title: A Delphi study on environmental factors that impact work and social life participation of individuals with multiple sclerosis in Austria and Switzerland.
abstract: OBJECTIVE
  This study aimed to gain knowledge about environmental factors (EFs) that impact work and social life participation of people with multiple sclerosis (MS) in Austria and Switzerland to extend the knowledge of participation and to identify key areas for measuring participation.
  
  
  METHODS
  A three-round Delphi study was conducted defining patients as experts. In the 1st round, qualitative data was gathered through questionnaires, analyzed with content analysis, and factors were assigned to EFs as classified in the ICF. In the 2nd and 3rd round, experts judged EFs according to its relevance to obtain consensus (cut-off 75%). Categories were ranked on a scale from mostly important to important.
  
  
  RESULTS
  One hundred and twelve Austrian and 109 Swiss experts were recruited. The content analysis revealed 768 EFs. The study resulted in a list of 176 consensus factors for Austria and 177 Switzerland. Five categories revealed to be highly important, 12 moderately important, 6 fairly important, and 10 important.
  
  
  CONCLUSIONS
  This study indicates that participation in work or social life is influenced by physical, social, attitudinal, and policy factors. Consensus factors afford insights into areas for consideration in the development of participation outcome measurements and support a comprehensive and inclusive rehabilitation approach.
authors.affiliation: Occupational Science Field, Graduate Program in Health and Rehabilitation Sciences, The University of Western Ontario, 1201 Western Rd., Elborn College, London, Ontario, N6G 1H1 Canada. bproding@uwo.ca
authors.forename: Birgit
authors.initials: B
authors.lastname: Prodinger
authors.forename: Andrea P
authors.initials: AP
authors.lastname: Weise
authors.forename: Lynn
authors.initials: L
authors.lastname: Shaw
authors.forename: Tanja A
authors.initials: TA
authors.lastname: Stamm
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D003697:Delphi Technique; D003710:Demography; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000503:physiopathology* / Q000534:rehabilitation; D012307:Risk Factors; D012931:Social Environment; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology; D014937:Work