Subjective health and associative social factors in emerging adults with different levels of participation limitations—A cross-sectional study

Background Participation was shown to be associative with subjective health (SH) in many different populations, including emerging adults. Objectives This study aimed to investigate SH and associative variables in emerging adults with different levels of participation limitations. Methods Healthy university students who were between 18–25 years of age were included. SH was assessed with the visual analog scale. The participants were grouped based on P-Scale. Multiple linear regressions were conducted to determine the associative variables of SH for each P-Scale group. Results A total of 572 participants were included. General health-related quality of life was associated with SH in all P-Scale groups. Other prominent findings of this study showed perception of health, income, and lifestyle were among the most significant associative variables of SH. Conclusion Variables associated with emerging adults’ SH change with their participation restrictions. Therefore, different approaches are needed to improve the subjectively perceived health status of emerging adults.

Predictors of Participation Restriction in Midlife Caregivers: An Exploratory Study

Mid-life family caregivers (CGs) are at risk for participation restrictions (reduced engagement in valued roles and activities) due to competing demands of work, parenting, and family caregiving responsibilities. When CGs experience participation restrictions, quality of care for care recipients (CR) decreases, yet CG burden and risk for poor health increases. The purpose of this study was to identify the factors contributing to decreased participation in mid-life CGs. Participants were CGs aged 45-64 years (n = 677) from the National Study of Caregiving/National Health and Aging Trends Study. We used multivariate logistic regression to determine attributes of CGs, CRs, and the care situation that independently contribute to participation restrictions. We found that negative aspects of caregiving (OR = 1.51, 95% CI = 1.33, 1.71) and CR depression and anxiety (OR = 0.90, 95% CI = 0.83, 0.99) significantly predicted participation restrictions (p < 0.05). Positive aspects of care (OR = 0.87, 95% CI = 0.74, 1.01), frequency of helping with chores (OR = 1.30, 95% CI = 0.98, 1.70), frequency of providing personal care (OR = 1.24, 95% CI = 0.97, 1.59), and frequency of providing help getting around the home (OR = 1.30, 95% CI = 0.97, 1.75) showed trends for association with participation restrictions (p < 0.10). We identified factors that are related to participation restriction in mid-life CGs. Some of these factors (e.g., positive and negative aspects of caregiving, frequency of assistance provided) are potentially modifiable intervention targets that could bolster participation in this at-risk group.

Toward a Multidimensional Understanding of Later Life Disability: A Latent Profile Analysis

Disability is difficult to define succinctly. Current literature on disability has primarily focused on physical functional limitations. However, relying on a single dimension or index cannot accurately represent disability as the experience of disability is nuanced and complex. To address these gaps, this study aims to understand the multidimensional nature of disability among retired, community-dwelling older adults. Using a sample of 414 older adults between the ages of 72 and 106 years (M=84.84, SD=4.56), latent profile analysis was employed to identify classes based on five indicators of disability across three domains. The five indicators of disability included difficulties with activities of daily living (ADLs), cognitive impairment, physical impairment, sensory impairment, and participation restrictions. Three classes were found to represent the data best. The most favorable and highly functioning group comprised the highest number of participants (n=242, 59.5%). The next group, class 2 (n=157, 37.9%), was characterized by high physical impairment and ADL-difficulty. The smallest group, class 3 (n=15, 3.6%), had the highest ADL-difficulty and participation restrictions but drastically lower cognitive and sensory impairment. Multinomial logistic regression revealed that class membership was related to sociodemographic characteristics. Finally, class membership predicted several mental health outcomes such as depressive symptoms, positive affect, and life satisfaction in the expected direction. If supported by future work, these findings could inform practitioners in developing more specific interventions relevant to older adults based on their disability profiles. Understanding various combinations of disablement has potential implications for services and interventions to be tailored to individuals’ distinct disability-related needs.

Association among dysmenorrhea and activity limitation and participation restrictions in adult women: a cross-sectional study, Brazil -2017

Background The present study aims to analyse if dysmenorrhea is associated with activity limitations and participation restrictions in experencied by adult women. Methods This is a cross-sectional study carried out with adult women recruited from primary health services in Brazil between 2016 and 2017. Dysmenorrhea was measured via a self-report and the activity limitation and participation restrictions was assessed by the World Health Disability Assessment Schedule (WHODAS2.0). Pain and level of physical activity were assessed, respectively, by the numerical pain rating scale and International Physical Activity Questionnaire (IPAQ), short version. Associations between groups, dysmenorrhea and without dysmenorrhea (WD), were analysed by the median difference, Mann Whitney test, effect size measures and 95 % confidence interval. Statistical significance was p <0.05. Results The prevalence of dysmenorrhea was 54 %. The pain lasted an average of three days or more (66 %). The average pain intensity, in the crisis period, was 6.1 ± 2.6, women who presented severe pain complaints were associated with considerable difficulties in their domains of mobility (p = 0.003; 2 = 0.115), participation (p = 0.030; 2 = 0.063) and total score (p = 0.012; 2 = 0.086), with a moderate effect size for all variables. Conclusions Severe dysmenorrhea was associated with higher scores of disabilities assessed by the WHODAS 2.0, especially in mobility, and participation domains.

The impact of Post-COVID-Syndrome on functioning – results from a community survey in patients after mild and moderate SARS-CoV-2-infections in Germany

Background In COVID-19 survivors a relatively high number of long-term symptoms have been observed. Besides impact on quality of life, these symptoms (now called Post-COVID-Syndrome) may have an impact on functioning and may also hinder to participation in social life in affected people. However, little is known about developing such syndrome a for patients with mild and moderate COVID-19 who did not need hospitalization or intensive care. Methods A cross-sectional study in 1027 patients with mild or moderate COVID-19 was performed in two communities in Bavaria, Germany. The Rehabilitation-Needs-Survey (RehabNeS) including the Short Form 36 Health Survey (SF-36) on health-related quality of life, was used. Descriptive statistics were calculated. Results In all, 97.5% of patients reported one symptom in the infection stage, such as fatigue, respiratory problems, limitations of the senses of taste and smell, fear and anxiety and other symptoms. In this time period, 84.1% of the participants experienced activity limitations and participation restrictions such as carrying out daily routines, handling stress, getting household tasks done, caring for/supporting others, and relaxing and leisure concerns. In all, 61.9% of participants reported persisting symptoms more than 3 months after infection. These were fatigue, sleep disturbances, respiratory problems, pain, fear and anxiety, and restrictions in movement; 49% of the participants reported activity limitations and participation restrictions. Predominately, these were handling stress, carrying out daily routines, looking after one’s health, relaxing and leisure activities and doing house work. The impacts on quality of life and vocational performance were rather low. Conclusion The results show that long-term symptoms after mild and moderate COVID-19 are common and lead to limitations of activities and participation. However, it seems that in most cases they are not severe and do not lead to frequent or serious issues with quality of life or work ability.

Assessing Change in Communication Limitations in Primary Progressive Apraxia of Speech and Aphasia: A 1-Year Follow-Up Study

Purpose Individuals with primary progressive apraxia of speech have apraxia of speech (AOS) as the initial and predominant symptom. Many develop aphasia and/or dysarthria later in the disease course. It was previously demonstrated that patients with neurodegenerative AOS experience reduced participation in communication that is further exacerbated by co-occurring language deficits ( Utianski et al., 2020 ). Measures of disease severity did not necessarily correlate with measures of participation restrictions. The aim of this follow-up study was to describe changes in communication limitations in these patients, again measured by (a) the patient via the Communicative Participation Item Bank (CPIB) and (b) the speech-language pathologist via the American Speech-Language-Hearing Association's (ASHA's) Functional Communication Measures (FCMs) and an adapted motor speech disorder (MSD) severity rating to determine if there are significant changes in these and other objective speech and language measures at follow-up after 1 year. Method Of the 24 patients reported in the study of Utianski et al. (2020) , 17 (10 men, seven women) returned for a second visit approximately 1 year following the first visit. Identical procedures were utilized; the communication measures collected at each visit were statistically compared. Correlations were calculated between the participation ratings and other clinical assessment measures at the second visit and for the change in scores on those measures between the first and second visits. Results There were statistically significant differences in AOS and aphasia severity between visits. There were significant changes in clinical assessments, MSD severity rating, and all ASHA FCMs between visits, but not the CPIB. Correlation analyses suggest the relationships among clinical and participation measures are complex; overall, patients with more severe changes in AOS experienced greater changes in participation restrictions. Conclusions The findings of this study support the use of patient-reported outcome measures as they may better reflect the patient experience, including the influence of factors such as ongoing speech therapy and the emergence of neuropsychiatric features, and associated changes in day-to-day functioning, when other measures may simply index the progression of the disease. Supplemental Material https://doi.org/10.23641/asha.16528512

Differences in activity limitations and participation restrictions between young adults with cancer and older age groups: A cross-sectional study

Purpose: To explore whether young adults with cancer have different activity limitations and participation restrictions compared to older age groups with cancer. Methods: A cross-sectional study including 654 people with cancer participating in a rehabilitation stay. Participants were in the age groups: 1) Young adults (n=121) = 18-39 years; 2) Middle-aged (n=406) = 40-64 years; and 3) older people (n=127) = ≥65 years. Outcomes were activity limitations and participation restrictions encompassing physical, role, social, and cognitive functioning, measured using the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30. Mean differences between age groups were calculated using linear regression analyses. Results: Young adults had a mean age of 32.1 years (SD = 5.1); middle-aged adults 53.4 years (SD = 6.8); and the older people 71.1 years (SD = 4.8). The majority of the participants were women (81.9%) with breast cancer (42.9%). Young adults had a statistically significant higher physical functioning compared to those middle-aged (-3.90: (95% CI: -6.84; -0.95)) and the older age group (-7.63: (95% CI: -11.29; -3.96)). Young adults had statistically significant lower role functioning (7.11: (95% CI: 1.13; 13.08)) and cognitive functioning (13.82: (95% CI: 7.35; 20.29)) compared to older people. There was no statistically significant difference in social functioning between the age groups. Conclusion: Young adults had different activity limitations and participation restrictions compared with higher age groups. Our findings suggest the need for further research and an increased clinical rehabilitation focus on different activity and participation challenges across age groups.

Two Approaches to Evaluating Sex Differences on Participation Outcomes Among Veterans With Traumatic Brain Injury

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. We used two different quantitative analytic approaches to examine whether there were sex differences in self-reported participation restrictions among male and female veterans with traumatic brain injury. Findings suggest that women have more challenges with leisure and employment and fewer challenges with residence and financial management than men. Total raw scores may obscure important differences in how men and women self-report participation restrictions. Primary Author and Speaker: Alison M. Cogan Contributing Authors: Jennifer A. Weaver, Trudy Mallinson, Theresa Bender Pape, and Joel Scholten