title: Developing a model of participation post-stroke: a mixed-methods approach.
abstract: OBJECTIVE
  To develop and verify a model of participation post stroke, as a domain of health related quality of life.
  
  
  METHODS
  An explanatory sequential mixed-methods design was selected. The quantitative phase developed a participation model with data from an observational study of 453 participants at 12 months post-stroke, using structural equation modeling. The qualitative phase followed to verify the model from the perspective of individuals post-stroke. Data was collected from two groups of eight stroke survivors involved in a multicentre trial about participation in the community. Individuals took photographs to describe participation; discussion of photographs was conducted over the course of three focus groups, and analysis identified emergent categories related to the model.
  
  
  RESULTS
  The 12-month post stroke participation model consisted of latent variables: accomplishment, restricted roles, and health efficacy. The model fit was reasonable: normed χ(2) = 2.95, RMSEA = 0.066(0.052; 0.079). The qualitative data verified the model; participants initiated photo-taking and discussion of all aspects of the model. Concepts of social support, environment, and cognitive difficulties were also discussed in relation to participation.
  
  
  CONCLUSIONS
  The participation model was developed and verified. Additions to future models are suggested. Theoretical, clinical, and research implications are discussed.
authors: Department of Physical Therapy, School of Medical Rehabilitation, University of Manitoba, R106-771 McDermot Ave, Winnipeg, MB, R3E 0T6, Canada. barclayg@cc.umanitoba.ca
authors: Ruth
authors: R
authors: Barclay-Goddard
authors: Jacquie
authors: J
authors: Ripat
authors: Nancy E
authors: NE
authors: Mayo
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D010781:Photography; D011594:Psychometrics; D036301:Qualitative Research; D011788:Quality of Life; D012944:Social Support; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*