Article

For rehabilitation and disability research, participation and environment are 2
crucial constructs that have been placed center stage by the International
Classification of Functioning, Disability and Health (ICF). However, neither
construct is adequately conceptualized by the ICF, and both are difficult to
measure. This article addresses conceptual and methodologic issues related to
these ICF constructs, and recommends an improved distinction between activities
and participation, as well as elaboration of environment. A division of the
combined ICF categories for activity and participation into 2 separate taxonomies
is proposed to guide future research. The issue of measuring participation from
objective and subjective perspectives is examined, and maintaining these distinct
conceptual domains in the measurement of participation is recommended. The
methodological issues contributing to the difficulty of measuring participation
are discussed, including potential dimensionality, alternative metrics, and the
appropriateness of various measurement models. For environment, the need for
theory to focus research on those aspects of the environment that interact with
individuals' impairments and functional limitations in affecting activities and
participation is discussed, along with potential measurement models for those
aspects. The limitations resulting from reliance on research participants as
reporters on their own environment are set forth. Addressing these conceptual and
methodological issues is required before the measurement of participation and
environmental factors can advance and these important constructs can be used more
effectively in rehabilitation and disability observational research and trials.

Langue : ANGLAIS