| Objective：The aim of this thesis was to produce the Chinese version of the Impact onParticipation and Autonomy (IPA) questionnaire and psychometric evaluation of thetranslated version to be used for persons with stroke and to explore and describeparticipation in daily life, and the factors associated with participation among persons withstroke survivors in community.Methods: This thesis was based on two studies. Study I developed the Chineseversion of Impact on Participation and Autonomy (IPA) questionnaire following aforward-backward translation procedure and cross-cultural adaptation process andevaluated the psychometric properties of the Chinese version of the Impact on Participationand Autonomy questionnaire (IPA-C) by testing the concurrent, construct validity, as wellas internal reliability, test-retest reliability.Study II, a total of197persons with stroke wereassessed in different aspects of functioning, contextual factors, and health conditions.Analysis the impacting factors of participation after stroke dwelling in community.Result:The founding of study I showed that domain of work and education was leftout for the low reply and Cronbach’s alphas for the remaining26items of IPA-I was0.959,for the four domains of IPA-I reange between0.782-0.965,for the IPA-II was0.905,indicating good homogeneity.1item (intimate relationship) was deleted for the lowcorrelations with totle score (r=0.173). The test-retest reliability of IPA-I ranged from0.915-0.984，IPA-II0.898.Convergent validity was largely supported by the correlationsbetween the Chinese version of London Handicap scale and the IPA. The correlations ofChinese version of IPA-I and Chinese version LHS was0.807, the correlations of Chineseversion of IPA-II and Chinese version LHS was0.657.Factor analysis extracted4factorswhich were approximately consistent with the structure and content of the foursubscales．The founding of study2showed score of participation was40.4±22.87,thestandardized mean score of participation in descending order were as thefollowing:outdoor autonomy（2.1±1.2）,family role（1.9±1.2）,social life（1.4±0.7）,indoorautonomy（1.2±1.1）.It was also identified physical function,anxiety,access to deseaseinformation,avoidance of medical coping and gender as the most influential variablesassociated with dimensions of indoor autonomy,wich explain69.1%variables; andphysical function,depression,access to rehabilitation service,subjective social support,access to desease informations and anxiety as the most influential variable associated withdimensions of family role, which explain58.6%; and physicial function, subjective social support,depression,access to rehabilitation service, access to desease information,obstacle-free facilities of community and restruction of family environment as the mostinfluential variables associated with dimensions of outdoor autonomy, which explain64.4%variables; and subjective social support, family function, access to deseaseinformation, physical function, anxiety and gender as the most influential variablesassociated with dimensions of social life, which explain45.5%variables.Conclusion:①The findings show that the Chinese version of IPA is a valid,reliableand acceptable measure of participation in people with chronic stroke.②The findingsdemonstrate that the stroke survivors have restriction in dementions of participation.Themost influential variables of participation of stroke survivors were physical function, moodstate, and the environmental factors should not be neglected. It is importance of providingculturally sensitive rehabilitation based on the individuals’ needs and consistent with thesociocultural context when planning appropriate rehabilitation interventions. |
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