Limitations of Social Participation in General Population - Normative Data of the IMET based on a Population-Based Survey in Northern Germany

Abstract

Medical rehabilitation in Germany is characterized by the biopsychosocial model of the ICF. Its complexity makes it less suitable for studies in rehabilitation sciences. For an implementation of the ICF, specific assessment instruments that are able to measure activity and participation efficiently in rehabilitation are needed. Instruments measuring social participation are rarely available in German language and have been employed only in a handful of empirical works. The "Index zur Messung von Einschränkungen der Teilhabe" (IMET) was developed in 2005 and measures participation of people with different chronic diseases as described in the ICF. The IMET has been applied in many studies in rehabilitation science, but as reference values were not available so far, the results could not be classified. In a population survey, 5 004 residents in Luebeck were randomly selected by the registration office and sent a short questionnaire. The questionnaire contained questions on the overall state of health, quality of life, prevalence of chronic diseases and limitations of participation (IMET). The completed questionnaire was returned by 2 755 of 4 692 eligible people (58.7%). 731 residents declined participation. Therefore, the participation quota is 43.1%. The mean age of participants was 53 years (SD: 17.1), 53% were women.Limitations of participation varied according to sex and age. Men tended to be more limited in their participation. As expected, limitations in participation increased with age. Participants with a low level of education showed a significantly higher rate of participation restrictions than people with a higher level of education. The IMET correlated significantly with the health status and quality of life as well as with the prevalence of various chronic diseases. The random sample of Luebeck inhabitants comprised people between 19 and 79 years of age. The age distribution of our sample deviated from the German population with younger people being underrepresented, and older people being overrepresented. With respect to the educational level, the random sample of the Hanseatic city showed a larger proportion of people with higher education.In this population sample, there was a sex and age-related variation in restriction in participation and this correlated highly with content-related constructs. Norm values for the IMET enable classification of limitations of participation for people undergoing rehabilitation or patients suffering from chronic diseases.