Department of Nursing, University of Alicante, Alicante, Spain.
Department of Health, Alcoy, Alicante, Spain.
Arch Gerontol Geriatr. 2014 Jul-Aug;59(1):122-30. doi: 10.1016/j.archger.2014.02.003. Epub 2014 Feb 17.
Despite the centrality of the difficulty concept in the study of disability, there has been little research on its significance from the point of view of people with functional limitations. The main objective of this study was to describe what older people understand when asked about difficulty in undertaking mobility activities. As a secondary objective, we considered whether there are any differences depending on the type of activities, according to the International Classification of Functioning (ICF) mobility domains.
Seventeen community-dwelling men and women aged 70 years old or over were interviewed by means of a questionnaire containing 55 items covering the ICF mobility domains. The participants responded to the items while thinking aloud, saying what led them to give a specific answer about their level of difficulty. Inductive content analysis was conducted and categories, subthemes and themes were identified.
Causes of difficulty (pathologies, impairments, symptoms) and accommodations (task modifications and use of aids) were the two themes identified; and their importance (and that of the subthemes included) varied across the types of activity. All the participants said that they had no difficulty in at least one task, despite mentioning changes in the way they performed them.
Older people's opinions were consistent with theoretical models of disability and with the standard practice of measuring functional limitations by asking about the degree of difficulty; however, the design of these measures needs to be improved in order to detect perceptions of no difficulty in the presence of task modification.
尽管困难概念在残疾研究中具有核心地位，但从功能受限者的角度来看，对其意义的研究却很少。本研究的主要目的是描述老年人在被问及进行移动活动的困难时所理解的内容。作为次要目标，我们考虑了根据国际功能、残疾和健康分类（ICF）的移动领域的活动类型是否存在任何差异。
通过包含涵盖 ICF 移动领域的 55 个项目的问卷，对 17 名居住在社区中的 70 岁或以上的男性和女性进行了访谈。参与者在回答问题时边想边说，说出了导致他们对自己的困难程度给出特定答案的原因。进行了归纳内容分析，并确定了类别、子主题和主题。
困难的原因（病理、损伤、症状）和适应（任务修改和使用辅助器具）是确定的两个主题；它们的重要性（包括包含的子主题）因活动类型而异。尽管所有参与者都提到了他们执行任务的方式发生了变化，但他们都表示至少有一种任务没有困难。
老年人的意见与残疾的理论模型以及通过询问困难程度来衡量功能限制的标准实践一致；然而，为了在存在任务修改的情况下检测到没有困难的感知，这些措施的设计需要改进。
