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Association between mobility, participation, and wheelchair-related factors in long-term care residents who use wheelchairs as their primary means of mobility.

https://arctichealth.org/en/permalink/ahliterature123407
Source
J Am Geriatr Soc. 2012 Jul;60(7):1310-5
Publication Type
Article
Date
Jul-2012
Author
W Ben Mortenson
William C Miller
Catherine L Backman
John L Oliffe
Author Affiliation
Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, University of Montreal, Montreal, Quebec, Canada. bmortens@interchange.ubc.ca
Source
J Am Geriatr Soc. 2012 Jul;60(7):1310-5
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
British Columbia
Chi-Square Distribution
Comorbidity
Cross-Sectional Studies
Disability Evaluation
Female
Geriatric Assessment
Humans
Long-Term Care
Male
Middle Aged
Mobility Limitation
Wheelchairs
Abstract
To explore how wheelchair-related factors, mobility, and participation are associated in a sample of long-term care residents who use wheelchairs as their primary means of mobility.
Cross-sectional survey.
Eleven residential care facilities in the lower mainland of British Columbia, Canada.
One hundred forty-six self-responding residents and 118 proxy respondents: mean age 84 (range 60-103). Most were female (69%), and a small proportion (9%) drove a power wheelchair.
The Nursing Home Life Space Diameter Assessment was used to measure resident mobility, and the Late Life Function and Disability Instrument: Disability Component was used to measure participation frequency in daily activities.
Path analysis indicated that wheelchair-related factors were associated with participation frequency directly and indirectly through their relationship with mobility. The final model explained 46% of the variance in resident mobility and 53% of the variance in resident participation frequency. Wheelchair skills, which include the ability to transfer in and out of and propel a wheelchair, were important predictors of life-space mobility and frequency of participation, and life space mobility was a significant predictor of frequency of participation. Depression was associated with poorer wheelchair skills and mobility and less-frequent participation. Counterintuitively, perceived environmental barriers were positively associated with frequency of participation.
The findings suggest that, by addressing wheelchair-related factors, resident's mobility and participation may be improved, but the efficacy of this approach needs to be confirmed experimentally.
Notes
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PubMed ID
22702515 View in PubMed
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Communications between volunteers and health researchers during recruitment and informed consent: qualitative content analysis of email interactions.

https://arctichealth.org/en/permalink/ahliterature130493
Source
J Med Internet Res. 2011;13(4):e84
Publication Type
Article
Date
2011
Author
Anne Townsend
Zubin Amarsi
Catherine L Backman
Susan M Cox
Linda C Li
Author Affiliation
Arthritis Research Centre of Canada, Vancouver, BC, Canada. atownsend@arthritisresearch.ca
Source
J Med Internet Res. 2011;13(4):e84
Date
2011
Language
English
Publication Type
Article
Keywords
Arthritis, Rheumatoid
British Columbia
Communication
Electronic Mail
Human Experimentation
Humans
Informed consent
Patient Participation
Patient Selection
Abstract
While use of the Internet is increasingly widespread in research, little is known about the role of routine electronic mail (email) correspondence during recruitment and early volunteer-researcher interactions. To gain insight into the standpoint of volunteers we analyzed email communications in an early rheumatoid arthritis qualitative interview study.
The objectives of our study were (1) to understand the perspectives and motivations of individuals who volunteered for an interview study about the experiences of early rheumatoid arthritis, and (2) to investigate the role of emails in volunteer-researcher interactions during recruitment.
Between December 2007 and December 2008 we recruited 38 individuals with early rheumatoid arthritis through rheumatologist and family physician offices, arthritis Internet sites, and the Arthritis Research Centre of Canada for a (face-to-face) qualitative interview study. Interested individuals were invited to contact us via email or telephone. In this paper, we report on email communications from 12 of 29 volunteers who used email as their primary communication mode.
Emails offered insights into the perspective of study volunteers. They provided evidence prospectively about recruitment and informed consent in the context of early rheumatoid arthritis. First, some individuals anticipated that participating would have mutual benefits, for themselves and the research, suggesting a reciprocal quality to volunteering. Second, volunteering for the study was strongly motivated by a need to access health services and was both a help-seeking and self-managing strategy. Third, volunteers expressed ambivalence around participation, such as how far participating would benefit them, versus more general benefits for research. Fourth, practical difficulties of negotiating symptom impact, medical appointments, and research tasks were revealed. We also reflect on how emails documented volunteer-researcher interactions, illustrating typically undocumented researcher work during recruitment.
Emails can be key forms of data. They provide richly contextual prospective records of an underresearched dimension of the research process: routine volunteer-researcher interactions during recruitment. Emails record the context of volunteering, and the motivations and priorities of volunteers. They also highlight the "invisible work" of research workers during what are typically considered to be standard administrative tasks. Further research is needed to fully understand the role of routine emails, what they may reveal about volunteers' decisions to participate, and their implications for research relationships-for example, whether they have the potential to foster rapport, trust, and understanding between volunteer and researcher, and ultimately shift the power dynamic of the volunteer-researcher relationship.
Notes
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PubMed ID
21997713 View in PubMed
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Community participation after spinal cord injury.

https://arctichealth.org/en/permalink/ahliterature164345
Source
Arch Phys Med Rehabil. 2007 Apr;88(4):427-33
Publication Type
Article
Date
Apr-2007
Author
Christine Carpenter
Susan J Forwell
Lyn E Jongbloed
Catherine L Backman
Author Affiliation
Department of Physiotherapy and Dietetics, Faculty of Health and Life Sciences, Coventry University, Coventry, UK. c.carpenter@coventry.ac.uk
Source
Arch Phys Med Rehabil. 2007 Apr;88(4):427-33
Date
Apr-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
British Columbia
Consumer Participation
Female
Humans
Interpersonal Relations
Life Style
Male
Middle Aged
Motor Activity
Patient Participation
Quality of Life - psychology
Questionnaires
Spinal Cord Injuries - psychology - rehabilitation
Transportation
Abstract
To describe participation among a community-based sample of adults with spinal cord injury (SCI) and to explore the relationship between participation and life satisfaction.
Survey.
Community.
A sample of 357 people (response rate, 44%) with SCI recruited through the British Columbia Paraplegic Association. The mean age +/- standard deviation was 46.0+/-14.7 years, mean time since SCI was 13.0+/-11.0 years, and 68% of the respondents were men.
Not applicable.
Descriptive survey data on community participation specifically related to social involvement, physical activity and relationship with others, transportation, and community access. Life satisfaction and happiness assessed using the Satisfaction With Life Scale and Happiness Scale.
No limitations to participation were experienced by 18.5% of the respondents. Satisfaction with transportation was associated with owning one's own vehicle (P
PubMed ID
17398242 View in PubMed
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Expert consensus on best practices for post-acute rehabilitation after total hip and knee arthroplasty: a Canada and United States Delphi study.

https://arctichealth.org/en/permalink/ahliterature107348
Source
Arthritis Care Res (Hoboken). 2014 Mar;66(3):411-23
Publication Type
Conference/Meeting Material
Article
Date
Mar-2014
Author
Marie D Westby
Asuko Brittain
Catherine L Backman
Author Affiliation
University of British Columbia, Vancouver, and Arthritis Research Centre of Canada, Richmond, British Columbia, Canada.
Source
Arthritis Care Res (Hoboken). 2014 Mar;66(3):411-23
Date
Mar-2014
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Adult
Aged
Arthroplasty, Replacement, Hip - rehabilitation
Arthroplasty, Replacement, Knee - rehabilitation
Canada
Delphi Technique
Female
Humans
Male
Middle Aged
Outcome Assessment (Health Care)
Practice Guidelines as Topic
United States
Abstract
To synthesize professional and patient expertise with available evidence to recommend best practices for post-acute rehabilitation following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) for osteoarthritis (OA).
Two expert panels of clinicians, researchers, and patients from Canada and the US participated in a 3-round, online Delphi survey.
Consensus was reached on 22 THA and 24 TKA best practice key statements. Recommendations common to both procedures included the need for supervised rehabilitation interventions provided by trained health professionals early after discharge from the acute care setting to optimize patient outcomes. Personal and environmental contextual factors were identified as influencing the process and outcomes of THA and TKA rehabilitation. Routine outcome assessment was recommended and several standardized outcome tools identified. Short-term followup care in the first 2 years postsurgery was recommended for both procedures. Specifics on timing, rehabilitation providers, need for long-term followup, and interventions differed for THA and TKA. Some recommendations received different levels of support based on the type of panelist (patient, physical therapist, surgeon), professional role (clinician, researcher), and/or country.
A rigorous consensus method led to key recommendations for post-acute rehabilitation after primary THA and TKA for OA, which together with available evidence and acknowledgment of contextual factors will inform the development of clinical practice guidelines. This is an important step toward reducing practice variation, closing the evidence-practice gap, and improving the quality of rehabilitation services after THA and TKA.
PubMed ID
24023047 View in PubMed
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Grey spaces: the wheeled fields of residential care.

https://arctichealth.org/en/permalink/ahliterature133423
Source
Sociol Health Illn. 2012 Mar;34(3):315-29
Publication Type
Article
Date
Mar-2012
Author
W Ben Mortenson
John L Oliffe
William C Miller
Catherine L Backman
Author Affiliation
Centre de recherche de l'institut universitaire de gériatrie de Montréal, Canada. bmortens@interchange.ubc.ca
Source
Sociol Health Illn. 2012 Mar;34(3):315-29
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Anthropology, Cultural
British Columbia
Female
Humans
Interviews as Topic
Male
Middle Aged
Models, Theoretical
Professional-Patient Relations
Residential Facilities
Wheelchairs
Abstract
Many individuals living in residential care use a wheelchair as their primary means of mobility. Although studies have documented challenges encountered by residents in these facilities, few have addressed the role that wheelchairs, as potential enablers and barriers to mobility and participation, play in their lives. To better understand residents' experiences, an ethnographic study was conducted drawing on Bourdieu's theoretical constructs of capital, field, and habitus. Participant observations were conducted at two facilities, and residents, family members and staff took part in in-depth individual interviews. Our analysis revealed three themes. Ready to roll detailed how residents used wheelchairs as a source of comfort and means for expanding their social space, while staff could use them as a means to move and control some residents. Squeaky wheels described how residents solicited assistance from staff and family amid having to wait to perform activities of daily living. In, out and about revealed diversity in the places residents went, spaces they shared and the social activities in which they engaged inside and outside their residential facilities. The study findings emphasise how wheelchairs constitute capital that governs many fields of practice for residents and staff and suggest how practice and policy might be adjusted.
Notes
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PubMed ID
21707660 View in PubMed
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Improving healthcare consumer effectiveness: an Animated, Self-serve, Web-based Research Tool (ANSWER) for people with early rheumatoid arthritis.

https://arctichealth.org/en/permalink/ahliterature149015
Source
BMC Med Inform Decis Mak. 2009;9:40
Publication Type
Article
Date
2009
Author
Linda C Li
Paul Adam
Anne F Townsend
Dawn Stacey
Diane Lacaille
Susan Cox
Jessie McGowan
Peter Tugwell
Gerri Sinclair
Kendall Ho
Catherine L Backman
Author Affiliation
Department of Physical Therapy, University of British Columbia, Vancouver, Canada. lli@arthritisresearch.ca
Source
BMC Med Inform Decis Mak. 2009;9:40
Date
2009
Language
English
Publication Type
Article
Keywords
Arthritis, Rheumatoid - drug therapy
British Columbia
Health Knowledge, Attitudes, Practice
Humans
Internet
Pilot Projects
Prospective Studies
Questionnaires
Self Efficacy
Software
User-Computer Interface
Abstract
People with rheumatoid arthritis (RA) should use DMARDs (disease-modifying anti-rheumatic drugs) within the first three months of symptoms in order to prevent irreversible joint damage. However, recent studies report the delay in DMARD use ranges from 6.5 months to 11.5 months in Canada. While most health service delivery interventions are designed to improve the family physician's ability to refer to a rheumatologist and prescribe treatments, relatively little has been done to improve the delivery of credible, relevant, and user-friendly information for individuals to make treatment decisions. To address this care gap, the Animated, Self-serve, Web-based Research Tool (ANSWER) will be developed and evaluated to assist people in making decisions about the use of methotrexate, a type of DMARD. The objectives of this project are: 1) to develop ANSWER for people with early RA; and 2) to assess the extent to which ANSWER reduces people's decisional conflict about the use of methotrexate, improves their knowledge about RA, and improves their skills of being 'effective healthcare consumers'.
Consistent with the International Patient Decision Aid Standards, the development process of ANSWER will involve: 1.) creating a storyline and scripts based on the best evidence on the use of methotrexate and other management options in RA, and the contextual factors that affect a patient's decision to use a treatment as found in ERAHSE; 2.) using an interactive design methodology to create, test, analyze and refine the ANSWER prototype; 3.) testing the content and user interface with health professionals and patients; and 4.) conducting a pilot study with 51 patients, who are diagnosed with RA in the past 12 months, to assess the extent to which ANSWER improves the quality of their decisions, knowledge and skills in being effective consumers.
We envision that the ANSWER will help accelerate the dissemination of knowledge and skills necessary for people with early RA to make informed choices about treatment and to manage their health. The latest in animation and online technology will ensure ANSWER fills a knowledge translation gap, focusing on the next generation of people living with RA.
Notes
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PubMed ID
19695086 View in PubMed
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Patient and health professional views on rehabilitation practices and outcomes following total hip and knee arthroplasty for osteoarthritis:a focus group study.

https://arctichealth.org/en/permalink/ahliterature143635
Source
BMC Health Serv Res. 2010;10:119
Publication Type
Article
Date
2010
Author
Marie D Westby
Catherine L Backman
Author Affiliation
Rehabilitation Sciences Research Graduate Program, Faculty of Medicine, University of British Columbia, Vancouver, Canada. marie.westby@vch.ca
Source
BMC Health Serv Res. 2010;10:119
Date
2010
Language
English
Publication Type
Article
Keywords
Arthroplasty, Replacement, Hip - rehabilitation
Arthroplasty, Replacement, Knee - rehabilitation
Attitude of Health Personnel
Attitude to Health
Canada
Female
Focus Groups
Health Personnel
Humans
Interviews as Topic
Male
Osteoarthritis, Hip - surgery
Osteoarthritis, Knee - surgery
Patient satisfaction
Treatment Outcome
United States
Abstract
There is worldwide variation in rehabilitation practices after total hip arthroplasty (THA) and total knee arthroplasty (TKA) and no agreement on which interventions will lead to optimal short and long term patient outcomes. As a first step in the development of clinical practice guidelines for post-acute rehabilitation after THA and TKA, we explored experiences and attitudes about rehabilitation practices and outcomes in groups of individuals identified as key stakeholders.
Separate focus groups and interviews were conducted with patients (THA or TKA within past year) and three health professional groups: allied health professionals (AHPs), orthopaedic surgeons, and other physicians, in Canada and the United States. Pairs of moderators led the focus groups using a standardized discussion guide. Discussions were audiotaped and transcribed verbatim. A content analysis within and across groups identified key themes.
Eleven focus groups and eight interviews took place in six sites. Patients (n = 32) varied in age, stage of recovery, and surgical and rehabilitation experiences. Health professionals (n = 44) represented a range of disciplines, practice settings and years of experience. Six key themes emerged: 1) Let's talk (issues related to patient-health professional and inter-professional communication); 2) Expecting the unexpected (observations about unanticipated recovery experiences); 3) It's attitude that counts (the importance of the patient's positive attitude and participation in recovery); 4) It takes all kinds of support (along the continuum of care); 5) Barriers to recovery (at patient, provider and system levels), and 6) Back to normal (reflecting diversity of expected outcomes). Patients offered different, but overlapping views compared to health professionals regarding rehabilitation practices and outcomes following THA and TKA.
Results will inform subsequent phases of guideline development and ensure stakeholders' perspectives shape the priorities, content and scope of the guidelines.
Notes
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PubMed ID
20459834 View in PubMed
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Physical effect of work on healthy individuals: implications for FCE testing.

https://arctichealth.org/en/permalink/ahliterature123435
Source
Work. 2012;42(2):233-9
Publication Type
Article
Date
2012
Author
Min Trevor Kyi
Jodi Ann Fischer
Jaclyn Penner
Jennifer A Read
Catherine L Backman
Author Affiliation
Functional Outcomes Rehabilitation Services Inc., Vancouver, BC, Canada. mkyi@functionaloutcomes.com
Source
Work. 2012;42(2):233-9
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
British Columbia
Female
Hand Strength - physiology
Humans
Male
Middle Aged
Muscle Strength Dynamometer - statistics & numerical data
Occupational Diseases - diagnosis - physiopathology
Physical Endurance - physiology
Physical Fitness - psychology
Questionnaires
Rotator Cuff - physiology
Sedentary lifestyle
Time Factors
Time and Motion Studies
Urban Population
Walking - physiology
Work Capacity Evaluation
Workload - psychology - statistics & numerical data
Abstract
The objective of this study was to assess the effect of time of day and job type on performance of three functional capacity evaluation measures in healthy (asymptomatic) adults. It was queried whether or not a healthy population of adults would demonstrate a change in physical performance ability, when re-tested at the end of their work day.
A convenience sample of 50 healthy adults (19-62 years, 66% male) was used from six work sites in an urban area.
Same day pre-test and post-test testing was performed, implementing use of three commonly used functional capacity tests: Jamar dynamometer grip strength test, Turning sub-test of the Complete Minnesota Dexterity Test, and the 50-foot walk test.
The study compared morning and afternoon test scores, and using t-tests, assessed the effect of job type (sedentary, light, medium, heavy) on performance using ANOVA.
All three measures improved from morning to afternoon; differences were statistically significant for 50-foot walk (mean=0.2 sec, p=0.02) and manual dexterity (mean=5 sec, p
PubMed ID
22699190 View in PubMed
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Predictors of mobility among wheelchair using residents in long-term care.

https://arctichealth.org/en/permalink/ahliterature132227
Source
Arch Phys Med Rehabil. 2011 Oct;92(10):1587-93
Publication Type
Article
Date
Oct-2011
Author
W Ben Mortenson
William C Miller
Catherine L Backman
John L Oliffe
Author Affiliation
Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada. bmortens@interchange.ubc.ca
Source
Arch Phys Med Rehabil. 2011 Oct;92(10):1587-93
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
British Columbia
Comorbidity
Cross-Sectional Studies
Female
Humans
Linear Models
Long-Term Care
Male
Middle Aged
Mobility Limitation
Predictive value of tests
Psychomotor Performance
Regression Analysis
Risk factors
Wheelchairs
Abstract
To identify predictors of mobility among long-term care residents who use wheelchairs as their main means of mobility. Based on the Matching Person to Technology Model, we hypothesized that wheelchair-related, personal, and environmental factors would be independent predictors of mobility.
Cross-sectional study.
Eleven long-term residential care facilities in the lower mainland of British Columbia, Canada.
Residents (N=268): self-responding residents (n=149) and residents who required proxy respondents (n=119).
Not applicable.
Mobility was measured using the Nursing Home Life-Space Diameter. Standardized measures of personal, wheelchair-related, and environmental factors were administered and sociodemographic data were collected as independent variables.
Independent mobility decreased as the distance from the resident's room increased: 63% of participants were independently mobile on their units, 40% were independently mobile off their units within the facilities, and 20% were independently mobile outdoors. For the total sample, the significant predictors of mobility, in descending order of importance, were: wheelchair skills (including the capacity to engage brakes and maneuver), functional independence in activities of daily living, having 4 or more visits per week from friends or family, and use of a power wheelchair. This regression model accounted for 48% of variance in mobility scores.
Limited independent mobility is a common problem among facility residents. Residents may benefit from interventions such as wheelchair skills training or provision of powered mobility, but the effectiveness of these interventions needs to be evaluated.
Notes
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PubMed ID
21840499 View in PubMed
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Rasch analyses of the Activities-specific Balance Confidence Scale with individuals 50 years and older with lower-limb amputations.

https://arctichealth.org/en/permalink/ahliterature133441
Source
Arch Phys Med Rehabil. 2011 Aug;92(8):1257-63
Publication Type
Article
Date
Aug-2011
Author
Brodie M Sakakibara
William C Miller
Catherine L Backman
Author Affiliation
Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Source
Arch Phys Med Rehabil. 2011 Aug;92(8):1257-63
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Aged
Amputation - psychology - rehabilitation
Artificial Limbs - psychology
Cross-Sectional Studies
Factor Analysis, Statistical
Female
Humans
Lower Extremity - surgery
Male
Ontario
Postural Balance - physiology
Psychometrics
Reproducibility of Results
Risk factors
Self Efficacy
Abstract
To explore shortened response formats for use with the Activities-specific Balance Confidence (ABC) Scale and then evaluate the unidimensionality of the scale, the item difficulty, the scale for redundancy and content gaps, and the item standard error of measurement (SEM) and internal consistency reliability among aging individuals with a lower-limb amputation living in the community.
Secondary analysis of cross-sectional survey and chart review data.
Outpatient amputee clinics, Ontario, Canada.
Community living adults (N=448; =50y; mean, 68y) who have used a prosthesis for at least 6 months for a major unilateral lower-limb amputation. Of the participants, 325 (72.5%) were men.
Not applicable.
ABC Scale.
A 5-option response format outperformed 4- and 6-option formats. Factor analyses confirmed a unidimensional scale. The distance between response options is not the same for all items on the scale, evident by the Rasch Partial Credit Model (PCM) having a better fit to the data than the Rasch Rating Scale Model. Two items, however, did not fit the PCM within statistical reason. Revising the wording of the 2 items may resolve the misfit and improve the construct validity and lower the standard error of measurement. Overall, the difficulty of the scale's items is appropriate for use with aging individuals with lower-limb amputation, and is most reliable (Cronbach a=0.94) for use with individuals with moderately low balance confidence levels.
The ABC Scale with a simplified 5-option response format is a valid and reliable measure of balance confidence for use with individuals aging with a lower-limb amputation.
Notes
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PubMed ID
21704978 View in PubMed
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