Lizette Norin

BACKGROUND The built environment needs to be designed so that all people can participate in the activities they want and need to do. Yet, accessibility is difficult to put into practice, and accessibility issues tend to be overlooked in the building and planning processes. OBJECTIVES The aim of this scoping review was to summarize the research front in the area of accessibility to public buildings. Specific aims were to identify knowledge gaps, to identify access activities in relation to environmental features and to link to predominant activities in terms of the International Classification of Functioning, Disability and Health (ICF). METHODS A literature search was performed in PubMed, PsycINFO, Inspec, Embase and Cochrane databases. Articles in English based on original empirical studies investigating accessibility of public buildings for adults aged ≥18 years with functional limitations were considered. RESULTS Of the 40 articles included, ten involved study participants, while 30 only examined buildings using instruments to assess accessibility. In addition, the psychometric properties were only tested for a few of them. All articles concerned mobility and several visual limitations, while few addressed cognitive or hearing limitations. Ten main access activities were identified, from using parking/drop-off area to exiting building. CONCLUSIONS By using the ICF and theoretically relating the accessibility problems to activities, the results revealed that there are large knowledge gaps about accessibility to public buildings for older people and people with functional limitations and that there is a need for more methodological considerations in this area of research.

Background: Advances in acute treatment, physiatric care, and rehabilitation have improved survival greatly after spinal cord injury (SCI) and increased longevity. This has led to a need for an in-depth understanding of factors associated with healthy aging in people with long-term SCI. Objective: To present the methodology and initial results of the Swedish Aging with Spinal Cord Injury Study, a longitudinal cohort survey targeting older adults with long-term SCI. Design: Cross-sectional cohort study. Setting: Home and community settings. Participants: People aged 50 years or older with SCI for at least 10 years. Methods: Data were collected through interviews and assessments during home visits and from the participants’ medical records. Main Outcome Measurements: Study-specific protocol with custom-designed questions, and validated generic and SCI-specific assessment tools focusing on functioning, disability, health, well-being, lifestyle, and personal and environmental factors. Results: Of 795 potential participants, 184 matched the inclusion criteria and the final sample comprised 123 participants (67% response rate; 36 women and 87 men, mean age 63 � 9 years, mean time since injury 24 � 12 years). Traumatic SCI accounted for 62%, and 31% had sustained a complete SCI. A majority was married or had a partner, and used some form of assistance and/or mobility device. Thirty-five percent were working full-time or part-time. Based on the American Spinal Injury Association Impairment Scale (AIS), 3 groups of SCI severity were formed. There were no significant differences in chronological age, marital status, or vocational situation between the tetraplegia AIS A-C group (n ¼ 22), the paraplegia AIS A-C group (n ¼ 41), and the all AIS D group (n ¼ 60). Participants in the all AIS D group were significantly older at injury, had a shorter time since injury, and were less likely to use mobility devices compared with the other 2 groups. Conclusion: These baseline data of the Swedish Aging with Spinal Cord Injury Study provide a description of older adults with longterm SCI. Forthcoming studies and subsequent follow-ups will generate new insights into factors that promote healthy aging, minimize disability and enhance participation, quality of life, and life satisfaction in people aging with long-term SCI.

Background: Advances in acute treatment, physiatric care, and rehabilitation have improved survival greatly after spinal cord injury (SCI) and increased longevity. This has led to a need for an in-depth understanding of factors associated with healthy aging in people with long-term SCI. Objective: To present the methodology and initial results of the Swedish Aging with Spinal Cord Injury Study, a longitudinal cohort survey targeting older adults with long-term SCI. Design: Cross-sectional cohort study. Setting: Home and community settings. Participants: People aged 50 years or older with SCI for at least 10 years. Methods: Data were collected through interviews and assessments during home visits and from the participants’ medical records. Main Outcome Measurements: Study-specific protocol with custom-designed questions, and validated generic and SCI-specific assessment tools focusing on functioning, disability, health, well-being, lifestyle, and personal and environmental factors. R...

Introduction Adults with spinal cord injuries are living longer than previously, and a majority are living in ordinary housing in the community. Housing accessibility is important for maintaining independent occupational performance for this population, but knowledge in this area is insufficient. We investigated housing adaptations and current accessibility problems among older adults with long-standing (>10 years) spinal cord injuries. Method Data from home visits among 122 older adults with spinal cord injuries in Sweden were used. Housing adaptations and environmental barriers were descriptively analysed. Findings Kitchens, entrances, and hygiene areas were common locations for housing adaptations and environmental barriers that generated accessibility problems. The most common adaptations were ramps, wheelchair-accessible stovetops, and ceiling-lifts. Wall-mounted cupboards and high shelves (kitchen), inaccessible storage areas (outside the dwelling), and a lack of grab bars ...

Introduction The Housing Enabler instrument, designed to measure housing accessibility, has not been used in samples with long-standing spinal cord injury. We aimed to investigate potential threats to the reliability and validity of the instrument when used among older adults with spinal cord injury. Method Cross-sectional data from the Swedish Aging with Spinal Cord Injury Study ( N = 123, injury levels C1–L5) were utilised. The potential effect on the reliability and content validity of the House Enabler was qualitatively considered and reviewed in an iterative evaluation procedure. To analyse the potential effect on construct validity, simulations adjusting accessibility problem scores for housing adaptations and use of mobility devices were conducted. Findings Considerable threats to the reliability and content validity of the Housing Enabler were identified. The simulated analysis of construct validity showed a modest overall effect on the accessibility problem scores, although...

En stodjande miljo ar centralt for att kunna uppratthalla ett sjalvstandigt liv och effektivt aktivitetsutforande, sarskilt med okande alder. For personer med funktionella begransningar, som konsekvenserna av en ryggmargsskada, ar balansen mellan personens funktionella kapacitet och miljons krav av yttersta vikt for att kunna leva ett sa valfungerande liv som mojligt. Livslangden efter en ryggmargsskada har okat dramatiskt sedan mitten av 1940-talet, aven om den fortfarande ar kortare an for befolkningen i allmanhet. Detta speglar bade den okande livslangden hos befolkningen i stort, och utvecklingen av akut omhandertagande, rehabilitering och vard av ryggmargsskadade. Trots detta var det inte forran under 1980-talet som personer med ryggmargsskada borjade uppna hog alder i storre utstrackning an tidigare. Ett overgripande syfte bade i rehabilitering och arbetsterapi ar forbattrad delaktighet, dar olika miljofaktorer kan stodja eller komplicera aktivitetsutforande. Bostadsanpassning...

To describe how men and women experience their use of powered wheelchairs (PW) and powered scooters (PS) in everyday occupations, in the home and in society at large. A qualitative research approach with focus-group methodology was used. Four focus groups were created, with men and women as well as PW and PS users in different groups. Applying a descriptive approach, data were analysed according to the principles described by Krueger. Three categories emerged and revealed that even though use of PW and PS increased independence and enabled everyday occupations, participants struggled to be independent powered mobility device (PMD) users. They experienced many accessibility problems in dwellings and in society, described similarly by users of PW and PS. Men and women experienced their use of (PMD) differently, especially in relation to the service delivery process. The study contributes with new knowledge on accessibility for PW and PS users and related service delivery processes, stating that gender differences regarding provision and training must be taken into account. Occupational therapists can contribute to an enhanced understanding of PMD users' challenges in person-environment-occupation transactions in the home and society, and thereby promote occupational justice for PMD users.