and Environment Measurement Instruments gathered indicate the comprehensiveness and depth of the different domains. Guiding principles on the utilization of these measurement instruments depending on the purpose and design of a research study are highly recommended to investigators.

Design of the Swiss Spinal Cord Injury Cohort Study

“…51 Finally, environmental factors relevant to functioning and health will be measured using items from a newly developed measure, the Nottwil Environmental Factors Inventory. 21 The Nottwil Environmental Factors Inventory is based on new theoretical assumptions on how environmental factors influence participation. 42,52 The environmental factors covered in the Nottwil Environmental Factors Inventory have been determined based on the ICF Core Sets for persons with SCI.…”

“…19Y22 Briefly, the bases for the selection of the Basic Domain Set are the Brief ICF Core Sets for SCI, 12Y14 which have been developed to guarantee that critical domains of functioning and disability of persons with SCI are systematically considered in clinical practice and research, 19 and the ICF Minimal Generic Set, developed as a minimal set of ICF categories to be used in any study. 15 Literature reviews, protocols of existing longitudinal studies, 11 and the data sets of the International Spinal Cord Injury Society (www.iscos.org.uk) 23,24 were used to select the domain sets and measurement instruments in the following three domains: biomedical factors, 20 environmental factors, 21 and psychologic personal factors. 22 A systematic appraisal of psychometric properties, feasibility, and other criteria, such as comparability with other studies, efficiency, and nonredundancy, led 25 to the selection of measurement instruments.…”

Measuring Environmental Factors: Unique and Overlapping International Classification of Functioning, Disability and Health Coverage of 5 Instruments

“…The most commonly cited EF measures in disability and rehabilitation 49 research are the Craig Hospital Inventory of Environmental Factors (CHIEF), 10 the Facilitators and Barri-50 ers Survey among people with lower limb mobility impairments and limitations (FABS/M), 11 the Home 51 and Community Environment Instrument (HACE), 12 13 All used classical test theory methods to quantify the magnitude of EFs. Consequently, they do 53 not disentangle item endorsability from respondents' barrier sensitivity as item response theory ap-54 proaches do.…”

Psychometric Properties of the Nottwil Environmental Factors Inventory Short Form

“…Persons with the same diagnosis may nevertheless experience different levels of disability (meaning problems in functioning) because of the presence or absence of environmental barriers and facilitators. [1][2][3][4] A number of instruments have been used to measure environmental factors in individuals with SCI 5 ; the most frequently used is the Craig Hospital Inventory of Environmental Factors. 6 However, none of these instruments have been specifically developed for use in individuals with SCI, and none completely cover all environmental factors indicated as important by individuals with SCI, as specified in the International Classification of Functioning, Disability and Health's Core Sets for SCI.…”