Late Life Function and Disability Instrument: I. Development and Evaluation of the Disability Component

Objective-To examine the relationship between frequency of participation and confidence with using a manual wheelchair among community-living, older wheelchair users, and the moderating effect of sex. Design-Cross-sectional Setting-CommunityParticipants-54 participants who were community-living manual wheelchair users (65% male), were ≥50 years of age (mean = 59 years), used their wheelchair daily, and had ≥6 months experience with using a wheelchair. Intervention-NoneMain Outcome Measures-The 16-item Late Life Disability Instrument, and the 65-item Wheelchair Use Confidence Scale measured participation and confidence respectively. Age, sex, and wheelchair skill measured using the performance-based Wheelchair Skills Test, were included as covariates in the multiple regression models.Results-Significant and positive relationships exist between participation and: 1) confidence (standardized coefficient (β)=0.83, p=0.002), and; 2) the interaction term (β=0.33, p=0.05). The We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated AND, we certify that all financial and material support for this research (eg, NIH or NHS grants) and work are clearly identified in the title page of the manuscript. Conclusions-Confidence with using a manual wheelchair is a positive and significant determinant of frequency of participation of older wheelchair users, after controlling for important covariates. Because the relationship is moderated by sex, treatments addressing low confidence may lead to increased frequency of participation especially for male wheelchair users. Keywordswheelchairs; mobility; social participation; self efficacy; agingParticipation is an individual's involvement in life situations. 1 It is characterized by a complex relationship between an individual's health condition, and the context in which the person conducts his/her life. 1 Because a high level of participation is important for better quality of life, 2 enabling participation in desired roles is an important rehabilitation focus.Individuals with mobility disabilities are often faced with less than optimal participation, and consequently have an increased risk of health issues, including depression. 3 Fortunately, manual wheelchairs are often prescribed to facilitate mobility and promote independent participation in various roles. However, older wheelchair users are more likely to report a lack of independence with using their wheelchair 4 and they experience less than desirable participation levels due to increased participation restrictions associated with aging. 3 Thus, an issue in the study of this population is that despite knowledge of an increase in the prevalence of older wheelchair users related to aging, an insufficient amount of research has focused only on a limited number of determinants of participation, accounting for modest amounts of variance. 5,6 Confidence with using a manual wheelchair is an em...

Section: Measurementmentioning

confidence: 99%

Section: Measurementmentioning

confidence: 99%

See 1 more Smart Citation

Preliminary Examination of the Relation Between Participation and Confidence in Older Manual Wheelchair Users

Sakakibara

Miller

Eng

et al. 2013

“…17,18 Research in the area of confidence with using a manual wheelchair has shown similar results. For example, a recent study has established that confidence with using a manual wheelchair, as measured by the Wheelchair Use Confidence Scale (WheelCon-M), 19 is a positive and significant determinant of frequency of participation, as measured by the Late Life Disability Instrument, 20 of older wheelchair users. 21 This finding is significant because it was observed after controlling for ability to use a wheelchair, thereby suggesting that low confidence may be a barrier to participation among older wheelchair users regardless of their ability to use their wheelchair.…”

mentioning

confidence: 99%

Wheelchair Skills Training to Improve Confidence With Using a Manual Wheelchair Among Older Adults: A Pilot Study

Sakakibara¹,

Miller²,

Souza³

et al. 2013

Objectives-To examine the effects of wheelchair skills training on confidence in older adults who are inexperienced with using a wheelchair. Design-Parallel group, single blind randomized controlled trial Setting-Vancouver, CanadaParticipants-Participants (N=20) who were community-living older adults at least 65 years old (mean = 70 years), 50% female, and who had no prior experience using a wheelchair were randomly allocated to an intervention (n=10) or control (n=10) group.Intervention-The intervention group received two 1-hour training sessions that followed the Wheelchair Skills Training Program (WSTP) protocol. The control group received a single socialization contact.Main Outcome Measure-The Wheelchair Use Confidence Scale-Manual (WheelCon-M) was used to evaluate confidence with using a manual wheelchair. The WheelCon-M is a self-report questionnaire comprised of 65 items in 6 conceptual areas.Results-A 1-way between groups analysis of covariance revealed a significant difference in post-intervention WheelCon-M scores between the intervention and control groups [F(1,17) = Corresponding author: William C. Miller, PhD, FCAOT, Department of Occupational Science and Occupational Therapy, University of British Columbia, T325-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Tel work: 604-714-4108, Fax: 604-714-4168, bcmiller@telus.net. Material in this manuscript was presented in part at the Canadian Association of Occupational Therapists Conference, Quebec City, QC, June 6-9, 2012.We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated AND, we certify that all financial and material support for this research (eg, NIH or NHS grants) and work are clearly identified in the title page of the manuscript.The manuscript submitted does not contain information about medical device(s). Individuals with mobility disabilities are often prescribed manual wheelchairs to promote independence with their mobility and social participation. 4,5 Ineffective use of the wheelchair, however, often compromises independence, and leads to the perception that the wheelchair itself is a barrier to doing things. 6,7 Therefore, treatment strategies that facilitate effective wheelchair use are increasing in importance. This is especially true for older adults who have been reported to more frequently lack independence using their wheelchair. 1In order for individuals to effectively use their wheelchair they must possess a variety of wheelchair skills. 8 Training to improve wheelchair skills is often employed to promote an individual's ability to use their wheelchair. For example, the Wheelchair Skills Training Program (WSTP) 9 was developed to provide an evidence-based, standardized approach to increase the likelihood of improving an individual's ability to use his/her wheelchair safely and effectively. 9 The WSTP has had positive results among wheelchair users undergoing initial rehabilitation, 10 and ...

“…As device use becomes more habitual, it may lead to changes in mobility and social participation. As illustrated in Table I, the toolkit included five measures: the Wheelchair Skills Test for powered wheelchair users (WST-P) (16), the Late Life Disability Index (LLDI) (17), Life-space Assessment (LSA) (18), the Assistive Technology Outcomes Profile for Mobility, which includes two independent sub-scales for activity and participation (ATOP/M-A and ATOP/M-P) and the Wheelchair Use Confidence Scale for powered mobility users (WheelCon-P) (18,19).…”

Section: Introductionmentioning

confidence: 99%

Exploratory Validation of a Multidimensional Power Wheelchair Outcomes Toolkit

Mortenson

Demers

Rushton

et al. 2015

OBJECTIVES-To evaluate the relationship among the measures in a power wheelchair outcomes toolkit. DESIGN-We performed path analysis of cross-sectional data from self-report questionnaires and one objective measure. SETTING-Data were collected in six Canadian sites.PARTICIPANTS-A convenience sample of 128 power wheelchair users. The majority, 69 (53.9%), were female. Multiple sclerosis and spinal cord injury/disease were the most common diagnoses. RESULTS-Wheelchair confidence was independently associated with less difficulty with activity (β =0.08, 0.01

0.05) and participation (β=0.39, p<0.01), increased life space (β=0.09, p<0.03) and greater wheelchair skills (β=0.37, p<0.01) Less perceived difficulty with activity was independently associated with increased frequency of participation (β=0.30, p<0.01). Life space mobility was independently associated with increased frequency of participation ((β=0.31, p<0.01). Less difficulty with participation was independently associated with greater life-space mobility (β=0.32, p<0.01) and greater frequency of participation (β=0.13, p<0.01). INTERVENTIONS-NotCONCLUSION-This study provides empirical support for the measures included as part of the power wheelchair outcomes toolkit. They appear to provide complementary information on a variety of constructs related to power wheelchair use.