title: Restrictions in social participation of young adults with spina bifida.
abstract: OBJECTIVE
  To determine participation restrictions of young adults with spina bifida (SB) in relation to health condition and activity limitations.
  
  
  METHODS
  A total of 179 persons aged 16-25 years and born with SB participated in a cross-sectional study. The main outcome on four domains of participation (independent living, employment, education and partner relationships) was assessed using a structured questionnaire.
  
  
  RESULTS
  At the mean age of 21 years only 16% were living independently, more than one-third of the participants went to special secondary education, 53% of those who finished education did not have a regular job and 71% did not have a partner. Health condition variables (type of SB, hydrocephalus and level of lesion) and to a lesser extent activity limitations (wheelchair dependence and incontinence) were significant determinants for having participation restrictions. Perceived hindrances in participation included long-distance transportation (19-36%), accessibility (10-42%), physical impairments (22-40%), emotional barriers (20-32%) and financial limits (3-17%). More severe SB, defined as hydrocephalus, high level of lesion and wheelchair dependence, was related with more experienced hindrances due to long-distance transportation accessibility of buildings.
  
  
  CONCLUSIONS
  Many young adults with spina bifida experience participation restrictions. Severity of SB was negatively related to participation. Social integration should be a major focus in the professional guidance of youngsters with physical disabilities.
authors.affiliation: Rehabilitation Centre De Hoogstraat, Utrecht, The Netherlands. h.a.barf@rvb.umcg.nl
authors.forename: H A
authors.initials: HA
authors.lastname: Barf
authors.forename: M W M
authors.initials: MW
authors.lastname: Post
authors.forename: M
authors.initials: M
authors.lastname: Verhoef
authors.forename: A
authors.initials: A
authors.lastname: Jennekens-Schinkel
authors.forename: R H J M
authors.initials: RH
authors.lastname: Gooskens
authors.forename: A J H
authors.initials: AJ
authors.lastname: Prevo
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D012919:Social Behavior; D016135:Spinal Dysraphism / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D055815:Young Adult