Article

OBJECTIVES: To develop a measure of perceived systems, services, and policies
facilitators (see Chapter 5 of the International Classification of Functioning,
Disability and Health) for people with neurologic disabilities and to evaluate
the effect of perceived systems, services, and policies facilitators on
health-related quality of life. DESIGN: Qualitative approaches to develop and
refine items. Confirmatory factor analysis including 1-factor confirmatory factor
analysis and bifactor analysis to evaluate unidimensionality of items. Rasch
analysis to identify misfitting items. Correlational and analysis of variance
methods to evaluate construct validity. SETTING: Community-dwelling individuals
participated in telephone interviews or traveled to the academic medical centers
where this research took place. PARTICIPANTS: Participants (N=571) had a
diagnosis of spinal cord injury, stroke, or traumatic brain injury. They were 18
years or older and English speaking. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: An item bank to evaluate environmental access and support levels of
services, systems, and policies for people with disabilities. RESULTS: We
identified a general factor defined as "access and support levels of the
services, systems, and policies at the level of community living" and 3 local
factors defined as "health services," "community living," and "community
resources." The systems, services, and policies measure correlated moderately
with participation measures: Community Participation Indicators (CPI) -
Involvement, CPI - Control over Participation, Quality of Life in Neurological
Disorders - Ability to Participate, Quality of Life in Neurological Disorders -
Satisfaction with Role Participation, Patient-Reported Outcomes Measurement
Information System (PROMIS) Ability to Participate, PROMIS Satisfaction with Role
Participation, and PROMIS Isolation. CONCLUSIONS: The measure of systems,
services, and policies facilitators contains items pertaining to health services,
community living, and community resources. Investigators and clinicians can
measure perceptions of systems, services, and policies resources reliably with
the items described here. Moderate relations between systems, services, and
policies facilitators and PROMIS and CPI variables provide support for the
measurement and theory of environmental effects on social functioning related to
participation.
CI - Copyright A(c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS