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Article: Longitudinal Association of Health Satisfaction With Functional Status and Income Satisfaction in Stroke Survivors.

Nam, Sanghun / Reistetter, Timothy A / Hong, Ickpyo

The American journal of occupational therapy : official publication of the American Occupational Therapy Association

2024 Volume 78, Issue 2

Abstract: Importance: Although cross-sectional studies have reported the relationships among performance of activities of daily living (ADLs), income satisfaction, and health satisfaction, longitudinal associations in stroke survivors remain unclear.: Objective! ...

Abstract	Importance: Although cross-sectional studies have reported the relationships among performance of activities of daily living (ADLs), income satisfaction, and health satisfaction, longitudinal associations in stroke survivors remain unclear. Objective: To examine the effects of ADL function and income satisfaction on health satisfaction over time in stroke survivors. Design: Retrospective longitudinal study designs with latent growth curve models (LGMs) to control for time-varying and time-invariant covariates. Setting: Community. Participants: A total of 198 stroke survivors. Outcomes and measures: Self-reported ADL performance, income satisfaction, and health satisfaction. Results: The average age of participants was 70.68 yr (SD = 8.09; 107 men, 91 women). Each LGM showed that an increase in ADL score (standardized β = 0.116∼0.296, all ps < .05) and income satisfaction (standardized β = 0.513∼0.726, all ps < .001) positively predicted health satisfaction over time, even after controlling for time-varying annual income, demographics, and behavioral characteristics. The fit results of all LGMs were within the acceptable range: χ2(47) = 66.378, p = .0327; χ2(47) = 57.742, p = .1355; root-mean-square error of approximation, <0.08; comparative fit index and Tucker-Lewis index, >0.90; standardized root-mean-square residual, <0.05. Conclusions and relevance: Because ADLs are significant modifiable health satisfaction factors, occupational therapy practitioners would need to focus more closely on ADL training in clinical settings. Furthermore, referring those clients to appropriate vocational rehabilitation to improve their income satisfaction would be necessary. Plain-Language Summary: This study recognizes the unique challenges and opportunities that arise when stroke survivors are preparing to return to their communities by emphasizing the significance of ADL training and income satisfaction during this stage of recovery. The study suggests that the therapeutic use of ADL training and income satisfaction could increase health satisfaction for stroke survivors. Therefore, comprehensive ADL training, as an occupational therapy intervention, could be crucial for stroke survivors who are preparing to return to their community from a clinical setting. Furthermore, connecting with vocational rehabilitation could also be important for improving income satisfaction for stroke survivors who are preparing to return to a community.
MeSH term(s)	Male ; Humans ; Female ; Activities of Daily Living ; Stroke Rehabilitation ; Cross-Sectional Studies ; Retrospective Studies ; Longitudinal Studies ; Functional Status ; Stroke ; Survivors ; Personal Satisfaction
Language	English
Publishing date	2024-02-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	219403-x
ISSN	1943-7676 ; 0272-9490 ; 0161-326X
ISSN (online)	1943-7676
ISSN	0272-9490 ; 0161-326X
DOI	10.5014/ajot.2024.050410
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Article ; Online: Dysphagia and Functional Limitations Among Adults in the United States: Findings from the 2022 National Health Interview Survey.

Hong, Ickpyo / Norman, Rocío S / Woo, Hee-Soon / Jin, Yeonju / Reistetter, Timothy A

Dysphagia

2024

Abstract: Dysphagia or swallowing dysfunction is associated with reduced quality of life and poor long term outcomes. While standard dysphagia treatment focuses on improving swallowing function, it is not clear if people with dysphagia also have difficulties ... ...

Abstract	Dysphagia or swallowing dysfunction is associated with reduced quality of life and poor long term outcomes. While standard dysphagia treatment focuses on improving swallowing function, it is not clear if people with dysphagia also have difficulties performing daily tasks. This study aimed to determine if individuals with dysphagia had difficulties with participating in daily tasks requiring physical function, as compared to those with no dysphagia. We conducted a secondary data analysis using the responses of 24,107 adults aged 18 years or older who completed the 2022 National Health Interview Survey. The independent variable was report of swallowing problem during the past 12 months, and the dependent variables were report of difficulty in physical function tasks (e.g., self-care, mobility, working, social participation). We utilized propensity score methods to balance demographic and clinical variables between groups, and examined if individuals with dysphagia had more difficulties with the physical function tasks. The propensity score methods balanced the demographic and clinical variables (absolute standardized differences < 0.1). People with dysphagia had significantly higher odds ratios (ranged from 1.23 to 1.70, all p < 0.05) of having difficulties in physical function tasks than those without dysphagia. The findings revealed an association between experiencing dysphagia and encountering difficulties in self-care, mobility, working, and social participation in the general adult population in the US. Results of our study indicate that during the course of rehabilitation, healthcare professionals should consider the potential impact of dysphagia symptoms on clients' ability to partake in independent activities in their community settings.
Language	English
Publishing date	2024-03-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	632764-3
ISSN	1432-0460 ; 0179-051X
ISSN (online)	1432-0460
ISSN	0179-051X
DOI	10.1007/s00455-024-10680-8
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Article ; Online: Vision Impairment and Frailty Among Mexican American Older Adults: A Longitudinal Study.

Sonnenfeld, Mandi L / Pappadis, Monique R / Reistetter, Timothy A / Raji, Mukaila A / Ottenbacher, Kenneth / Al Snih, Soham

Journal of applied gerontology : the official journal of the Southern Gerontological Society

2024 Volume 43, Issue 6, Page(s) 755–764

Abstract: We examined the relationship between vision impairment (VI) and new-onset frailty among non-frail Mexican American older adults (≥70 years) at baseline and determined the differential impact of VI on each frailty criteria. Data were from an 18-year ... ...

Abstract	We examined the relationship between vision impairment (VI) and new-onset frailty among non-frail Mexican American older adults (≥70 years) at baseline and determined the differential impact of VI on each frailty criteria. Data were from an 18-year prospective cohort from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1998/1999,
MeSH term(s)	Humans ; Mexican Americans/statistics & numerical data ; Aged ; Male ; Female ; Frailty/ethnology ; Frailty/epidemiology ; Longitudinal Studies ; Aged, 80 and over ; Vision Disorders/epidemiology ; Vision Disorders/ethnology ; Prospective Studies ; Frail Elderly/statistics & numerical data ; Geriatric Assessment ; Weight Loss
Language	English
Publishing date	2024-02-27
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	155897-3
ISSN	1552-4523 ; 0733-4648
ISSN (online)	1552-4523
ISSN	0733-4648
DOI	10.1177/07334648241231374
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Article: Responsiveness of the Revised Low Vision Independence Measure (LVIM-R).

Smith, Theresa M / Hong, Ickpyo / Reistetter, Timothy A

The American journal of occupational therapy : official publication of the American Occupational Therapy Association

2020 Volume 74, Issue 5, Page(s) 7405205040p1–7405205040p11

Abstract: Importance: The Low Vision Independence Measure (LVIM) was designed to measure the effectiveness of occupational therapy to improve visual ability in low vision rehabilitation.: Objective: To validate the Revised LVIM (LVIM-R) as an outcome measure ... ...

Abstract	Importance: The Low Vision Independence Measure (LVIM) was designed to measure the effectiveness of occupational therapy to improve visual ability in low vision rehabilitation. Objective: To validate the Revised LVIM (LVIM-R) as an outcome measure by determining its sensitivity to visual ability changes after occupational therapy. Design: In this observational study, LVIM-R scores were collected before and after customary low vision intervention. Setting: Home health agency or outpatient facility. Participants: Forty-four participants with a mean age of 80.2 yr (standard deviation = 11.2) and an average length of visual impairment of 6.2 yr. Twenty-three participants (52.3%) were treated in an outpatient setting, and 21 (47.7%) were treated in the home. The majority of participants were non-Hispanic White (92.8%) and had macular degeneration (54.5%). Intervention: Customary low vision intervention by occupational therapists. Outcomes and measures: LVIM-R scores were collected before and after intervention, and participants' pre- and posttest scores were anchored into Rasch-calibrated item parameters. Results: Paired t tests demonstrated significant increases in person measures with large effect sizes for both constructs of the LVIM-R, the visual field or scotoma (t[43] = 6.46, p < .0001; Cohen's d = 0.92) and visual acuity (t[43] = 9.08, p < .0001; Cohen's d = 1.14) constructs. Conclusions and relevance: The LVIM-R is sensitive to changes in visual ability in clients who have good rehabilitation potential and can be used to examine the effectiveness of occupational therapy for low vision. What this article adds: The LVIM-R is useful for measuring occupational therapy outcomes in low vision rehabilitation in the home or in outpatient settings.
MeSH term(s)	Humans ; Outcome Assessment, Health Care ; Outpatients ; Surveys and Questionnaires ; Vision Disorders ; Vision, Low ; Visual Acuity
Language	English
Publishing date	2020-08-17
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	219403-x
ISSN	1943-7676 ; 0272-9490 ; 0161-326X
ISSN (online)	1943-7676
ISSN	0272-9490 ; 0161-326X
DOI	10.5014/ajot.2020.038307
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Article ; Online: Lessons Learned and Future Actions: Modifying a Stroke Specific Self-Management Program.

Hreha, Kimberly / Sonnenfeld, Mandi / Na, Annalisa / Kitchens, Riqiea / Reistetter, Timothy A

Frontiers in health services

2022 Volume 2, Page(s) 841082

Abstract: Background: Self-management programs have been shown to be effective at providing support to individuals who want to manage chronic health conditions independently. It has been shown that adapting self-management programs for different diagnostic groups, ...

Abstract	Background: Self-management programs have been shown to be effective at providing support to individuals who want to manage chronic health conditions independently. It has been shown that adapting self-management programs for different diagnostic groups, such as stroke, is essential. Objective: To report modifications made during trial implementation, the barriers identified during the delivery of an evidence based, stroke-specific self-management program and minor data (including strategies made) from a small cohort of stroke survivors with multiple chronic conditions. Methods: Prospective type III hybrid implementation-effectiveness trial for stroke survivors, with chronic conditions, living in the community, and interested in self-management. Modifications were reported by the following: (1) researcher reflections (2) barriers to implementation and (3) strategies used to address the barrier using the Consolidated Framework for Implementation Research (CFIR) guidelines from field notes. Results: Twenty-five individuals consented (42% of eligible sample) at the time of acute stroke and five were interested in continuing at the 3-month call. Multiple barriers to implementation were identified, resulting in modifications. For example, before the group sessions began, the COVID-19 pandemic necessitated changes to the intervention delivery. The protocol was modified to an online mode of delivery. In total, there were seven modifications made. Conclusions: The CFIR was a facilitative tool to report barriers and strategies and emphasized the importance of comprehensive reporting. The modifications to the study were an essential first step to address the research climate and needs of this stroke cohort. Next steps include continued research with a larger cohort to implement effective strategies and answer the clinical question of effectiveness of the adapted and modified intervention.
Language	English
Publishing date	2022-06-21
Publishing country	Switzerland
Document type	Journal Article
ISSN	2813-0146
ISSN (online)	2813-0146
DOI	10.3389/frhs.2022.841082
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Article ; Online: Development and Evaluation of Rehabilitation Service Areas for the United States.

Reistetter, Timothy A / Dean, Julianna M / Haas, Allen M / Prochaska, John D / Jupiter, Daniel C / Eschbach, Karl / Kuo, Yong-Fang

BMC health services research

2023 Volume 23, Issue 1, Page(s) 204

Abstract: Background: Geographic areas have been developed for many healthcare sectors including acute and primary care. These areas aid in understanding health care supply, use, and outcomes. However, little attention has been given to developing similar ... ...

Abstract	Background: Geographic areas have been developed for many healthcare sectors including acute and primary care. These areas aid in understanding health care supply, use, and outcomes. However, little attention has been given to developing similar geographic tools for understanding rehabilitation in post-acute care. The purpose of this study was to develop and characterize post-acute care Rehabilitation Service Areas (RSAs) in the United States (US) that reflect rehabilitation use by Medicare beneficiaries. Methods: A patient origin study was conducted to cluster beneficiary ZIP (Zone Improvement Plan) code tabulation areas (ZCTAs) with providers who service those areas using Ward's clustering method. We used US national Medicare claims data for 2013 to 2015 for beneficiaries discharged from an acute care hospital to an inpatient rehabilitation facility (IRF), skilled nursing facility (SNF), long-term care hospital (LTCH), or home health agency (HHA). Medicare is a US health insurance program primarily for older adults. The study population included patient records across all diagnostic groups. We used IRF, SNF, LTCH and HHA services to create the RSAs. We used 2013 and 2014 data (n = 2,730,366) to develop the RSAs and 2015 data (n = 1,118,936) to evaluate stability. We described the RSAs by provider type availability, population, and traveling patterns among beneficiaries. Results: The method resulted in 1,711 discrete RSAs. 38.7% of these RSAs had IRFs, 16.1% had LTCHs, and 99.7% had SNFs. The number of RSAs varied across states; some had fewer than 10 while others had greater than 70. Overall, 21.9% of beneficiaries traveled from the RSA where they resided to another RSA for care. Conclusions: Rehabilitation Service Areas are a new tool for the measurement and understanding of post-acute care utilization, resources, quality, and outcomes. These areas provide policy makers, researchers, and administrators with small-area boundaries to assess access, supply, demand, and understanding of financing to improve practice and policy for post-acute care in the US.
MeSH term(s)	Humans ; Aged ; United States ; Medicare ; Health Facilities ; Insurance, Health ; Skilled Nursing Facilities ; Administrative Personnel
Language	English
Publishing date	2023-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-09184-2
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Article ; Online: Factors Associated with Duration of Rehabilitation Among Older Adults with Prolonged Hospitalization.

Nguyen, Danh Q / Ifejika, Nneka L / Reistetter, Timothy A / Makam, Anil N

Journal of the American Geriatrics Society

2020

Abstract: Background/objectives: Older adults are prone to functional decline during prolonged hospitalization. Although rehabilitation therapy is critical to preserving function, little is known about rehabilitation duration (RD) in this population. We sought to ...

Abstract	Background/objectives: Older adults are prone to functional decline during prolonged hospitalization. Although rehabilitation therapy is critical to preserving function, little is known about rehabilitation duration (RD) in this population. We sought to determine the extent of rehabilitation therapy provided to older adults during prolonged hospitalization, and whether this differs by sociodemographic and clinical characteristics. Design: Retrospective cohort. Setting: Single-site safety-net hospital. Participants: Older adults (≥65 years) hospitalized for ≥14 days between 2016 and 2017. Measurements: The primary outcome was RD, defined as the average number of minutes of physical and occupational therapy per week. We used a multivariable generalized linear model to assess for differences in RD by sociodemographic and clinical characteristics. For a sub-cohort of hospitalizations with a baseline mobility assessment, we repeated analyses including mobility limitation as a covariate. Results: Among 1,031 hospitalizations by 925 unique patients (median age 72, 49% female, 79% non-white, 40% non-English speaking), the median RD was 61.3 minutes/week (interquartile range = 16.5-127.3). Covariates associated with lesser RD included black (57.2 fewer minutes/week; 95% confidence interval (CI) = 22.9-91.4) and Hispanic (75.6 fewer minutes/week; 95% CI = 33.8-117.4) race/ethnicity, speaking a language other than English or Spanish (51.7 fewer minutes/week; 95% CI = 21.3-82.0), prolonged mechanical ventilation (30.0 fewer minutes/week; 95% CI = 6.6-53.3), and do-not-resuscitate code status (36.0 fewer minutes/week; 95% CI = 17.1-54.8). The inclusion of mobility limitation among the sub-cohort (n = 350) did not meaningfully change the associations. Conclusion: We found large disparities in RD for racial/ethnic and language minorities and clinically vulnerable older adults (mechanical ventilation and do-not-resuscitate code status), independent of clinical severity and functional and cognitive impairment. Greater RD for these groups may improve functional outcomes and narrow the disparity gap.
Language	English
Publishing date	2020-12-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/jgs.16988
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Article ; Online: Feasibility Study Using Propensity Score Matching Methods for the Pseudo-Common Person Equating Requirement.

Hong, Ickpyo / Hay, Catherine C / Reistetter, Timothy A

OTJR : occupation, participation and health

2018 Volume 39, Issue 1, Page(s) 32–40

Abstract: We tested if a propensity score (PS) matching method supports the unidimensionality assumption of the Rasch model which is critical to link similar rehabilitation instruments. We obtained 1,013 respondents from the 2009 Hispanic Established Populations ... ...

Abstract	We tested if a propensity score (PS) matching method supports the unidimensionality assumption of the Rasch model which is critical to link similar rehabilitation instruments. We obtained 1,013 respondents from the 2009 Hispanic Established Populations for Epidemiologic Studies of the Elderly Frailty study. We used a unidimensional item pool of 10 SF-36 physical function and nine activities of daily living items. Subjects were matched based on their functionality (high and low), and exploratory factor analysis was used to test if the item pool in the matched sample holds the unidimensionality assumption. The study findings revealed that the matched sample demonstrated two distinct measurement structures with excellent model fit. This finding indicates that the PS matching did not mimic the common-person assumption. Therefore, the combination of PS matching and common-person equating method may not be appropriate to equate two rehabilitation-related instruments administered to two different groups.
MeSH term(s)	Activities of Daily Living/psychology ; Aged ; Aged, 80 and over ; Disability Evaluation ; Factor Analysis, Statistical ; Feasibility Studies ; Female ; Frail Elderly ; Geriatric Assessment/methods ; Humans ; Male ; Occupational Therapy/psychology ; Outcome Assessment, Health Care/methods ; Propensity Score ; Psychometrics ; Reproducibility of Results ; Surveys and Questionnaires/statistics & numerical data ; Treatment Outcome
Language	English
Publishing date	2018-06-08
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2081243-7
ISSN	1938-2383 ; 1539-4492 ; 0276-1599
ISSN (online)	1938-2383
ISSN	1539-4492 ; 0276-1599
DOI	10.1177/1539449218778535
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Article: Measurement Validity of the Low Vision Independence Measure (LVIM).

Smith, Theresa M / Krishnan, Shilpa / Hong, Ickpyo / Reistetter, Timothy A

The American journal of occupational therapy : official publication of the American Occupational Therapy Association

2019 Volume 73, Issue 3, Page(s) 7303205070p1–7303205070p11

Abstract: Objective: This study's objective was to test the psychometrics of Smith's (2013) Low Vision Independence Measure (LVIM) using the Rasch model.: Method: A cohort design was used with 93 participants receiving occupational therapy for low vision. ... ...

Abstract	Objective: This study's objective was to test the psychometrics of Smith's (2013) Low Vision Independence Measure (LVIM) using the Rasch model. Method: A cohort design was used with 93 participants receiving occupational therapy for low vision. Confirmatory factor analysis (CFA) with a parceling approach was used to test the LVIM factors and Rasch analysis to examine item-level psychometrics. Results: Participants' average age was 78.9 yr (standard deviation = 12.1), and the majority were female (72.8%) with macular degeneration (62.3%). The CFA revealed two measurement factors: visual field or scotoma (n = 28) and visual acuity (n = 24). We removed six misfitting items, and the two factors of the revised LVIM demonstrated good rating scale function, good internal consistency (person reliability: visual field, .87; visual acuity, .90), good precision (person strata: visual field, 3.91; visual acuity, 4.40), no ceiling or floor effects, and no differential item functioning. Conclusion: The revised LVIM demonstrates good psychometrics on the Rasch model and can be used as a valid outcome measure in low vision rehabilitation.
MeSH term(s)	Aged ; Aged, 80 and over ; Female ; Humans ; Middle Aged ; Psychometrics ; Quality of Life ; Reproducibility of Results ; Sickness Impact Profile ; Surveys and Questionnaires/standards ; Vision, Low/physiopathology ; Visual Acuity/physiology ; Visually Impaired Persons/psychology
Language	English
Publishing date	2019-05-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	219403-x
ISSN	1943-7676 ; 0272-9490 ; 0161-326X
ISSN (online)	1943-7676
ISSN	0272-9490 ; 0161-326X
DOI	10.5014/ajot.2019.031070
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Article ; Online: The Impact of High- Versus Low-Dose Home Rehabilitation for Functional Independence after Hip or Knee Replacement.

Pritchard, Kevin T / Baillargeon, Jacques / Westra, Jordan / Li, Chih-Ying / Mroz, Tracy / Reistetter, Timothy A / Lee, Wei-Chen / Raji, Mukaila A / Kuo, Yong-Fang

Journal of the American Medical Directors Association

2023 Volume 25, Issue 1, Page(s) 118–120

MeSH term(s)	Humans ; Functional Status ; Arthroplasty, Replacement, Knee/rehabilitation ; Treatment Outcome
Language	English
Publishing date	2023-08-08
Publishing country	United States
Document type	Letter
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2023.06.039
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