Environmental Barriers and Supports to Everyday Participation: A Qualitative Insider Perspective From People With Disabilities

Hammel, Joy; Magasi, Susan; Heinemann, Allen W.; Gray, David B.; Stark, Susan; Kisala, Pamela A.; Carlozzi, Noelle E.; Tulsky, David S.; Garcia, Sofia F.; Hahn, Elizabeth A.

doi:10.1016/j.apmr.2014.12.008

Cited by 234 publications

(170 citation statements)

References 23 publications

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“…Disability research focusing on environmental factors is of particular importance for rehabilitation, in addition to social policies, since many environmental barriers are man-made (e.g. poorly accessible buildings), or represent natural obstacles that can be moderated or removed by targeted intervention, such as snow clearing by dedicated winter services (6). Environmental factors can thus be modified in favour of people with disabilities (2,3,7).…”

Section: Introductionmentioning

confidence: 99%

Perceived impact of environmental barriers on participation among people living with spinal cord injury in Switzerland

Reinhardt

Ballert

Post³

2016

J Rehabil Med

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Section: Introductionmentioning

confidence: 99%

Perceived impact of environmental barriers on participation among people living with spinal cord injury in Switzerland

Reinhardt

Ballert

Post³

2016

J Rehabil Med

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“…This decision was reinforced by the focus group data reviewed in the parent study, which underscored the importance of social attitudes and perceptions on the everyday participation of people with disabilities. 21 Throughout the qualitative item review process, the Workgroup refined the definition of Social Attitudes to include (1) both negative and positive social attitudes, including marginalization, stigmatization, oppression and discrimination as well as inclusion, acceptance, integration, respect and societal equity and (2) both the perceived attitudes of specific members of respondents' communities and social networks (e.g., health care providers) as well as the larger society. The Workgroup wrote 32 new items (primarily capturing facilitators in addition to barriers) and winnowed the pool to 90 items for cognitive interviewing.…”

Section: Resultsmentioning

confidence: 99%

“…15,21 An interdisciplinary expert panel then completed domain identification so that all candidate items were assigned to domains within the conceptual framework. 15 The Social Environment Workgroup—consisting of psychologists, occupational therapists, and disability and health outcomes researchers—assigned items to conceptual groups informed by both theory and item content.…”

Section: Methodsmentioning

confidence: 99%

Development of Self-Report Measures of Social Attitudes That Act As Environmental Barriers and Facilitators for People With Disabilities

Garcia¹,

Hahn²,

Magasi³

et al. 2015

Archives of Physical Medicine and Rehabilitation

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Objective To describe the development of new self-report measures of social attitudes that act as environmental facilitators or barriers to the participation of people with disabilities in society. Design A mixed methods approach included a literature review; item classification, selection and writing; cognitive interviews and field testing with participants with spinal cord injury (SCI), traumatic brain injury (TBI) or stroke; and rating scale analysis to evaluate initial psychometric properties. Setting General community. Participants Nine individuals with SCI, TBI or stroke participated in cognitive interviews; 305 community residents with those same conditions participated in field testing. Interventions None. Main Outcome Measure(s) Self-report item pool of social attitudes that act as facilitators or barriers to people with disabilities participating in society. Results An interdisciplinary team of experts classified 710 existing social environment items into content areas and wrote 32 new items. Additional qualitative item review included item refinement and winnowing of the pool prior to cognitive interviews and field testing 82 items. Field test data indicated that the pool satisfies a one-parameter item response theory measurement model and would be appropriate for development into a calibrated item bank. Conclusions Our qualitative item review process supported a social environment conceptual framework that includes both social support and social attitudes. We developed a new social attitudes self-report item pool. Calibration testing of that pool is underway with a larger sample in order to develop a social attitudes item bank for persons with disabilities.

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“…The unique contributions from this study provide information to guide clinicians and researchers in developing patient-centered measures post-stroke. The use of a qualitative approach increased our understanding of the mobility outcome preferences of stroke survivors and their caregivers [18,35]. …”

Section: Discussionmentioning

confidence: 99%

Patient-centered mobility outcome preferences according to individuals with stroke and caregivers: a qualitative analysis

Krishnan

Pappadis

Weller

et al. 2017

Disability and Rehabilitation

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Purpose To explore the mobility-related preferences among stroke survivors and caregivers following post-acute rehabilitation at inpatient or skilled nursing facilities. Methods In this cross-sectional study; semi-structured, qualitative interviews of stroke survivors (n=24) and informal caregivers (n=15) were conducted. The participants were recruited from the community. Results Comparative content analysis was used to identify themes by two independent coders. The survivors (68 years) and caregivers (58 years) mentioned mobility related consequences including inability to walk, balance, drive, and transfer; and increased falls. The survivors (63%) and caregivers (73%) also mentioned the use of assistive devices. The common rehabilitation activities included: walking (62%); followed by standing and mobility; strength and balance; and wheelchair skills. Some stroke survivors were dissatisfied as their rehabilitation was not patient-centered. Frequently mentioned outcome preferences by survivors were ability to walk (88%), move, and balance. They also wanted to acquire assistive devices to move independently. Caregivers were concerned with the survivor’s safety and wanted them to drive (53%), prevent falls, have home accommodations, and transfer independently. Caregivers (40%) also expressed the importance of receiving realistic information. Conclusions This study suggests a need to consider the stroke survivors’ and caregivers’ mobility outcome preferences to improve the patient-centered rehabilitation care.

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Environmental Barriers and Supports to Everyday Participation: A Qualitative Insider Perspective From People With Disabilities

Cited by 234 publications

References 23 publications

Perceived impact of environmental barriers on participation among people living with spinal cord injury in Switzerland

Perceived impact of environmental barriers on participation among people living with spinal cord injury in Switzerland

Development of Self-Report Measures of Social Attitudes That Act As Environmental Barriers and Facilitators for People With Disabilities

Patient-centered mobility outcome preferences according to individuals with stroke and caregivers: a qualitative analysis

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