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.


METHODS
Cohort study.


METHODS
Postacute care.


METHODS
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.


METHODS
Not applicable.


METHODS
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
Julie J
JJ
Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA. jkeysor@bu.edu
Jette
Alan M
AM
Coster
Wendy
W
Bettger
Janet Prvu
JP
Haley
Stephen M
SM
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001107:Architectural Accessibility; D001900:Boston; D015331:Cohort Studies; D003256:Community Participation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006798:Housing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009983:Orthopedic Equipment; D010351:Patient Discharge; D012047:Rehabilitation Centers; D012656:Self-Help Devices; D012944:Social Support