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There is limited empirical knowledge about how older adults living with dementia enact their social citizenship through out-of-home participation. This study aimed: (a) to investigate out-of-home participation among older adults with and without dementia in four countries and (b) to compare aspects of stability or change in out-of-home participation. Using a cross-sectional design, older adults with mild-to-moderate dementia and without dementia, aged 55 years and over, were interviewed using the Participation in ACTivities and Places OUTside the Home questionnaire in Canada ( n = 58), Sweden ( n = 69), Switzerland ( n = 70), and the United Kingdom ( n = 128). Data were analyzed using descriptive statistics and a two-way analysis of variance. After adjustment for age, diagnosis of dementia and country of residence had significant effects on total out-of-home participation ( p < .01). The results contribute to policies and development of programs to facilitate social citizenship by targeting specific activities and places.

Background. Persons living with dementia face a reduction of their life space outside home and disengagement from participation, linked to places visited. Purpose. This study explored stability and change in perceived participation in places visited outside home and its relationship with occupational gaps among older adults. Method. Older adults living with ( n = 35) or without ( n = 35) dementia were interviewed using the Participation in ACTivities and Places OUTside Home (ACT-OUT) questionnaire and the Occupational Gaps Questionnaire (OGQ). Data analysis used descriptive and inferential statistics. Findings. The group of people living with dementia reported significantly fewer places ( p < .001) visited than the comparison group and having abandoned more places visited ( p < .001) than the comparison group. The number of occupational gaps was significantly different between groups ( p < .001). Implications. Participation outside home is not influenced in a uniform and straightforward way for persons living with dementia; the shrinking world effect appears differently in relation to types of places.

Introduction Older persons with cognitive impairment have often been disregarded in providing information on their own perceptions. This study explored the number of relevant everyday technologies and the ability to use everyday technologies as perceived by persons with cognitive impairment in comparison with their proxies’ estimates using the Short Everyday Technology Use Questionnaire. Method In this cross-sectional study, persons with cognitive impairment ( n = 21) and their proxies ( n = 21) were interviewed on separate occasions with the Short Everyday Technology Use Questionnaire, which measures the number of relevant everyday technologies and the ability to use everyday technologies. The data were analysed with t-tests, z-comparisons, and Fisher’s exact test. The level of significance was set at p Results At the group level, no significant differences were found between persons with cognitive impairments’ perceptions and their proxies’ estimates regarding the number of relevant everyday technologies or the ability to use everyday technologies. On the individual level, significant differences were found in the ability measures within four out of the 21 dyads. Conclusion The persons with cognitive impairment and their proxies verified each other’s responses, providing evidence that persons with cognitive impairment should be the primary source for information about their own everyday technology use.

Background: Older adults manage increasing numbers of everyday technologies to participate in home and community activities. Purpose: We investigated how assessing use of everyday technologies enhanced predictions of overall needed assistance among urban older adults. Method: We used a cross-sectional design to analyze responses from 114 participants completing the Everyday Technology Use Questionnaire, the Montreal Cognitive Assessment, and a sociodemographic questionnaire. We estimated overall needed assistance based on definitions in the Assessment of Motor and Process Skills. We created logistic regression models and receiver operator characteristic curves to analyze variables predicting overall needed assistance. Findings: With high specificity and sensitivity, the Everyday Technology Use Questionnaire and the Montreal Cognitive Assessment were the strongest predictors of overall needed assistance. Implications: Assessing everyday technology use enhanced predictions of overall needed assistance among urban older adults.

Objectives: The aim of this pilot study was to explore psychometric properties of two versions of the Home Observation for Measurement of the Environment Inventory in a Swedish social service sample. Method: Social workers employed at 22 Swedish child protections agencies participated in the data collection. Both classic test theory approaches and Rasch analysis were used. Seventy-five (46 double) protocols of the Early Childhood version and 65 (43 double) protocols of the Middle Childhood version were obtained. Results: The interobserver reliability and Rasch reliability displayed acceptable results. Targeting was satisfying for the middle and more adequate home environments. However, there were mixed results concerning model fit. Conclusion: The scores may be used to identify families with inadequate home environments where children may be at risk.

Introduction: Occupational therapists working in psychiatry are routinely required to undertake vocational assessments and to support clients into work. To make such efforts successful, the use of evidence-based practice and outcome measures is becoming increasingly important. Objectives: The objectives were to examine the psychometric properties of the Worker Role Interview (WRI, version 10.0) with a psychiatric population in the United Kingdom, particularly its construct validity as a baseline assessment and an outcome measure. Method: Data were collected from 34 psychiatric clients rated by seven occupational therapists. Rasch analysis was used to examine scale validity, validity of therapists' rating patterns of clients, rater consistency, precision of client measurement and the scale's aptitude in detecting different ability levels. Results: All items except one demonstrated acceptable goodness-of-fit to the Rasch model. Over 90% of clients fitted the model. The scale detected five ability levels, but client measures were slightly imprecise. Raters used the scale consistently and implications of rater leniency are discussed. Conclusion: The study provides evidence of construct validity, supporting the use of the WRI as a standardised baseline assessment in a mental health population. Further development of the WRI might be indicated and its usefulness as an outcome measure should be tested with larger samples.

Background. Limited self-awareness of disabilities can compromise individuals' occupational performance. Purpose. The Assessment of Awareness of Disability (AAD) provides occupational therapists with a standardized methodology for measuring clients' self-awareness when performing activities of daily living (ADL). This is the first study that formally examines the stability of the AAD measures. Methods. The AAD was administered twice to 15 participants with acquired brain injury (ABI) within one or two days. One participant's data were excluded because significant changes in his ADL process abilities were detected. Two criteria were used to examine the stability of the remaining 14 participants' AAD measures: standardized diference Z-scores and a difference of 0.65 logits. Findings. All 14 participants' AAD measures were stable on the basis of their Z-scores; 13 participants' measures were stable based on the 0.65 logit difference. Implications. Occupational therapists can have confidence that the AAD generates stable measures when administered to adults with ABI.

Because the ability to perform activities of daily living (ADL) is associated with global aspects of community functioning, it is critical to evaluate whether the information gained from specific ADL assessments contributes to a reliable prediction of the overall amount of assistance needed for a person to function in the community. The purpose of this study was to evaluate the predictive use of an ADL assessment, the Assessment of Motor and Process Skills (AMPS), to determine which people with mental retardation need support or assistance to function in the community. A sample of 380 data records from the AMPS international database of people with various levels of mental retardation was included in the study. Many-faceted Rasch analyses and logistic regression models were used for data analysis. The results indicated that only the AMPS ADL process ability measures contributed significantly and substantially to the prediction of the level of assistance required to function in the community for individuals with mild to moderate mental retardation when used in conjunction with age, gender, and level of mental retardation. The results have clinical implications for occupational therapists working with these people because ADL process ability can be improved by occupational therapy interventions.