Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Apr;21(3):417-26.
doi: 10.1007/s11136-011-9968-6. Epub 2011 Jul 12.

Developing a model of participation post-stroke: a mixed-methods approach

Ruth Barclay-Goddard  1 , Jacquie Ripat, Nancy E Mayo
Affiliations

Developing a model of participation post-stroke: a mixed-methods approach

Ruth Barclay-Goddard et al. Qual Life Res. 2012 Apr.

Abstract

Purpose: To develop and verify a model of participation post stroke, as a domain of health related quality of life.

Methods: An explanatory sequential mixed-methods design was selected. The quantitative phase developed a participation model with data from an observational study of 453 participants at 12 months post-stroke, using structural equation modeling. The qualitative phase followed to verify the model from the perspective of individuals post-stroke. Data was collected from two groups of eight stroke survivors involved in a multicentre trial about participation in the community. Individuals took photographs to describe participation; discussion of photographs was conducted over the course of three focus groups, and analysis identified emergent categories related to the model.

Results: The 12-month post stroke participation model consisted of latent variables: accomplishment, restricted roles, and health efficacy. The model fit was reasonable: normed χ(2) = 2.95, RMSEA = 0.066(0.052; 0.079). The qualitative data verified the model; participants initiated photo-taking and discussion of all aspects of the model. Concepts of social support, environment, and cognitive difficulties were also discussed in relation to participation.

Conclusions: The participation model was developed and verified. Additions to future models are suggested. Theoretical, clinical, and research implications are discussed.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Participation model—12 months. χ2 = 118.13, df = 40, P = 0.0000, normed χ2 = 2.95, RMSEA = 0.066 (0.052; 0.079). Standardized model shown. Negative correlations reflect the measures PBSI and the EQ5D, where the highest score is the worse health condition. SF-36 Short Form 36, SIS Stroke Impact Scale, PBSI Preference Based Stroke Index, EQ5D EuroQol 5 dimensions
Fig. 2
Fig. 2
Representative photos
Fig. 3
Fig. 3
Participation model—suggested additions based on qualitative component. Dotted lines represent additions to the model
See this image and copyright information in PMC

References

    1. Renwick R, Friefeld S. Quality of life and rehabilitation. In: Renwick R, Brown I, Nagler M, editors. Quality of life in health promotion and rehabilitation. Thousand Oaks: SAGE Publications; 1996. pp. 26–37.
    1. Mayo N, Wood-Dauphinee S, Cote R, Durcan L, Carlton J. Activity, participation, and quality of life 6 months poststroke. Archives of Physical Medicine and Rehabiltation. 2002;83:1035–1042. doi: 10.1053/apmr.2002.33984. - DOI - PubMed
    1. Sprangers MA. Quality-of-life assessment in oncology. Achievements and challenges. Acta oncologica Stockholm, Sweden. 2002;41:229–237. doi: 10.1080/02841860260088764. - DOI - PubMed
    1. Barclay-Goddard, R., Mayo, N., Lix, L., Tate, R., & Weinberg, L. (2008). Does response shift occur in physical function post stroke? In Proceedings of Canadian Physiotherapy Association Congress.
    1. Barclay-Goddard R, Lix L, Tate R, Weinberg L, Mayo N. Response shift was identified over multiple occasions with a structural equation modeling framework. Journal of Clinical Epidemiology. 2009;62:1181–1188. doi: 10.1016/j.jclinepi.2009.03.014. - DOI - PubMed

Publication types