title: Health, Personal, and Environmental Predictors of Wheelchair-Use Confidence in Adult Wheelchair Users.
abstract: BACKGROUND
  There are no predictive models of wheelchair-use confidence. Therefore, clinicians and researchers are limited in their ability to screen for and identify wheelchair users who may be more prone to low wheelchair-use confidence and may benefit from clinical intervention.
  
  
  OBJECTIVE
  The purpose of this study was to identify health-related, personal, and environmental factors that predict perceived wheelchair-use confidence in community-dwelling adults who use manual wheelchairs.
  
  
  METHODS
  A cross-sectional study was conducted.
  
  
  METHODS
  Community-dwelling manual wheelchair users (N=124) were included in the study if they were ≥50 years of age, had ≥6 months of wheelchair use experience, and had no cognitive impairment. The Wheelchair Use Confidence Scale was used to assess wheelchair-use confidence. The sociodemographic information form, Functional Comorbidity Index, Seating Identification Tool, Interpersonal Support and Evaluation List, and Home and Community Environment Instrument captured the independent variables. Blocks of health, personal, and environmental variables were sequentially entered into the regression model.
  
  
  RESULTS
  Five personal variables (age, standardized beta [β]=-0.18; sex, β=-0.26; daily hours of wheelchair occupancy, β=0.20; wheelchair-use training, β=0.20; and wheelchair-use assistance, β=-0.34) and one environmental variable (need for seating intervention, β=-0.18) were statistically significant predictors, explaining 44% of the confidence variance.
  
  
  CONCLUSIONS
  The sample comprised volunteers and, therefore, may underrepresent or overrepresent particular groups within the population. The study's cross-sectional research design does not allow for conclusions to be made regarding causality.
  
  
  CONCLUSIONS
  Older women who use wheelchairs and who require assistance with wheelchair use may have low wheelchair-use confidence. The same is true for individuals who have no formal wheelchair-use training, who are in need of a seating intervention, and who report few hours of daily wheelchair use. These wheelchair users may require clinical attention and benefit from intervention.
authors.affiliation: B.M. Sakakibara, PhD, Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, Canada, and Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
authors.forename: Brodie M
authors.initials: BM
authors.lastname: Sakakibara
authors.affiliation: W.C. Miller, PhD, FCAOT, Graduate Program in Rehabilitation Sciences and Department of Occupational Science and Occupational Therapy, University of British Columbia, T325-2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5 Canada, and Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada. bcmiller@telus.net.
authors.forename: William C
authors.initials: WC
authors.lastname: Miller
authors.affiliation: J.J. Eng, PhD, BSc(PT/OT), Graduate Program in Rehabilitation Sciences and Department of Physical Therapy, Faculty of Medicine, University of British Columbia, and Rehabilitation Research Program, GF Strong Rehabilitation Centre, Vancouver Coastal Health Research Institute.
authors.forename: Janice J
authors.initials: JJ
authors.lastname: Eng
authors.affiliation: F. Routhier, PEng, PhD, Department of Rehabilitation, Université Laval, Quebec City, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Routhier
authors.affiliation: C.L. Backman, PhD, FCAOT, Graduate Program in Rehabilitation Sciences and Department of Occupational Science and Occupational Therapy, University of British Columbia.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Backman
mesh_terms: D000367:Age Factors; D000368:Aged; D002170:Canada; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology*; D004779:Environment Design; D004867:Equipment Design; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012649:Self Concept; D012737:Sex Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D014910:Wheelchairs / Q000523:psychology*