Environmental Barriers and Supports to Everyday Participation: A Qualitative Insider Perspective From People With Disabilities
Environmental Barriers and Supports to Everyday Participation: A Qualitative Insider Perspective From People With Disabilities
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DOI：
10.1016/j.apmr.2014.12.008
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发表时间：
2015-04-01
影响因子：
4.3
通讯作者：
Hahn, Elizabeth A.
中科院分区：
文献类型：
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作者：
Hammel, Joy;Magasi, Susan;Hahn, Elizabeth A.
目的：探讨影响残障人士参与的环境因素。设计：对5个研究项目中36个焦点小组的记录进行持续的比较和定性分析。环境：家庭、社区、工作和社会参与环境。参与者：来自8个州的不同残疾（主要是脊髓损伤、创伤性脑损伤和中风）的社区居民（N=201）。干预措施:没有。主要结果测量：参与的环境障碍和支持。结果:我们开发了一个概念框架来描述环境因素如何影响残疾人的参与，突出了环境促进因素和障碍的8个领域（建筑，自然，辅助技术，交通，信息和技术获取，社会支持和态度，系统和政策，经济）和一个交易模型，显示了环境因素对微观（个人），平台（社区），宏观（社会）层面。焦点小组的数据证实了《国际功能、残疾和健康分类》的一些环境类别，同时也使独特因素（如信息和技术的获取、经济生活质量）脱颖而出。数据被用来构建项目，使残疾人能够从他们的第一手经验中评估环境因素对日常参与的影响。结论：残疾参与者表示有必要评估环境对他们在直接、社区和社会层面的参与的影响。研究结果对评估康复和社区环境中参与的环境促进因素和障碍，评估环境干预措施的结果，以及影响系统和政策变化以针对可能导致社会参与差异与机会的环境障碍具有重要意义。(C) 2015年由美国康复医学大会发布
Objective: To describe environmental factors that influence participation of people with disabilities.Design: Constant comparative, qualitative analyses of transcripts from 36 focus groups across 5 research projects.Setting: Home, community, work, and social participation settings.Participants: Community-dwelling people (N=201) with diverse disabilities (primarily spinal cord injury, traumatic brain injury, and stroke) from 8 states.Interventions: None.Main Outcome Measures: Environmental barriers and supports to participation.Results: We developed a conceptual framework to describe how environmental factors influence the participation of people with disabilities, highlighting 8 domains of environmental facilitators and barriers (built, natural, assistive technology, transportation, information and technology access, social support and attitudes, systems and policies, economics) and a transactional model showing the influence of environmental factors on participation at the micro (individual), mesa (community), and macro (societal) levels. Focus group data validated some International Classification of Functioning, Disability and Health environmental categories while also bringing unique factors (eg, information and technology access, economic quality of life) to the fore. Data were used to construct items to enable people with disabilities to assess the impact of environmental factors on everyday participation from their firsthand experience.Conclusions: Participants with disabilities voiced the need to evaluate the impact of the environment on their participation at the immediate, community, and societal levels. The results have implications for assessing environmental facilitators and barriers to participation within rehabilitation and community settings, evaluating outcomes of environmental interventions, and effecting system and policy changes to target environmental barriers that may result in societal participation disparities versus opportunities. (C) 2015 by the American Congress of Rehabilitation Medicine