Using Self-Regulation Assessment to Explore Associations between Self-Regulation, Participation and Health-Related Quality of Life in a Rehabilitation Population

Authors

  • Tanja I. Mol Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen
  • Eline W. M. Scholten Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht
  • Coen A. M. van Bennekom Heliomare Rehabilitation Center, Research and Development, Wijk aan Zee; Amsterdam University Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam
  • Johanna M. A. Visser Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht; Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Centre, University Medical Centre Utrecht
  • Michiel F. Reneman University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen
  • Vincent de Groot Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam
  • Jan-Willem G. Meijer Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht; De Hoogstraat Rehabilitation, Utrecht, The Netherlands
  • Rob J.E.M. Smeets Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Life Sciences and Medicine, Maastricht University, Maastricht, Netherlands; CIR Rehabilitation, Netherlands; Pain in Motion International Research Group (PiM)
  • Marcel W. M. Post Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen

DOI:

https://doi.org/10.2340/jrm.v55.2531

Keywords:

Self-regulation, Participation, Health-Related Quality of life, Rehabilitation, Outcome measurement

Abstract

Objective: Self-regulation, participation and health-related quality of life are important rehabilitation outcomes. The aim of this study was to explore associations between these outcomes in a multi-diagnostic and heterogenic group of former rehabilitation patients.
Methods: This cross-sectional survey used the Self-Regulation Assessment (SeRA), Utrecht Scale for Evaluation of Rehabilitation-participation (USERParticipation) and the Patient-Reported-Outcome-Measurement-System (PROMIS) ability and PROMIS satisfaction with participation in social roles, and the EuroQol-5L-5D and PROMIS-10 Global Health. Regression analyses, controlling for demographic and condition-related factors, were performed.
Results: Respondents (n = 563) had a mean age of 56.5 (standard deviation (SD) 12.7) years. The largest diagnostic groups were chronic pain disorder and brain injury. In addition to demographic and condition-related factors, self-regulation subscales explained 0–15% of the variance in participation outcome scores, and 0–22% of the variance in HRQoL outcome scores. Self-regulation subscales explained up to 22% of the variance in satisfaction subscales of participation (USER-Participation and PROMIS) and the mental health subscale of the PROMIS-10. Self-regulation subscales explained up to 11% of the restriction and frequency subscales of participation (USER-Participation) and the physical health subscale of the PROMIS-10.
Conclusion: Self-regulation is more strongly associated with outcomes such as satisfaction with participation and mental health compared with outcomes such as restrictions in participation and physical health.

LAY ABSTRACT
This article provide insights into the assocations between self-regulation, participation and health-related quality of life. This was studied in a rehabilitation population. Diagnostic groups included were: brain injury, chronic pain disorder, spinal cord injury, neurological and neuromuscular disorder, musculoskeletal disorder and oncology. We found that persons with higher levels of self-regulation, experience more satisfaction with their functioning in the community and experience less mental health problems. Also, when persons have trust in themselves, they tend to have less mental health problems and are more satisfied in their daily life.

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References

World Health Organization. Rehabilitation in health systems. Geneva: WHO; 2017.

World Health Organization. International classification of functioning, disability and health: ICF. Geneva: WHO; 2001, p. 299.

Barthel D, Otto C, Nolte S, Meyrose AK, Fischer F, Devine J, et al. The validation of a computer-adaptive test (CAT) for assessing health-related quality of life in children and adolescents in a clinical sample: study design, methods and first results of the Kids-CAT study. Qual Life Res An Int J Qual Life Asp Treat Care Rehabil 2017; 26: 1105-1117. DOI: https://doi.org/10.1007/s11136-016-1437-9

https://doi.org/10.1007/s11136-016-1437-9 DOI: https://doi.org/10.1007/s11136-016-1437-9

Brands I, Köhler S, Stapert S, Wade D, van Heugten C. Influence of self-efficacy and coping on quality of life and social participation after acquired brain injury: a 1-year follow-up study. Arch Phys Med Rehabil 2014; 95: 2327-2334. DOI: https://doi.org/10.1016/j.apmr.2014.06.006

https://doi.org/10.1016/j.apmr.2014.06.006 DOI: https://doi.org/10.1016/j.apmr.2014.06.006

Hoving JL, Van Der Meer M, Volkova AY, Frings-Dresen MHW. Illness perceptions and work participation: a systematic review. Int Arch Occup Environ Health 2010; 83: 595-605. DOI: https://doi.org/10.1007/s00420-010-0506-6

https://doi.org/10.1007/s00420-010-0506-6 DOI: https://doi.org/10.1007/s00420-010-0506-6

Peter C, Müller R, Post MWM, van Leeuwen CMC, Werner CS, Geyh S. Psychological resources, appraisals, and coping and their relationship to participation in spinal cord injury: a path analysis. Arch Phys Med Rehabil 2014; 95: 1662-1671. DOI: https://doi.org/10.1016/j.apmr.2014.04.012

https://doi.org/10.1016/j.apmr.2014.04.012 DOI: https://doi.org/10.1016/j.apmr.2014.04.012

Mol TI, van Bennekom CAM, Scholten EWM, Visser-Meily JMA, Reneman MF, Riedstra A, et al. Self-regulation as rehabilitation outcome: what is important according to former patients? Disabil Rehabil 2021; Nov 6: 1-7.

Wilski M, Tasiemski T. Health-related quality of life in multiple sclerosis: role of cognitive appraisals of self, illness and treatment. Qual Life Res 2016; 25: 1761-1770. DOI: https://doi.org/10.1007/s11136-015-1204-3

https://doi.org/10.1007/s11136-015-1204-3 DOI: https://doi.org/10.1007/s11136-015-1204-3

Meulenkamp T, Rijken M, Cardol M, Francke AL, Rademakers J. People with activity limitations' perceptions of their health condition and their relationships with social participation and experienced autonomy. BMC Public Health 2019; 19: 1-10. DOI: https://doi.org/10.1186/s12889-019-7698-9

https://doi.org/10.1186/s12889-019-7698-9 DOI: https://doi.org/10.1186/s12889-019-7698-9

Geytenbeek M, Fleming J, Doig E, Ownsworth T. The occurrence of early impaired self-awareness after traumatic brain injury and its relationship with emotional distress and psychosocial functioning. Brain Inj 2017; 31: 1791-1798. DOI: https://doi.org/10.1080/02699052.2017.1346297

https://doi.org/10.1080/02699052.2017.1346297 DOI: https://doi.org/10.1080/02699052.2017.1346297

Giles GM, Clark-Wilson J, Baxter DM, Tasker R, Holloway M, Seymour S. The interrelationship of functional skills in individuals living in the community, following moderate to severe traumatic brain injury. Brain Inj 2019; 33: 129-136. DOI: https://doi.org/10.1080/02699052.2018.1539762

https://doi.org/10.1080/02699052.2018.1539762 DOI: https://doi.org/10.1080/02699052.2018.1539762

Geyh S, Nick E, Stirnimann D, Ehrat S, Michel F, Peter C, et al. Self-efficacy and self-esteem as predictors of participation in spinal cord injury-an ICF-based study. Spinal Cord 2012; 50: 699-706. DOI: https://doi.org/10.1038/sc.2012.18

https://doi.org/10.1038/sc.2012.18 DOI: https://doi.org/10.1038/sc.2012.18

Martins AC. Using the International Classification of Functioning, Disability and Health (ICF) to address facilitators and barriers to participation at work. Work 2015; 50: 585-593. DOI: https://doi.org/10.3233/WOR-141965

https://doi.org/10.3233/WOR-141965 DOI: https://doi.org/10.3233/WOR-141965

Keysor JJ, Jette AM, Coster W, Bettger JP, Haley SM. Association of environmental factors with levels of home and community participation in an adult rehabilitation cohort. Arch Phys Med Rehabil 2006; 87: 1566-1575. DOI: https://doi.org/10.1016/j.apmr.2006.08.347

https://doi.org/10.1016/j.apmr.2006.08.347 DOI: https://doi.org/10.1016/j.apmr.2006.08.347

Mol. TI, van Bennekom. CA, Scholten EWM, Post MWM. Measures of self-regulation used in adult rehabilition populations: a systematic review and content screening. Clin Rehabil 2022; 36: 1120-1138. DOI: https://doi.org/10.1177/02692155221091510

https://doi.org/10.1177/02692155221091510 DOI: https://doi.org/10.1177/02692155221091510

Revalidatie Nederland. Brancherapport Revalidatie 2019 [Rehabilitation Report 2019]. Utrecht; 2019. Revalidatie Nederland.

Veld de D. Oncologische revalidatie geen luxe [Oncological rehabilition not luxury]. Medische oncologie 2018; 7: 44-47.

Mol TI, van Bennekom CAM, Scholten EWM, Visser-Meily JMA, Beckerman H, Passier PECA, et al. The Self-Regulation Assessment (SeRA) questionnaire: development and exploratory analyses of a new patient-reported outcome measure for rehabilitation. Disabil Rehabil 2022; Jun 7: 1-8. DOI: https://doi.org/10.1080/09638288.2022.2080289

https://doi.org/10.1080/09638288.2022.2080289 DOI: https://doi.org/10.1080/09638288.2022.2080289

Mol, TI Scholten, EWM Bennekom, CAM. Post MWM. Development of a novel self-regulation measure and content validation using cognitive interviews in a multicultural rehabilitation population. [Submitted for publication] 2022.

Van Der Zee CH, Priesterbach AR, Van Dussen L Der, Kap A, Schepers VPM, Visser-Meily JMA, et al. Reproducibility of three self-report participation measures: The ICF measure of participation and activities screener, the participation scale, and the utrecht scale for evaluation of rehabilitation-participation. J Rehabil Med 2010; 42: 752-757. DOI: https://doi.org/10.2340/16501977-0589

https://doi.org/10.2340/16501977-0589 DOI: https://doi.org/10.2340/16501977-0589

Terwee CB, Crins MHP, Boers M, de Vet HCW, Roorda LD. Validation of two PROMIS item banks for measuring social participation in the Dutch general population. Qual Life Res 2019; 28: 211-220. DOI: https://doi.org/10.1007/s11136-018-1995-0

https://doi.org/10.1007/s11136-018-1995-0 DOI: https://doi.org/10.1007/s11136-018-1995-0

Mol, TI. Bennekom CAM, Scholten, EWM, Post MWM. Het Meten van Uitkomsten van Revalidatie in Nederland (MUREVAN) (Measurement of outcomes of rehabilitation in the Netherlands). Ned Tijdschr voor Revalid (Dutch J Rehabil) 2021; 43: 13-15.

Janssen MF, Pickard AS, Golicki D, Gudex C, Niewada M, Scalone L, et al. Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study. Qual Life Res 2013; 22: 1717-1727. DOI: https://doi.org/10.1007/s11136-012-0322-4

https://doi.org/10.1007/s11136-012-0322-4 DOI: https://doi.org/10.1007/s11136-012-0322-4

Pellicciari L, Chiarotto A, Giusti E, Crins MHP, Roorda LD, Terwee CB. Psychometric properties of the patient-reported outcomes measurement information system scale v1.2: global health (PROMIS-GH) in a Dutch general population. Health Qual Life Outcomes 2021; 19: 1-17. DOI: https://doi.org/10.1186/s12955-021-01855-0

https://doi.org/10.1186/s12955-021-01855-0 DOI: https://doi.org/10.1186/s12955-021-01855-0

Terwee CB, Prinsen CAC, Chiarotto A, Westerman MJ, Patrick DL, Alonso J, et al. COSMIN methodology for evaluating the content validity of patient-reported outcome measures: a Delphi study. Qual Life Res 2018; 27: 1159-1170. DOI: https://doi.org/10.1007/s11136-018-1829-0

https://doi.org/10.1007/s11136-018-1829-0 DOI: https://doi.org/10.1007/s11136-018-1829-0

Poerbodipoero SJ, Sturkenboom IH, van Hartingsveldt MJ, Nijhuis-van der Sanden MWG, Graff MJ. The construct validity of the Dutch version of the activity card sort. Disabil Rehabil 2016; 38: 1943-1951. DOI: https://doi.org/10.3109/09638288.2015.1107779

https://doi.org/10.3109/09638288.2015.1107779 DOI: https://doi.org/10.3109/09638288.2015.1107779

Post MWM, Van Der Zee CH, Hennink J, Schafrat CG, Visser-Meily JMA, Van Berlekom SB. Validity of the Utrecht scale for evaluation of rehabilitation - participation. Disabil Rehabil 2012; 34: 478-485. DOI: https://doi.org/10.3109/09638288.2011.608148

https://doi.org/10.3109/09638288.2011.608148 DOI: https://doi.org/10.3109/09638288.2011.608148

Van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D, et al. Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Heal 2012; 15: 708-715. DOI: https://doi.org/10.1016/j.jval.2012.02.008

https://doi.org/10.1016/j.jval.2012.02.008 DOI: https://doi.org/10.1016/j.jval.2012.02.008

Feng YS, Kohlmann T, Janssen MF, Buchholz I. Psychometric properties of the EQ-5D-5L: a systematic review of the literature. Qual Life Res 2021; 30: 647-673. DOI: https://doi.org/10.1007/s11136-020-02688-y

https://doi.org/10.1007/s11136-020-02688-y DOI: https://doi.org/10.1007/s11136-020-02688-y

Hays RD, Bjorner JB, Revicki DA, Spritzer KL, Cella D. Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Qual Life Res 2009; 18: 873-880. DOI: https://doi.org/10.1007/s11136-009-9496-9

https://doi.org/10.1007/s11136-009-9496-9 DOI: https://doi.org/10.1007/s11136-009-9496-9

Sharma B. A focus on reliability in developmental research through Cronbach's alpha among medical, dental and paramedical professionals. Asian Pacific J Heal Sci 2016; 3: 271-278. DOI: https://doi.org/10.21276/apjhs.2016.3.4.43

https://doi.org/10.21276/apjhs.2016.3.4.43 DOI: https://doi.org/10.21276/apjhs.2016.3.4.43

Cohen J. Statistical power analysis for behavioral science. Second edn. New York: Lawrence Erlbaum Associates, Inc; 1988, p. 283.

Stucki G, Cieza A, Melvin J. The International Classification of Functioning, Disability and Health: a unifying model for the conceptual description of the rehabilitation strategy. J Rehabil Med 2007; 39: 279-285. DOI: https://doi.org/10.2340/16501977-0041

https://doi.org/10.2340/16501977-0041 DOI: https://doi.org/10.2340/16501977-0041

Jette AM, Keysor J, Coster W, Ni P, Haley S. Beyond function: predicting participation in a rehabilitation cohort. Arch Phys Med Rehabil 2005; 86: 2087-2094. DOI: https://doi.org/10.1016/j.apmr.2005.08.001

https://doi.org/10.1016/j.apmr.2005.08.001 DOI: https://doi.org/10.1016/j.apmr.2005.08.001

Gross-Hemmi MH, Post MWM, Bienert S, Chamberlain JD, Hug K, Jordan X, et al. Participation in people living with spinal cord injury in switzerland: degree and associated factors. Arch Phys Med Rehabil 2019; 100: 1894-1906. DOI: https://doi.org/10.1016/j.apmr.2019.03.018

https://doi.org/10.1016/j.apmr.2019.03.018 DOI: https://doi.org/10.1016/j.apmr.2019.03.018

van Diemen T, Craig A, van Nes IJW, van Laake C, Bloemen J, Stolwijk-Swuste J, et al. Enhancing our conceptual understanding of state and trait self-efficacy by correlational analysis of four self-efficacy scales in people with spinal cord injury. BMC Psychol 2020; 8: 1-9. DOI: https://doi.org/10.1186/s40359-020-00474-6

https://doi.org/10.1186/s40359-020-00474-6 DOI: https://doi.org/10.1186/s40359-020-00474-6

Jones F, Riazi A. Self-efficacy and self-management after stroke: a systematic review. Disabil Rehabil 2011; 33: 797-810. DOI: https://doi.org/10.3109/09638288.2010.511415

https://doi.org/10.3109/09638288.2010.511415 DOI: https://doi.org/10.3109/09638288.2010.511415

Rottmann N, Dalton SO, Christensen J, Frederiksen K, Johansen C. Self-efficacy, adjustment style and well-being in breast cancer patients: a longitudinal study. Qual Life Res 2010; 19: 1-10. DOI: https://doi.org/10.1007/s11136-010-9653-1

https://doi.org/10.1007/s11136-010-9653-1 DOI: https://doi.org/10.1007/s11136-010-9653-1

Tielemans NS, Schepers VP, Visser-Meily JM, Post MW, van Heugten CM. Associations of proactive coping and self-efficacy with psychosocial outcomes in individuals after stroke. Arch Phys Med Rehabil 2015; 96: 1484-1491. DOI: https://doi.org/10.1016/j.apmr.2015.04.009

https://doi.org/10.1016/j.apmr.2015.04.009 DOI: https://doi.org/10.1016/j.apmr.2015.04.009

Nedelandse vereniging van revalidatieartsen [Dutch organisation of rehabilitation physicians]. Position paper Medical Rehabilitation. Utrecht; 2015.

Additional Files

Published

2023-02-07

How to Cite

Mol, T. I., Scholten, E. W. M., van Bennekom, C. A. M., Visser, J. M. A., Reneman, M. F., de Groot, V., … Post, M. W. M. (2023). Using Self-Regulation Assessment to Explore Associations between Self-Regulation, Participation and Health-Related Quality of Life in a Rehabilitation Population. Journal of Rehabilitation Medicine, 55, jrm00369. https://doi.org/10.2340/jrm.v55.2531

Funding data

  • ZonMw
    Grant numbers 630000004