![]() ![]() ![]() Therefore, the aim of this study was to translate the KAP into Dutch and examine the measurement properties of the Dutch version of the KAP in older adults with joint pain and comorbidity.įirst, two persons (bilingual speakers with Dutch as first language one with a medical background and the other without) independently translated the KAP into Dutch followed by a consensus meeting. 21 However, it has not been tested in a Dutch older population and evidence is lacking for its dimensionality and responsiveness. 20 In contrast, the Keele Assessment of Participation (KAP) was suitable for our study it is brief (contains 11 items), designed to be self-administered and there is some evidence of sufficient measurement properties to support its potential application in epidemiological studies in older populations. The same held for several commonly used instruments developed in English that is, the Participation Objective, Participation Subjective, 18 the Rating of Perceived Participation 19 and the Social Role Participation Questionnaire. 17 However, these questionnaires were not suitable for our study because they were developed for specific populations, a different (rehabilitation) setting, were not to be self-administrated and/or too burdensome because of an extensive number of items. 11 12 Four Dutch questionnaires have been designed to capture participation: the Impact on Participation and Autonomy (IPA), 13 the Utrecht Scale for Evaluation of Rehabilitation-Participation, 14 15 the Participation Scale 16 and the Maastricht Social Participation Profile. 10 There are instruments available that measure participation in accordance with the definition proposed by the ICF model. In a large cohort study in the Netherlands, we wanted to investigate the impact of joint pain and comorbidity on social participation, as joint pain and other chronic diseases often co-occur in older populations and the combination of diseases can increase levels of disability. ![]() 1 8 Significantly, participation can be maintained in older adults despite the presence of impairments and physical limitations, 9 which provides other opportunities for optimising healthcare. 4 Furthermore, maintaining participation is linked with lower levels of morbidity and mortality, 6 7 a key component of healthy ageing and well-being and therefore increasingly included as a target for intervention. ![]() Participation allows fulfilment of valued life activities, aspects of identity and social roles (eg, being a worker, carer or community member), 2–5 which are indicated as important by older adults. This goes beyond measuring the individual's capacity to fulfil basic tasks (ie, activity limitations), such as walking or gripping objects, and includes interaction between an individual's capabilities and his environment and needs. Measuring participation (or restriction in participation) offers the potential to capture the impact of health conditions in the context in which people live. 2 Of the different levels of disability, participation has been considered least in research studies. 1 The WHO proposes the International Classification of Functioning, Disability and Health (ICF) to classify disability into biological (ie, impairments), individual (ie, activity limitation) and societal (ie, participation restriction) levels. Identifying and preventing the disabling effects of highly prevalent diseases in older adults, such as joint pain, is a major health priority for clinicians. ![]()
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