Differences in societal participation across diagnostic groups: Secondary analyses of eight studies using the Utrecht Scale for Evaluation of Rehabilitation-Participation.

Objectives To determine differences in participation problems between diagnostic groups and to examine diagnosis as a determinant of participation with and without statistically accounting for confounders. Design Secondary analyses of data from eight studies (total 1,735 participants). Setting Community, the Netherlands PARTICIPANTS: Diagnostic-groups included: stroke (n=534), subarachnoid hemorrhage (n=104), other acquired brain injury (n=163), progressive neurological diseases (n=112), acute coronary syndrome (n=536) and spinal cord injury (n=286). Main outcome measure Participation was measured with the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation). This measure has three scales: Restrictions, Satisfaction and Frequency. Scores were also computed for three domains across these scales: Productivity, Leisure and Social in this study. The range of all scores is from 0 (worst) up to 100 (best). Possible confounders were age, sex, level of education, marital status and time since onset of the condition. Results Significant differences in levels of participation between diagnostic-groups were found. People with acute coronary syndrome showed better participation scores in all scales and domains compared to most or all other diagnostic groups, except for the Social domain. People with progressive neurological diseases showed the lowest (worst) Restriction- and Satisfaction scores, whereas people with stroke showed the lowest Frequency scores. After correcting for confounders, diagnosis explained significant proportions of the variance of participation (Frequency 6.4%; Restrictions 15.1%; Satisfaction 5.1%, Productivity 13.2%; Leisure 13.8%; Social: 6.9%). Conclusions Participation problems occurred in all six diagnostic groups within this study. Differences in participation between diagnostic-groups were found, thereby showing diagnosis-specific participation profiles, also after correcting for confounders.