James McGill Professor, Division of Clinical Epidemiology, Department of Medicine, McGill University Health Center, Royal Victoria Hospital Site, Ross Pavilion R4.29, 687 Pine Ave W, Montreal, QC, H3A 1A1, Canada,
Qual Life Res. 2014 Feb;23(1):39-47. doi: 10.1007/s11136-013-0441-6. Epub 2013 Jun 11.
Participation, a construct within the disability/functioning framework, is evaluated on a person's involvement in life situations including family, community, work, social, and civic life. In the context of recovering from a major health event, participation is a treatment goal and it is known to correlate with the quality of life.
The purpose of this study is to track the dynamics of participation post-stroke in relationship to the dynamics of walking capacity, social support, and mood.
An inception cohort was followed over the first post-stroke year. Group-based trajectory analysis, a form of latent class analysis, was used to identify distinctive groups of individuals with similar trajectories. Dual trajectories were used to estimate concordance between participation trajectory and trajectories for each of the three constructs under study.
From the sample of 102 persons (mean age 70), four trajectories of participation were identified, two of which were qualified as excellent and very good, and two qualified as fair and poor. All those with excellent walking showed excellent participation. However, people with excellent (and very good) community participation had a range of walking capacities. Most (82%) people with normal mood showed excellent participation. People with good mood but not meeting norms for age showed the complete range of participation trajectories from excellent to poor. The higher proportion of people with excellent or good social support (57%) showed excellent participation.
Two treatable component causes of participation, walking capacity and mood, were identified; of these, only excellent walking capacity could be considered a sufficient cause.
参与度是残疾/功能框架中的一个概念，评估的是一个人在家庭、社区、工作、社会和公民生活等生活情境中的参与程度。在从重大健康事件中恢复的背景下，参与度是一个治疗目标，并且与生活质量相关。
本研究旨在追踪卒中后参与度的动态变化，以及与步行能力、社会支持和情绪的动态变化的关系。
对一个起始队列进行了为期一年的跟踪研究。采用群组轨迹分析（一种潜在类别分析形式）来识别具有相似轨迹的个体的独特群组。双轨迹用于估计参与轨迹与研究中的三个构念的轨迹之间的一致性。
从 102 名参与者（平均年龄 70 岁）中，确定了四种参与轨迹，其中两种为优秀和非常好，两种为良好和较差。所有步行能力优秀的人都表现出了优秀的参与度。然而，具有优秀（和非常好）社区参与度的人具有不同的步行能力。大多数（82%）情绪正常的人表现出了优秀的参与度。情绪良好但不符合年龄标准的人表现出了从优秀到较差的完整参与轨迹范围。具有优秀或良好社会支持的人比例较高（57%），表现出了优秀的参与度。
确定了两个可治疗的参与度组成原因，即步行能力和情绪，其中只有优秀的步行能力才能被视为充分原因。
