Bibliographic record
Abstract
Multiple Sclerosis (MS) is a progressive and unpredictable disease that presents sufferers with multifaceted challenges in participation in everyday life. The main purpose of this dissertation was twofold: first, to explore the participation and perceived functioning of moderately and severely disabled people with MS in everyday life, and second to investigate the effect of a two-year multidisciplinary rehabilitation on everyday activities. This dissertation is based on data from a multidisciplinary group rehabilitation project for people with MS (n=113). Additional data (n=89) collected to evaluate the psychometric properties of the Finnish version of the Impact on Participation and Autonomy (IPA) questionnaire and predictors of participation using structural equation modelling (SEM). Participation and activities in everyday life were studied with the IPA questionnaire and the semi-structured interview Canadian Occupational Performance Measure (COPM), which are both self-assessment measures. The framework of the International Classification of Functioning, Disability and Health (ICF) was applied in the analysis. Improvement in performance in daily activities of the people with moderate and severe MS during the two-year multidisciplinary group rehabilitation was investigated with the COPM using repeated measures of analysis of variance. The results showed that the IPA is a valid and reliable measure that captures the autonomy aspect of participation of people with MS. In addition, perceived problems in participation and activities in daily life of people with MS supported the ICF comprehensive and brief core sets for MS. The results of the SEM indicated that quality of life and the psychological and physical impacts of the disease were the main predictors of participation and autonomy. The two-year multidisciplinary group rehabilitation improved performance and satisfaction with daily activities of people with both moderate and severe MS. The most noteworthy self-reported reasons for change during rehabilitation program were personal and environmental factors. Overall, the findings highlight both the diversity of experiences of participation and activities in everyday life of people with MS and that these experiences are not explained by disease severity. Therefore, self-assessment measures are recommended for measuring participation and activities in everyday life of people with MS. Moreover, the findings suggest that changes in performance and satisfaction in daily activities require long-term multidisciplinary rehabilitation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".