Participation Restriction Questionnaire: A New Tool to Evaluate Participation in Children

Year 2023, Volume: 12 Issue: 1, 96 - 103, 15.03.2023

Ayşe Numanoğlu Akbaş , Özge Çankaya

https://doi.org/10.53424/balikesirsbd.1190538

Abstract

Objective: This study was planned to develop the Participation Restriction Questionnaire for children based on the International Classification of Functioning, Disability and Health: Children and Youth (ICF-CY). Materials and Methods: A total of 242 children; 209 typically developing (mean age:6.82±4.22 years) and 33 with chronic diseases (mean age:74±4.98 years) and their parents were included in the study. The processes followed were literature review, item pooling based on ICF-CY, eliciting and evaluating expert opinion, scoring the scale, collecting data (with google forms), and analyzing the data. Exploratory and confirmatory factor analysis was performed for scale validity, and Cronbach α and Intraclass Correlation Coefficients (ICC) were used for scale reliability. The re-test was applied to 33 volunteer families two weeks after the first test. Results: The final version of the scale was constituted of 23 items (after removing 7 items out of 30 items) and three subscales as body structures and functions, activity and participation, and environmental factors. The model fit was found acceptable (The Root Mean Square Error of Approximation=0.084, Goodness of Fit Index=0.779, Adjusted Goodness of Fit Index=0.732, Chi-Square/degrees of freedom=2.696, p<0.001). For internal consistency Cronbach’s  (α=0.884-0.959) and for test-retest reliability ICC values (ICC=0.625-0.895) were found moderate to high (p<0.05). Conclusion: These findings show that the Participation Restriction Questionnaire, developed as a new tool is a valid and reliable scale for children with typically developing and chronic diseases for evaluating participation. The questionnaire is recommended for use in further studies to identify the factors which restrict participation.

Keywords

Child, Parental Perspective, Participation, ICF-CY

Thanks

We would like to thank the parents to participate the study. We also would like to thank the experts who shared their valuable comments and suggestions and Prof. Dr. Sabri ERDEM for statistical support.

Katılımda Kısıtlılık Anketi: Çocuklarda Katılımı Değerlendirmek için Yeni Bir Araç

Abstract

Amaç: Bu çalışma, Uluslararası İşlevsellik, Engellilik ve Sağlık Sınıflandırması: Çocukluk ve Gençlik (ICF-CY) temelli çocuklar için bir Katılımda Kısıtlılık Anketi geliştirmek için planlandı. Gereç ve Yöntem: İki yüz dokuz tipik gelişen (ortalama yaş:6.82±4.22 yıl) ve 33 kronik hastalığı olan (ortalama yaş:74±4.98 yıl) toplam 242 çocuk ve ebeveynleri çalışmaya dahil edildi. İzlenen süreçler; literatür taraması, ICF-CY'ye dayalı madde havuzu oluşturma, uzman görüşünün alınması ve değerlendirilmesi, ölçeğin puanlanması, veri toplanması (Google formlar ile) ve verilerin analizidir. Ölçek geçerliliği için açıklayıcı ve doğrulayıcı faktör analizi, ölçek güvenirliği için Cronbach α ve Sınıf İçi Korelasyon Katsayısı (ICC) kullanıldı. İlk testten iki hafta sonra 33 gönüllü aileye tekrar test uygulandı. Bulgular: Ölçeğin son halini vücut yapı ve fonksiyonları, aktivite ve katılım ve çevresel faktörler olmak üzere 23 madde (30 maddeden 7 madde çıkarıldıktan sonra) ve üç alt boyuttan oluştu. Model uyumu kabul edilebilir bulundu (Yaklaşık Hataların Ortalama Karekökü=0.084, Uyum İyiliği İndeksi=0.779, Düzeltilmiş Uyum İyiliği İndeksi=0.732, Ki Kare/Serbestlik Derecesi=2.696, p<0.001). İç tutarlılık için Cronbach's α (α=0.884-0.959) ve test-tekrar test güvenirliği için ICC değerleri (ICC=0.625-0.895) orta-yüksek (p<0.05) bulundu. Sonuç: Bu bulgular, yeni bir araç olarak geliştirilen Katılımda Kısıtlılık Anketinin tipik gelişen ve kronik hastalığı olan çocuklarda katılımı değerlendirmek için geçerli ve güvenilir bir ölçek olduğunu göstermektedir. Anketin, katılımı kısıtlayan faktörleri belirlemek için daha sonraki çalışmalarda kullanılması önerilir.

Keywords

Çocuk, Ebeveyn Perspektifi, Katılım, ICF-CY.

References

• Adair, B., Ullenhag, A., Rosenbaum, P., Granlund, M., Keen, D., & Imms, C. (2018). Measures used to quantify participation in childhood disability and their alignment with the family of participation-related constructs: a systematic review. Developmental Medicine & Child Neurology, 60(11), 1101-1116. doi:10.1111/dmcn.13959
• Björck-Åkesson, E., Wilder, J., Granlund, M., Pless, M., Simeonsson, R., Adolfsson, M., Lillvist, A. (2010). The International Classification of Functioning, Disability and Health and the version for children and youth as a tool in child habilitation/early childhood intervention–feasibility and usefulness as a common language and frame of reference for practice. Disability and Rehabilitation, 32(sup1), S125-S138.
• Bolte, S., Mahdi, S., Coghill, D., Gau, S. S., Granlund, M., Holtmann, M., Selb, M. (2018). Standardised assessment of functioning in ADHD: consensus on the ICF Core Sets for ADHD. European Child and Adolescent Psychiatry, 27(10), 1261-1281. doi:10.1007/s00787-018-1119-y.
• Coster, W., Bedell, G., Law, M., Khetani, M. A., Teplicky, R., Liljenquist, K., Kao, Y. C. (2011). Psychometric evaluation of the Participation and Environment Measure for Children and Youth. Developmental Medicine & Child Neurology, 53(11), 1030-1037.
• DeVellis, R. F. (2016). Scale development: Theory and applications (Vol. 26): Sage publications. Fauconnier, J., Dickinson, H. O., Beckung, E., Marcelli, M., McManus, V., Michelsen, S. I., Arnaud, C. (2009). Participation in life situations of 8-12 year old children with cerebral palsy: cross sectional European study. BMJ, 338, b1458.
• Hammal, D., Jarvis, S. N., & Colver, A. F. (2004). Participation of children with cerebral palsy is influenced by where they live. Developmental Medicine & Child Neurology, 46(5), 292-298. Kang, L. J., Palisano, R., King, G., Chiarello, L., Orlin, M., Polansky, M. (2012). Social participation of youths with cerebral palsy differed based on their self‐perceived competence as a friend. Child: Care, Health and Development, 38(1), 117-127.
• King, G., Law, M., Hanna, S., King, S., Hurley, P., Rosenbaum, P., Petrenchik, T. (2006). Predictors of the leisure and recreation participation of children with physical disabilities: a structural equation modeling analysis. Children's Health Care, 35(3), 209-234. King, G., Law, M., King, S., Hurley, P., Hanna, S., Kertoy, M., Young, N. (2004). Children's Assessment of Participation and Enjoyment (CAPE) and Preferences for Activities of Children (PAC) San Antonio, TX: Harcourt Assessment. In: Inc.
• King, G., Lawm, M., King, S., Rosenbaum, P., Kertoy, M. K., & Young, N. L. (2003). A conceptual model of the factors affecting the recreation and leisure participation of children with disabilities. Physical & Occupational Therapy in Pediatrics, 23(1), 63-90. Koo, T. K., Li, M.Y. J. (2016). A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine.15(2):155-163.
• Law, M., Anaby, D., Imms, C., Teplicky, R., & Turner, L. (2015). Improving the participation of youth with physical disabilities in community activities: An interrupted time series design. Australian Occupational Therapy Journal, 62(2), 105-115. doi:10.1111/1440-1630.12177
• Law, M., King, G., King, S., Kertoy, M., Hurley, P., Rosenbaum, P., Hanna, S. (2006). Patterns of participation in recreational and leisure activities among children with complex physical disabilities. Developmental Medicine & Child Neurology, 48(5), 337-342. Law, M., King, G., Petrenchik, T., Kertoy, M., & Anaby, D. (2012). The assessment of preschool children's participation: internal consistency and construct validity. Physical & Occupational Therapy in Pediatrics, 32(3), 272-287. Michelsen, S. I., Flachs, E. M., Damsgaard, M. T., Parkes, J., Parkinson, K., Rapp, M., Fauconnier, J. (2014). European study of frequency of participation of adolescents with and without cerebral palsy. European Journal of Paediatric Neurology, 18(3), 282-294.
• Noonan, V. K., Kopec, J. A., Noreau, L., Singer, J., Chan, A., Mâsse, L. C., & Dvorak, M. F. (2009). Comparing the content of participation instruments using the International Classification of Functioning, Disability and Health. Health and Quality of Life Outcomes, 7(1), 93.
• Noonan, V. K., Kopec, J. A., Noreau, L., Singer, J., & Dvorak, M. F. (2009). A review of participation instruments based on the International Classification of Functioning, Disability and Health. Disability and Rehabilitation, 31(23), 1883-1901.
• Noreau, L., Lepage, C., Boissiere, L., Picard, R., Fougeyrollas, P., Mathieu, J., Nadeau, L. (2007). Measuring participation in children with disabilities using the Assessment of Life Habits. Developmental Medicine & Child Neurology, 49(9), 666-671.
• Nunnally, J.C., Wilson, W.H. (1975). Method and theory for developing measures in evaluation research. Handbook in Research and Evaluation, 1:227–288.
• World Health Organization, (2007). International classification of functioning, disability and health: Children and youth version: ICF-CY: World Health Organization.
• Polat, B. D., Ersoy, Ö. A., & Toran, M. (2017). Çocuk katılımı farkındalık ölçeği (ÇKFÖ): Ölçek geliştirme, güvenirlik ve geçerlik çalışması. Erken Çocukluk Çalışmaları Dergisi, 1(2), 186-215.
• Rosenbaum, P., & Stewart, D. (2004). The World Health Organization International Classification of Functioning, Disability, and Health: a model to guide clinical thinking, practice and research in the field of cerebral palsy. Seminars in Pediatric Neurology, 11(1):5-10. doi: 10.1016/j.spen.2004.01.002.
• Rosenberg, L., Ratzon, N., Jarus, T., & Bart, O. (2012). Perceived environmental restrictions for the participation of children with mild developmental disabilities. Child: Care, Health and Development, 38(6), 836-843.
• Rosenberg, L., Ratzon, N. Z., Jarus, T., & Bart, O. (2010). Development and initial validation of the Environmental Restriction Questionnaire (ERQ). Research in Developmental Disabilities, 31(6), 1323-1331.
• Sandberg, A., & Eriksson, A. (2010). Children’s participation in preschool–on the conditions of the adults? Preschool staff’s concepts of children’s participation in preschool everyday life. Early Child Development and Care, 180(5), 619-631.
• Schiariti, V., Longo, E., Shoshmin, A., Kozhushko, L., Besstrashnova, Y., Krol, M., Amado, S. (2018). Implementation of the International Classification of Functioning, Disability, and Health (ICF) Core Sets for Children and Youth with Cerebral Palsy: Global Initiatives Promoting Optimal Functioning. International Journal of Environmental Research and Public Health, 15(9). doi:10.3390/ijerph15091899.
• Shikako-Thomas, K., Shevell, M., Schmitz, N., Lach, L., Law, M., Poulin, C., QUALA Group. (2013). Determinants of participation in leisure activities among adolescents with cerebral palsy. Research in Developmental Disabilities, 34(9), 2621-2634.
• Uzunsakal, E., Yıldız, D. (2018) Alan Araştirmalarinda Güvenilirlik Testlerinin Karşilaştirilmasi Ve Tarimsal Veriler Üzerine Bir Uygulama [A Comparison Of Reliability Tests In Field Researches And An Application On Agricultural Data]. Uygulamalı Sosyal Bilimler Dergisi [Applied Social Sciences Journal of Istanbul University-Cerrahpasa], 2, 14-28.
• Yurdugül, H. (2005). Ölçek geliştirme çalışmalarında kapsam geçerliği için kapsam geçerlik indekslerinin kullanılması. XIV. Ulusal Eğitim Bilimleri Kongresi, 1, 771-774.