Assessing the validity of Task Analysis as a quantitative tool to measure the efficacy of rehabilitation in brain injury.

BACKGROUND: Inpatient rehabilitation with patients who have sustained an acquired brain injury (ABI), including traumatic brain injury (TBI), focuses on improving performance in activities of daily living (ADLs). Although not studied to date in patients with ABI/TBI, Task Analysis (TA) integrates assessment and the prompting/cueing levels required to complete various tasks, with the goal to achieve effective skill acquisition and rehabilitation planning. TA has demonstrated efficacy in teaching life skills in individuals with developmental disabilities and in this study is applied to teaching ADL skills in ABI/TBI rehabilitation. PRIMARY OBJECTIVE: To validate the use of TA in measuring progress in teaching ADLs by comparing it with three common ADL measures: Functional Independence Measure, Barthel Index and Klein-Bell. METHODS: Twenty-four inpatients were administered the Functional Independence Measure (FIM), Barthel Index (BI) and the Klein-Bell ADL Scale (KB) TA within 72 hours of admission, at 4 weeks and within 72 hours of discharge, for showering and dressing tasks. A repeated measures ANOVA compared scores across the four measures, at three time points, for both tasks. CONCLUSION: Concurrent validity of TA in measuring improvements in the ADL tasks was established. Improvements were associated with reductions in supervision and disability levels. TA was shown to be an effective evaluation and teaching strategy during rehabilitation, with demonstrated reductions in disability and supervision levels.

Sewing and Inuit women's health in the Canadian Arctic.

Traditional Inuit cultural values and practices are integral to an Inuit understanding of health. We examine the role of sewing in Inuit women's health in the Canadian Arctic in a case study of Ulukhaktok, Northwest Territories, Canada. An analysis of data collected using semi-structured interviews with 30 Inuit women reveals that sewing contributes to participant's health and the collective health of the community in several ways including: pride and sense of accomplishment; cultural identity; relaxation, decompression, and socialization; and spirituality and healing. As a cultural practice, sewing is about older generations teaching younger generations about their identity, who they are and where they come from. For some participants, sewing is a way through which they express their culture. Sewing brings people together at a time when social isolation is becoming more apparent, and gives women the chance to learn vital, tangible skills that continue to have social, economic, and cultural importance. Sewing is also a form of healing that helps women ease their minds and focus on a challenging and productive task that brings them satisfaction, self-worth, and value. We conclude that sewing is important for cultural continuity, enabling Inuit to both practice and carryon their culture, and contributing positively to individual and the collective health of the community.