Factors Influencing Participation in Society among Community-Dwelling Adults with Physical Disabilities in South Korea

Research Objectives: To identify the association between demographic, socioeconomic, and functional factors and participation in society among community-dwelling adults with physical disabilities in South Korea

Design: Secondary analyses of a cross-sectional study with seven independent variables: demographics (age and gender), socioeconomic status (employment and financial status), and clinical factors (disease duration, mental health, and functional ability). Pearson correlation analysis examined factors correlated with participation. Hierarchical multiple regression models predicting participation were constructed, incorporating significant factors. The models included three blocks based on factor categories.

Setting: General community.

Participants: 1079 community-dwelling adults with physical disabilities resulting from central nervous system disorders (Mean age = 62.15±13.41 years; 45.4% female; mean disease duration = 13.56±12.97 years; and 22.3% employed). In-person interviews were conducted at 65 primary healthcare centers, with 15-20 participants randomly selected from each center.

Interventions: Not applicable.

Main Outcome Measures: Participation was assessed using the Participation domain of the Korean-version World Health Organization Disability Assessment Schedule 2.0, functional ability to perform activities of daily living (ADLs) using the Modified Barthel Index, mental health using the mental composite score of the 8-item Short-Form Health Survey, and other factors through interview.

Results: Gender and disease duration were not correlated with participation in society. Each Pearson's coefficient r was -.10 (age), 0.11 (employment status), 0.18 (financial status), -0.49 (mental health), and -0.53 (functional ability) (all p<.003). In regression models (all p<.003), age accounted for 0.8% of the variance, while socioeconomic factors (employment and financial status) increased ΔR2 by 4.1%, and clinical factors (mental health and functional ability) increased by 35.3%. In the final model (R2=.403, p<.001), significant predictors of participation were financial status, mental health, and functional ability (β=.09, β=-.35, and β=-.41, respectively).

Conclusions: Lower financial status, worse mental health, and decreased functional ability to perform ADLs are associated with reduced participation in society. This study emphasizes the importance of multidisciplinary collaboration among healthcare providers in rehabilitation, social work, and mental health, to promote participation among individuals with physical disabilities.

Author(s) Disclosures: No conflicts of interest.