Abstract

Introduction This study is aimed at understanding how practicing the use of public transportation can affect the self-efficacy and perceptions of occupational enablement among patients with physical disabilities in a recovery rehabilitation hospital. Method We recruited 21 inpatients with physical disabilities caused by stroke or orthopedic diseases from a recovery rehabilitation hospital in Japan and used a multimethod design including an intervention study and a follow-up survey. The intervention study utilized a before-after trial and provided hands-on training in the use of public transportation as the intervention. How self-efficacy and perceptions of occupational enablement changed before and after the intervention was measured using the visual analog scale (VAS). The follow-up survey was conducted to investigate whether patients used public transportation postdischarge. Results Only differences in the VAS scores regarding self-efficacy were significant between before and after the hands-on training in the use of public transportation, whereas differences regarding the perceptions of occupation enablement were not. Self-efficacy after the intervention was higher than that before the intervention. In the follow-up survey, both VAS scores of the psychological factors were significantly higher in the group that used public transportation postdischarge than in the group that did not. Conclusion Providing hands-on training in the use of public transportation for inpatients with physical disabilities increased their self-efficacy, indicating that psychological factors should be evaluated to predict their occupational skill improvement and to verify the outcomes of an occupational therapeutic intervention.

Highlights

  • This study is aimed at understanding how practicing the use of public transportation can affect the self-efficacy and perceptions of occupational enablement among patients with physical disabilities in a recovery rehabilitation hospital

  • Inpatients with physical disabilities caused by stroke or orthopedic diseases resulting in limited mobility were recruited from a recovery rehabilitation hospital in Tokyo

  • All participants were selected according to the following five inclusion criteria: (1) having a hope to use a train or bus after their discharge, (2) score of greater than 24 points on the Mini-Mental State Examination (MMSE) and no apparent symptoms of higher brain dysfunction, (3) scheduled to be discharged to their home, (4) their home located nearer than 1 km from a train station or bus stop, and (5) a score of greater than 6 points on the Walk/Wheelchair section in the motor subscale of the Functional Independence Measure (FIM), demonstrating modified independence

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Summary

Introduction

This study is aimed at understanding how practicing the use of public transportation can affect the self-efficacy and perceptions of occupational enablement among patients with physical disabilities in a recovery rehabilitation hospital. Differences in the VAS scores regarding self-efficacy were significant between before and after the hands-on training in the use of public transportation, whereas differences regarding the perceptions of occupation enablement were not. In the follow-up survey, both VAS scores of the psychological factors were significantly higher in the group that used public transportation postdischarge than in the group that did not. Providing hands-on training in the use of public transportation for inpatients with physical disabilities increased their self-efficacy, indicating that psychological factors should be evaluated to predict their occupational skill improvement and to verify the outcomes of an occupational therapeutic intervention. Especially in places with well-developed public transportation system, not being able to use public transportation can be a serious social problem for people with physical disability.

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