Sound psychometric properties of the Swedish version of the Spinal Cord Independence Measure Self-Report.

OBJECTIVE: To describe data completeness, targeting and reliability of the Swedish version of the Spinal Cord Independence Measure Self-Report (s-SCIM-SR). DESIGN: Translation and reliability study. SUBJECTS: Programme participants (n = 48) and peer mentors (n = 42) with spinal cord injury enrolled in the INTERnational Project for the Evaluation of "activE Rehabilitation" (inter-PEER). METHODS: The translation process was based on guidelines/recommendations, and involved expert competence, including consumers. The s-SCIM-SR was distributed online, once for programme participants and twice for peer mentors. RESULTS: Sixty-nine individuals (77%) obtained a total score. Most missing data were found in the items Respiration and Using the toilet. Cronbach's alpha for the full scale was 0.89, for Self-care 0.92, for Respiration and sphincter management 0.37 and for Mobility 0.86. The intraclass correlation coefficient was excellent for all subscales and the full scale. Measures of variability showed high sensitivity to changes and Bland Altman analyses revealed no systematic changes between evaluation points. CONCLUSION: These results support the data completeness, targeting and reliability of the Swedish version of the SCIM-SR. However, some problems were found in the subscale Respiration and sphincter management. The s-SCIM-SR can be considered psychometrically sound and suitable to assess physical independence among persons with spinal cord injury in Swedish community settings.

Children's perceptions of playing on inclusive playgrounds: A qualitative study.

BACKGROUND: Inclusive playgrounds aim to enable all children to participate and be socially included on playgrounds through the way they are designed. However, knowledge is lacking about how children with and without disabilities perceive playing on inclusive playgrounds and whether these playgrounds lead to more social inclusion. AIMS/OBJECTIVES: The study explores the experiences of children, with and without disabilities, of playing on inclusive playgrounds. MATERIAL AND METHODS: Semi-structured interviews and observations were conducted on six inclusive playgrounds in Switzerland. Overall, 32 children aged 7-12 years participated; 14 children had a disability while 18 children did not. A qualitative content analysis was used for data analysis. RESULTS: The children's experiences of playing on an inclusive playground resulted in the creation of three categories describing: how children with and without disabilities experience play activities on inclusive playgrounds; invisible barriers on inclusive playgrounds; and the fact that children with disabilities have recommendations for the design of inclusive playgrounds. CONCLUSIONS AND SIGNIFICANCE: The results showed that achieving inclusion on a playground is complex and must be considered as a transaction among different environments. For occupational therapists, this could mean that, to support play as an activity on inclusive playgrounds, intervention is necessary at the community and political levels.

"To Work Just Like Anyone Else"-A Narrative from a Man Aging with Spinal Cord Injury.

People aging with spinal cord injury (SCI) develop medical problems commonly associated with the aging process at a younger age than the general population. However, research about how the life story changes and how meaning will be experienced in occupations is lacking. The aim was to describe and offer an explanation of how a man experienced meaning in everyday occupations while aging with an SCI. Four narrative interviews were performed over a four-year period, with a man in his fifties, who lived with SCI for 39 years. The narrative analysis generated an overall plot, named "To Work Just Like Anyone Else," and gives a picture of his experiences, thoughts, and reflections about meaning in occupations, from when he became injured to the present, and in relation to his future. His life story is characterized by secondary health complications, and his experiences of negotiating with the aging body and making choices to continue working. Further, how occupational risk factors, e.g., imbalance, alienation, and deprivation, occur as a result of lack of rehabilitation and support from social systems is addressed. Future research should explore how rehabilitation and social systems can support people aging with SCI to experience meaning in everyday occupations and to have balance in everyday life.

Experiences of participation in everyday occupations among persons aging with a tetraplegia.

PURPOSE: This study aimed to gain understanding of participation in everyday occupations through life stories of persons aging with a traumatic spinal cord injury (SCI). METHOD: A narrative method was used for data collection and a paradigmatic analysis was used to analyze data. RESULTS: The analysis resulted in three themes that illustrate how the participants acted to participate in everyday occupations, how that changed over time, and some concerns about their future. The first theme illustrates how participants following SCI acted to become agents of their lives and participate in everyday occupations. The second theme illustrates how participants had to prioritize participation in meaningful occupations due to personal and environmental factors. The third theme shows how they had to try new strategies to continue participation in occupations, due to secondary health complications related to aging. CONCLUSIONS: This study captures how persons aging with tetraplegia acted to participate in everyday occupations from soon after the injury until several decades later. In addition, their ability to act and participate changed over time. Our findings provide knowledge that can guide clinicians in their work within this complex area of rehabilitation. Besides, it can also guide the work with policy recommendations for healthcare and social service systems. IMPLICATIONS FOR REHABILITATION: Aging with a SCI is a complex daily struggle in order to be able to continue acting and participating in everyday occupations, and thereby this gives implications for a lifelong support. This study provides knowledge that can guide clinicians in their work within this complex area of rehabilitation. Knowledge from this study can guide the work with policy recommendations for healthcare and social service systems.

Leisure repertoire among persons with a spinal cord injury: interests, performance, and well-being.

OBJECTIVE: To explore and describe the leisure repertoire of persons with traumatic spinal cord injury (SCI) and how the repertoire is related to interest, performance, and well-being. DESIGN: Cross-sectional study. SETTING: A total of 97 persons with traumatic SCI were recruited from the non-profit national organization, RG Active Rehabilitation in Sweden. OUTCOME MEASURE: Data were collected through a two-part postal survey. The first comprised of questions investigating socio-demographic variables and injury characteristics; the second part included an interest checklist with 20 areas of leisure activities. RESULTS: The participants were mostly interested in, performed, and experienced well-being from social and culture activities and TV/DVD/movies. The areas of leisure activities in which they had most likely experienced changes after the SCI were outdoor activities, exercise, and gardening. Sex, age, and to some extent, time since injury were related to interest, performance, well-being, and changed performance. CONCLUSIONS: The results provided an explanation and limited description of a changed leisure repertoire among persons after a traumatic SCI. The study showed that sex, age, and time since injury were more closely related to the choice of leisure activities to include in the leisure repertoire than the level of injury. This knowledge can be of importance when professionals in the field of rehabilitation are planning and implementing interventions concerning leisure activities for persons with SCI.