Participation In Everyday Activities Research Articles

Personal and environmental pathways to participation in young children with and without mild motor disabilities

Participation in everyday activities has a positive influence upon health and well-being and is considered as an outcome measure. According to recent models child participation is the product of the dynamic interaction between health states and both individual and environmental factors. Children with mild developmental disabilities often present decreased participation in everyday activities. The purpose of this study was to explore the extent to which individual and environmental factors explain the participation of young children, with and without mild motor disabilities. The study population included 58 kindergarten children together with their parents (29 children with mild motor disabilities who were referred to occupational therapy and 29 children without motor disabilities). Both groups of children were matched for: age; gender; age of parents; and socio-economic status (SES). We assessed participation using the Child Participation Questionnaire (intensity, diversity, independence, child enjoyment and parental satisfaction) and we assessed children's self-efficacy and motor abilities for individual factors. Parental self-efficacy and SES were collected by questionnaires. Participation diversity (number of activities) was predicted by child and mother self-efficacy and by SES. Child independence and enjoyment as well as parental satisfaction were predicted by child motor ability but mainly by maternal self-efficacy. Results suggest that the total explained variance is more than double when the environmental variables (parental self-efficacy and SES) are inserted to the participation model. Maternal self-efficacy and SES serve as facilitators to increased participation and well-being of children with mild motor disabilities.

Motor ability and weight status are determinants of out-of-school activity participation for children with developmental coordination disorder

According to the International Classification of Functioning, Disability and Health model endorsed by the World Health Organization, participation in everyday activities is integral to normal child development. However, little is known about the influence of motor ability and weight status on physical activity participation in children with developmental coordination disorder (DCD). This study aimed to (1) compare motor performance, weight status and pattern of out-of-school activity participation between children with DCD and those without; and (2) identify whether motor ability and weight status were determinants of participation patterns among children with DCD. We enrolled 81 children with DCD (boys, n = 63; girls, n = 18; mean age, 8.07 ± 1.5 years) and 67 typically developing children (boys, n = 48; girls, n = 19; mean age, 8.25 ± 1.6 years). Participation patterns (diversity, intensity, companionship, location, and enjoyment) were evaluated with the Children Assessment of Participation and Enjoyment. Motor ability was evaluated with the Movement Assessment Battery for Children, second edition (MABC-2). Other factors that may influence participation such as age, gender, and body weight were also recorded. Analysis of variance was used to compare outcome variables of the two groups, and significant determinants of activity participation were identified by multiple regression analysis. Children with DCD participated in fewer activities (i.e., limited participation diversity) and participated less frequently (i.e., limited participation intensity) than their typically developing peers; however, companionship, location of participation, and enjoyment level did not differ between the two groups. Children in the DCD group demonstrated significantly worse motor ability as assessed by the MABC-2. Further, a greater proportion of children in the DCD group were in the overweight/obese category compared with their typically developing peers. After accounting for the effects of age and gender, motor ability and weight category explained 7.6% and 5.0% of the variance in participation diversity, respectively, for children with DCD. Children with DCD showed less diverse and less intense out-of-school activity participation than typically developing children. Motor impairment and weight status were independently associated with the lower participation diversity. Interventions aiming at improving participation for children with DCD should target weight control and training in motor proficiency. Further study is needed to identify other factors that may hinder participation in this group of children.

Loss of activities and its effect on the well-being of substance abusers

Aims. Participation in everyday activities positively influences well-being, but few have studied how participation in activities influences well-being among patients with substance use disorders. The authors examined the number of past, recent, and desired future activities of patients being admitted to five units for inpatient substance abuse treatment at a Norwegian university hospital. Major findings. The total number of activities had dropped significantly compared with before the respondents started abusing substances, and the respondents desired an increase in activities in the future. A lower level of well-being as measured by the WHO-5 was predicted by a more pronounced drop in number of activities from past to recent and by more severe use of alcohol and other substances. Principal conclusion. Substance abuse is associated with a change in number of activities. Losing activities may contribute to a decrease in well-being. Helping substance abuse patients regain positive activities could improve well-being.

Participation when using cognitive assistive devices – from the perspective of people with intellectual disabilities

The aim of the study was to describe how people with intellectual disabilities experienced their participation in everyday activities when using cognitive assistive devices. The purpose of cognitive assistive devices is to compensate for cognitive problems, to enhance independence when performing activities and to support decision making in daily life. Nine persons, 17-37 years old, with mild intellectual disability were selected by purposive sampling. Data collection was conducted by semi-structured interviews. The results showed that participation in everyday activities increased when using cognitive assistive devices. The persons experienced having more control and health benefits using cognitive assistive devices in daily activities. There were participation restrictions related to attitudes from the social network towards participation, and attitudes towards the use of cognitive assistive devices from the persons themselves and from the social network. Occupational therapists should be aware of the social factors that may influence a client's participation in everyday activities when using cognitive assistive devices. There is a need for more research with clients with intellectual disabilities and further research concerning long-time use of cognitive assistive devices.

Starość a przemiany więzi społecznych

The article contains an attempt to discuss the “socialisation” of elderly people today. In the 20th century there were considerable changes within the family, the relationships between old parents and adult children underwent gradual transformation — links formerly based on collaboration, dependence and togetherness were replaced by relationships of the type of “staying in contact” and symbolic exchanges. In Poland, especially in the countryside these changes occurred over a longer period than in the west due to the later introduction of retirement and the traditions of extended families. In the 20th century however there occurred at the same time changes in the feelings of communality — instead of relationships based on physical contact and geographical closeness, there developed symbolic groups and communities, often based on indirect means of communication. An effect of the loosening of the ties between the generations in a family and changes in the form of communality is loneliness which is declared by a considerable number of old people in Poland who in their youth had been socialized in communities characterized by physical closeness and joint participation in everyday activities. On the basis of ethnographic studies in Warsaw the article presents four case studies which serve as examples of the lifestyles of four elderly women in families with stronger and looser relationships and in other types of groups/communities: in a daycare centre and non-governmental organization.

Long-term impact of irritable bowel syndrome: a qualitative study

To explore how irritable bowel syndrome (IBS) impacts on patients' lives in order to explain the reported reduction in quality of life (QOL). IBS affects 10-20% of the population and over half of the people with the condition consult in primary care, with many consultations ending unsatisfactorily. IBS is known to have a detrimental effect on the QOL, though the mechanisms through which this is affected are poorly understood. A greater understanding of the patient experience of IBS would facilitate better healthcare provision. Eighteen semi-structured, in-depth interviews were undertaken in the West Midlands, United Kingdom from August 2006 to March 2008. Interviews were carried out until data saturation was achieved. All interviewees had previously taken part in one of the two recent primary care-based IBS studies and were long-term sufferers of IBS. Participants were purposively sampled to capture a range of experiences and included both genders, a range of ages, symptom severity scores and IBS sub-types. In contrast to the previously reported 'worried well' label, participants reported integration of the disease into their lives to the extent that it became a part of their identity. Even so, IBS did at times prevent their participation in everyday activities. Strategies used by participants to manage symptoms were an integral part of daily living and events which threatened routine coping strategies caused stress and exacerbated symptoms. Both adaptive and maladaptive coping strategies were identified. These were in part patient created, but for many incorporated advice or medication provided by their doctor. The findings not only confirm the extensive impact of IBS on daily living but also expose the additional impacts of IBS on emotional well-being and self-identity. The reduced QOL reported in previous studies may be an underestimate of the impact of IBS on patients' lives as patients integrate coping mechanisms completely into daily living.

Exploring the Use of Cognitive Intervention for Children with Acquired Brain Injury

ABSTRACTIntroduction: Children with acquired brain injury (ABI) often experience cognitive, motor, and psychosocial deficits that affect participation in everyday activities. Cognitive Orientation to Daily Occupational Performance (CO-OP) is an individualized treatment that teaches cognitive strategies necessary to support successful performance. Objective: This study explores the use of CO-OP with children with ABI. Method: Children with ABI, experiencing school and self-care difficulties, were identified from a previous study. Six children, aged 6–15 years, completed 10 weekly intervention sessions with occupational therapists. Children and parents rated the child's performance of challenging everyday tasks and their satisfaction with this performance. Task performance was also evaluated objectively through videotape analysis. Results: Participants showed significant improvement in their ability to perform child-chosen tasks and maintained this performance 4 months later. However, they had difficulty applying the executive problem-solving strategy and discovering cognitive strategies on their own. Issues related to the use of CO-OP with this population are discussed.

Ability to manage everyday technology: a comparison of persons with dementia or mild cognitive impairment and older adults without cognitive impairment

Purpose. The ability to manage technology is important for performance and participation in everyday activities. This study compares the management of technology in everyday activities among people with mild-stage dementia or mild cognitive impairment (MCI) with older adults without known cognitive impairment (OA).Method. Persons with mild-stage dementia (n = 38), MCI (n = 33) and OA (n = 45) were observed and interviewed when managing their everyday technology at home by using the Management of Everyday Technology Assessment (META). A computer application of a Rasch measurement model was used to generate measures of participants' ability to manage technology. These measures were compared groupwise with ANCOVA.Results. The management of everyday technology was significantly more challenging for the samples with mild-stage Alzheimer's disease (AD) or MCI compared to the OA sample (AD – OA, p <0.001; d = 1.87, MCI – OA, p <0.001; d = 0.66). The sample with MCI demonstrated a significantly higher ability to manage technology than the sample with mild-stage AD (AD – MCI, p <0.001; d = 1.23). However, there were overlaps between the groups and decreased ability appeared in all groups.Conclusions. Persons with cognitive impairment are likely to have decreased ability to manage everyday technology. Since their decreased ability can have disabling consequences, ability to manage technology is important to consider when assessing ability to perform everyday activities.

Children's conceptualization of the term ‘satisfaction’: relevance for measuring health outcomes

Health outcomes measurement is integral to planning and evaluating paediatric health care. Recent outcome measures have been developed to capture children's participation in everyday activities, a core component of which is the child's perceived satisfaction. Satisfaction, however, is a complex concept and it is not known how children conceptualize satisfaction and hence how it should best be measured. The purpose of this study was to explore children's conceptualization of the term 'satisfaction' and compare this with the description of satisfaction given in the literature to inform how satisfaction can be assessed in children. Forty children aged between 10 and 15 years participated in eight focus groups, guided by a descriptive qualitative approach, to describe how they conceptualize 'satisfaction'. Children with disabilities were excluded as it was considered important to first ascertain how children without disabilities conceptualize satisfaction. Recruitment occurred through seven urban and rural public schools. Data were analysed using qualitative content analysis. Participants identified three methods by which a person may determine their level of satisfaction (i) making comparisons with previous experiences, and other's and self-expectations; (ii) evaluating one's emotions; and (iii) receiving positive external feedback. Participants described drawing upon one of these methods in isolation, rather than integrating outcomes from each method into one judgement of satisfaction. Participants also demonstrated confusion between the terms 'satisfaction' and 'satisfactory'. Partial congruence between children's conceptualization of satisfaction and that reported in the literature was observed in this study. Not all children between the ages of 10 and 15, however, have a full understanding of satisfaction. Caution must therefore be taken when using the term satisfaction in children's assessments to minimize the potential for varying interpretations of the question. Further studies are required to explore how children with disabilities view the term satisfaction and if their understanding differs to that of typically developing children.

Beyond Flow: Temporality and Participation in Everyday Activities

Experience sampling examined how temporality, the lived experience of time, varied related to specific activity qualities and experiences in everyday life. Thirty-five students completed electronic surveys regarding their current activity and feelings and rated the activity's novelty and complexity, their depth of emotional and intellectual engagement, the direction and depth of attention, and the demands of the activity on their skills. Using configural frequency analysis and an analysis of narrative responses, configurations of factors (types) associated with variations in perceived temporalities were described. Four composite types identified occurred with any temporality. In most habitual activities, time was perceived as passing the same as clock time. Most faster or timeless temporalities occurred in complex, novel, and skill-requiring activities that engaged participants. Unexpected activity configurations were also associated with accelerated perceptions of time. Occupational therapists may use this knowledge to assist clients to redesign activities that promote positive experiences without high activity demands.

Stroke maintenance exercise group: pilot study on daily functioning in long-term stroke survivors

Typical models of stroke rehabilitation usually direct minimal resources for ongoing maintenance beyond discharge. However, there is increasing recognition of the benefits of community-based rehabilitation to maintain physical function and health in frail and disabled clients. A stroke maintenance exercise group was established to provide long-term care for stroke survivors. A pilot study was conducted to explore its effects compared with a traditional peer support group. Self-reported questionnaires, measuring daily task participation with the Home Functioning Questionnaire and quality of life with the EQ-5D, were utilised to compare twenty-two clients in the stroke maintenance exercise group and twenty-one in the peer support group. The results indicated that both these groups showed a significant increase with daily task participation over a 3-month period. However, no improvement was evident in either group on self-rated quality of life or health status, as measured by the EQ-5D. This pilot study suggests that both stroke maintenance exercise groups and peer support groups are effective with assisting long-term stroke survivors to improve participation in everyday activities. More research is recommended to further explore the long-term needs of this clinical group.

A framework of children's hand skills for assessment and intervention

BACKGROUND; Hand skill development or mastery has a huge influence on children's early development and participation in everyday activities. Assessment of difficulties with children's hand skills typically involves a systematic process considering all potential factors that may impact on hand skills. This helps identify key hand skill difficulties and select specific interventions that are relevant to the individual child. This paper describes the development of the Children's Hand Skills Framework (CHSF) that can be used as a conceptual guide to analyse and describe children's hand skills in the assessment and intervention process. A comprehensive literature review of the existing hand skill models and instruments was conducted to develop the CHSF content, and experts' reviews via an evaluation feedback questionnaire were used as a means to validate the CHSF. The literature review revealed that the functional repertoire of children's hand skills can be divided into six distinct categories. Manual gesture and body contact hand skills are two categories, in which the hands do not make contact with any object. Arm-hand use, adaptive skilled hand use and bimanual use are object-related hand skill categories where the hands do contact objects. The final category is related to the general quality of children's hand skills. Each of the six hand skill categories can be further broken down into three to seven subcategories. The feedback from the experts further demonstrated high levels of agreement for the inclusion of the CHSF subcategories. The CHSF offers a helpful guide to comprehensively describe the complexity of children's hand skills in the assessment process and has the potential to enhance and promote communication about functional use of children's hand skills among professionals. The CHSF is also conceptually compatible with the International Classification of Functioning, Disability, and Health, providing a holistic consideration of both children's hand skills and relevant International Classification of Functioning, Disability, and Health factors for further assessment and intervention planning.

Participation in everyday activities and quality of life in pre-teenage children living with cerebral palsy in South West Ireland

BackgroundCerebral palsy (CP) is the most common cause of physical disability in children but its impact on quality of life is not well understood. This study examined participation in everyday activities among children without CP and children with mild, moderate and severe impairment due to CP. We then examined ten domains of quality of life in children with CP and investigated whether participation in everyday activities was associated with improved quality of life independent of gender, age and level of impairment.MethodsThis was a cross-sectional study of children aged 8–12 years based on two questionnaires, frequency of participation (FPQ) and KIDSCREEN, completed by parents of 98 children on the South of Ireland Cerebral Palsy Register (response rate = 82%) and parents of 448 children attending two Cork city schools (response rate = 69%) who completed one questionnaire (FPQ). Multiple linear regression was used: firstly to estimate the effect of severity of CP on participation in everyday activities independent of age and gender and secondly we estimated the effect of participation on quality of life independent of age gender and level of impairment.ResultsParticipation in 11 of the 14 everyday activities examined varied across the children without CP and the children with varying severity of CP. In general, increased impairment decreased participation. Independent of age and gender, there was a highly significant decrease in overall participation with a fall of -6.0 (95% CI = -6.9 to -5.2) with each increasing level of impairment. The children with CP generally had high quality of life. Increased impairment was associated with diminished quality of life in just two domains – Physical well-being and Social support and peers. Overall participation in everyday activities was significantly associated with quality of life in 3 of the 10 domains (Physical well-being, Social support and peers & Moods and emotions) in analysis adjusted for gender age and level of impairment.ConclusionWhile increased impairment due to CP restricts participation in the majority of everyday activities, the level of participation has a limited effect on the quality of life of the children with CP in age 8–12 years.

Relationship between parental PODCI questionnaire and School Function Assessment in measuring performance in children with CP

Little data exists assessing the relationship between functional limitations in children with cerebral palsy (CP) and their participation in everyday activities. This prospective study evaluates the relationship between the Pediatric Outcomes Data Collection Instrument (PODCI), a functional health-related quality of life instrument for children and their parents, and the School Function Assessment (SFA), a school-based functional assessment. One hundred and two children with CP (80.4% dipliegia; 10.8% hemiplegia; 3.9% triplegia; 2.0% quadriplegia; 2.9% unspecified; 60 males, 42 females, mean age 11 years 8 months (SD 3 y 3 mo, range 6-8 y), Gross Motor Function Classification System levels I to IV (13.7% Level I 50% Level II 35.3% Level III 1% Level IV), had complete PODCI and SFA assessments. Significant relationships were noted among multiple PODCI subscales and subscales of the SFA, as well as among individual questions. PODCI predicted performance in all 31 subscales of the SFA when comorbidity subscales were included (r =0.35-0.64). The PODCI in-clinic questionnaire provides an accurate reflection of the child's actual participation in the community setting, as assessed by the SFA. PODCI can reliably be used to help ensure that outcomes assessed in the clinic setting reflect function within the community, and can be used to help with treatment planning, goal setting, and improved patient care.

Adaptation Interventions to Promote Participation in Natural Settings

Children's participation in everyday activities and routines in home and community settings is an important focus of services for infants and young children with disabilities. Data indicate that assistive technology (AT) is not widely used nor do early intervention service providers report frequent use of AT devices with infant-toddlers. Adaptation interventions combine environmental accommodations and AT in ways that promote children's participation in activities and routines and provide functional skill-building learning opportunities. A decision-making process for planning and implementing adaptation interventions is outlined with examples of strategies and formats that service providers can use to create successful interventions for infants and young children.

Defining the Content for a New Quality of Life Questionnaire for Students with Low Vision (The Impact of Vision Impairment on Children: IVI_C)

Purpose: To obtain statements describing the impact of vision impairment on participation in every day activities of school-aged children (8–18 years) capturing their opinion, as the primary step in developing a pediatric vision-related quality of life instrument. Methods: Separate focus groups for students with low vision, parents and teachers plus in-depth individual interviews were conducted in Victoria, Australia. Focus groups followed a topic guide, were digitally audio recorded and transcribed verbatim. Statements were identified, coded and ascribed into major themes. Results: 102 participants provided just over 2600 statements (an average of 146 statements per verbatim transcript) which were classified into 5 themes: school/specialist instruction, social interaction, family, community and vision impairment peer interaction. The identified areas likely to facilitate good participation in every day activities, and accounted for 79% of the statements were class teacher knowledge and specialist support (40%) and social interaction (39%). The student perspective focused on communication skills and orientation and mobility whereas the specialist instructors' emphasis was on specialist support. Emphases across the themes varied between focus groups and highlight the benefit of including the perspectives of all stakeholders in questionnaire design. Conclusions: The multi-perspective development strategy for a new questionnaire has established that it is crucial to integrate different stakeholders' perspectives. By doing so, it will be possible to develop a balanced questionnaire.

Understanding participation in activities and quality of life in children with cerebral palsy

Cerebral palsy (CP) is the most common cause of physical disability in children. The impact of CP on quality of life is not well understood. This paper explores the literature to understand what participation in everyday activities and quality of life means for children living with CP and their families. Quality of life and participation in disability, namely CP, are starting to be researched but the longitudinal element of QOL has not yet been done. Further studies based on longitudinal designs should be carried out to determine the quality of life and activity levels of these children long into adult life.

Focus on Function - a randomized controlled trial comparing two rehabilitation interventions for young children with cerebral palsy.

BackgroundChildren with cerebral palsy receive a variety of long-term physical and occupational therapy interventions to facilitate development and to enhance functional independence in movement, self-care, play, school activities and leisure. Considerable human and financial resources are directed at the "intervention" of the problems of cerebral palsy, although the available evidence supporting current interventions is inconclusive. A considerable degree of uncertainty remains about the appropriate therapeutic approaches to manage the habilitation of children with cerebral palsy. The primary objective of this project is to conduct a multi-site randomized clinical trial to evaluate the efficacy of a task/context-focused approach compared to a child-focused remediation approach in improving performance of functional tasks and mobility, increasing participation in everyday activities, and improving quality of life in children 12 months to 5 years of age who have cerebral palsy.Method/DesignA multi-centred randomized controlled trial research design will be used. Children will be recruited from a representative sample of children attending publicly-funded regional children's rehabilitation centers serving children with disabilities in Ontario and Alberta in Canada. Target sample size is 220 children with cerebral palsy aged 12 months to 5 years at recruitment date. Therapists are randomly assigned to deliver either a context-focused approach or a child-focused approach. Children follow their therapist into their treatment arm. Outcomes will be evaluated at baseline, after 6 months of treatment and at a 3-month follow-up period. Outcomes represent the components of the International Classification of Functioning, Disability and Health, including body function and structure (range of motion), activities (performance of functional tasks, motor function), participation (involvement in formal and informal activities), and environment (parent perceptions of care, parental empowerment).DiscussionThis paper presents the background information, design and protocol for a randomized controlled trial comparing a task/context-focused approach to a child-focused remediation approach in improving functional outcomes for young children with cerebral palsy.Trial registration[clinical trial registration #: NCT00469872]

Health economic and process evaluation of AT interventions for persons with dementia and their relatives – A suggested assessment model

There is growing interest in assistive technology (AT) as a means of enabling participation in everyday activities for persons with dementia and their relatives. Health economic assessment of AT in ...

Use of time in childhood and adolescence: A literature review on the nature of activity participation and depression

Despite a philosophical belief in the health benefits of balanced participation in everyday activities, occupational therapists have devoted scant research attention to the relationship between mental health and activity participation in childhood and adolescence. Time use studies offer valuable insights into this relationship. In this literature review the methodologies employed in time use studies are described, and empirical findings linking depression to the distribution of time to leisure, productive and self‐care activities, and sleep are then outlined. The relevance of findings to occupational therapy assessment and intervention is discussed. Therapists are challenged to further research the area, as gaining thorough knowledge of young people's time use has implications for both professional practice and broader public health policy.