Lysack Cathy, Komanecky Marie, Kabel Allison, Cross Katherine, Neufeld Stewart
Occupational Therapy and Gerontology, Wayne State University, Detroit, MI 48202, USA
Can J Occup Ther. 2007;74 Spec No.:243-54. doi: 10.1177/00084174070740S304.
The International Classification of Functioning, Disability and Health (ICF) model presents an opportunity to better understand previously neglected longterm social outcomes after traumatic spinal cord injury (SCI), especially the experience of participation.
The study explored the relationship between perceived environmental barriers and perceived community integration (a participation proxy) in a sample of adults with traumatic SCI.
The study interviewed African American and White women and men (n = 136) who had lived with SCI for an average of 11.5 years.
Participants reported environmental barriers at twice the level indicated by previous studies; the natural environment and the policies of government were the most problematic. Levels of community integration were also high. Data suggest a significant relationship (p < .01) between perceived environmental barriers and community integration for adults with SCI, providing support for the ICF model.
Improved measures and more sophisticated concepts and theories are needed to explicate the relationship between environmental factors and participation concepts in the ICE With respect to practice, occupational therapists need to be aware that removal of environmental barriers is only a first step in the more complex effort to facilitate optimal community integration after SCI.
国际功能、残疾和健康分类（ICF）模型为更好地理解创伤性脊髓损伤（SCI）后先前被忽视的长期社会结果提供了契机，尤其是参与体验。
本研究探讨了创伤性SCI成年样本中感知到的环境障碍与感知到的社区融合（参与的替代指标）之间的关系。
该研究对平均患有SCI 11.5年的非裔美国人和白人男性及女性（n = 136）进行了访谈。
参与者报告的环境障碍程度是先前研究表明水平的两倍；自然环境和政府政策问题最大。社区融合水平也很高。数据表明，SCI成年人感知到的环境障碍与社区融合之间存在显著关系（p <.01），为ICF模型提供了支持。
需要改进测量方法以及更复杂的概念和理论来阐明ICF中环境因素与参与概念之间的关系。在实践方面，职业治疗师需要意识到，消除环境障碍只是促进SCI后实现最佳社区融合这一更为复杂努力的第一步。
