Participation in Community-Dwelling Rehabilitation Patients---Measurement Development and Factors Investigation Based on the International Classification of Functioning, Disability, and Health (Icf)

Participation is an ultimate rehabilitation goal that is important to patients, providers, and insurance payers. Since the International Classification of Functioning, Disability, and Health (ICF) published, a growing body of literature has emerged to investigate participation among people with functional limitations in diverse service settings. Participation has been described as a rehabilitation outcome indicator and a health indicator of people with disabilities. However, in Taiwan, there is dearth of research that has focused on participation. More empirical evidence is needed to understand how individuals with functional limitations in Taiwan participate in the community and what barriers and facilitators may contribute to their participation outcomes during or following rehabilitation. This grant contains two projects. The objective of Project 1 is to develop a robust measure of participation and validate its measurement properties in community-dwelling rehabilitation patients. The objective of Project 2 is to identify factors that influence participation outcomes in rehabilitation patients. Both Project 1 and Project 2 will adopt the mixed-methods approach. Project 1 will include three stages: (1) generating items through the literature review of exiting instruments and expert opinions; (2) refining the items through cognitive interviews with 15-20 rehabilitation patients; and (3) field testing and validating the developed measure through personal interviews with 400 community-dwelling rehabilitation patients following major neurological impairments, multiple trauma, or medically complex conditions. For Project 2, three to five focus groups will be conducted with rehabilitation patients to explore the barriers and facilitators that they face in the community. A survey to investigate the factors of participation will be conducted simultaneously with the field test in Project 1 in 400 participants. Information on potential factors will be abstracted from the medical charts and through personal interviews using questionnaires. These projects will together lead to an improved understanding of participation among community-dwelling rehabilitation patients in Taiwan, and the factors that can act as barriers or facilitators to participation.