Association of environmental factors with levels of home and community participation in an adult rehabilitation cohort.
OBJECTIVE: To examine whether home and community environmental barriers and facilitators are predictors of social and home participation and community participation at 1 and 6 months after discharge from an acute care or inpatient rehabilitation hospital. DESIGN: Cohort study. SETTING: Postacute care. PARTICIPANTS: Adults (N=342) age 18 years or older with a diagnosis of complex medical, orthopedic, or neurologic condition recruited from acute care and inpatient rehabilitation facilities. The mean age +/- standard deviation of participants was 68+/-14 years; 49% were women and 92% were white. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participation in social, home and community affairs as assessed with the Participation Measure for Post-Acute Care. RESULTS: Adjusting for covariates, 1 month after discharge a greater presence of home mobility barriers (P<.01) was associated with less social and home participation; whereas greater community mobility barriers (P<.01) and more social support (P<.001) were associated with greater participation. At 6 months, social support was the only environmental factor associated with participation after adjusting for covariates. CONCLUSIONS: This study provides new empirical evidence that environmental barriers and facilitators do influence participation in a general rehabilitation cohort, at least in the short term.
Keysor, JJ; Jette, AM; Coster, W; Bettger, JP; Haley, SM
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