The Voice of the Consumer: A Survey of Veterans and Other Users of Assistive Technology.
ABSTRACT: Introduction:A total of 3.6 million Americans and over 250,000 veterans use wheelchairs. The need for advancements in mobility-assistive technologies is continually growing due to advances in medicine and rehabilitation that preserve and prolong the lives of people with disabilities, increases in the senior population, and increases in the number of veterans and civilians involved in conflict situations. The purpose of this study is to survey a large sample of veterans and other consumers with disabilities who use mobility-assistive technologies to identify priorities for future research and development. Materials and Methods:This survey asked participants to provide opinions on the importance of developing various mobility-assistive technologies and to rank the importance of certain technologies. Participants were also asked to provide open-ended comments and suggestions. Results:A total of 1,022 individuals, including 500 veterans, from 49 states within the USA and Puerto Rico completed the survey. The average age of respondents was 54.3 yr, and they represented both new and experienced users of mobility-assistive technologies. The largest diagnostic group was spinal cord injury (SCI) (N = 491, 48.0%). Several themes on critical areas of research emerged from the open-ended questions, which generated a total of 1,199 comments. Conclusion:This survey revealed several themes for future research and development. Advanced wheelchair design, smart device applications, human-machine interfaces, and assistive robotics and intelligent systems emerged as priorities. Survey results also demonstrated the importance for researchers to understand the effects of policy and cost on translational research and to be involved in educating both consumers and providers.
Project description:PURPOSE:The purpose of this study was to evaluate the opinions of providers of mobility assistive technologies to help inform a research agenda and set priorities. MATERIALS AND METHODS:This survey study was anonymous and gathered opinions of individuals who participate in the process to provide wheelchairs and other assistive technologies to clients. Participants were asked to rank the importance of developing various technologies and rank items against each other in terms of order of importance. Participants were also asked to respond to several open-ended questions or statements. RESULTS:A total of 161 providers from 35 states within the USA consented to participation and completed the survey. CONCLUSIONS:This survey revealed themes of advanced wheelchair design, assistive robotics and intelligent systems, human machine interfaces and smart device applications. It also outlined priorities for researchers to provide continuing education to clients and providers. These themes will be used to develop research and development priorities. Implications for Rehabilitation •?Research in advanced wheelchair design is needed to facilitate travel and environmental access with wheelchairs and to develop alternative power sources for wheelchairs.•?New assistive robotics and intelligent systems are needed to help wheelchairs overcome obstacles or self-adjust, assist wheelchair navigation in the community, assist caregivers and transfers, and aid ambulation.•?Innovations in human machine interfaces may help advance the control of mobility devices and robots with the brain, eye movements, facial gesture recognition or other systems.•?Development of new smart devices is needed for better control of the environment, monitoring activity and promoting healthy behaviours.
Project description:Spinal cord injury (SCI) often affects a person's ability to perform critical activities of daily living and can negatively affect his or her quality of life. Assistive technology aims to bridge this gap in order to augment function and increase independence. It is critical to involve consumers in the design and evaluation process as new technologies such as brain-computer interfaces (BCIs) are developed. In a survey study of 57 veterans with SCI participating in the 2010 National Veterans Wheelchair Games, we found that restoration of bladder and bowel control, walking, and arm and hand function (tetraplegia only) were all high priorities for improving quality of life. Many of the participants had not used or heard of some currently available technologies designed to improve function or the ability to interact with their environment. The majority of participants in this study were interested in using a BCI, particularly for controlling functional electrical stimulation to restore lost function. Independent operation was considered to be the most important design criteria. Interestingly, many participants reported that they would consider surgery to implant a BCI even though noninvasiveness was a high-priority design requirement. This survey demonstrates the interest of individuals with SCI in receiving and contributing to the design of BCIs.
Project description:Assistive devices (ADs) can help individuals with disabilities achieve greater independence, and it can enhance the quality of their lives. This study investigated the use of and self-perceived need for ADs in individuals with disabilities, and determined the influence of gender, age as well as type and degree of disability on the use of and self-perceived need for ADs. This descriptive study utilized a cross-sectional survey design with a convenience sample of participants. A total of 1018 subjects with disabilities who visited an exhibition of assistive technology and two ADs research and development centers completed a questionnaires either by themselves or via a caregiver who completed the questionnaire on behalf of the subject or via interviewers trained specifically for this study. The Mann-Whitney U test and Kruskal-Wallis test were used to determine the influence of participant characteristics on the use of ADs. The results showed that 77.2% and 83.3% of the participants reported that they used and needed AD(s) to engage in activities of daily living. The mean quantity of the use of and self-perceived need for total types of ADs were 3.0 and 5.3, respectively. Participants with different disabilities reported different percentages of the use of various types of ADs. No difference was found between genders and among the age groups in the use of quantity of ADs. Individuals with different types and degrees of disability used different quantities of ADs. Participants with physical, visual and multiple disabilities used significantly more ADs compared to participants with intellectual disability. The total quantity of ADs used increased significantly with increased severity of disability. The mean use of assistive devices was lower compared to the mean need of individuals with disabilities. Further study is required to determine why patients feel the need for but not currently use a specific assistive device.
Project description:Exoskeleton technology has potential benefits for wheelchair users' health and mobility. However, there are practical barriers to their everyday use as a mobility device. To further understand potential exoskeleton use, and facilitate the development of new technologies, a study was undertaken to explore perspectives of wheelchair users and healthcare professionals on reasons for use of exoskeleton technology, and the importance of a variety of device characteristics.An online survey with quantitative and qualitative components was conducted with wheelchair users and healthcare professionals working directly with individuals with mobility impairments. Respondents rated whether they would use or recommend an exoskeleton for four potential reasons. Seventeen design features were rated and compared in terms of their importance. An exploratory factor analysis was conducted to categorize the 17 design features into meaningful groupings. Content analysis was used to identify themes for the open ended questions regarding reasons for use of an exoskeleton.481 survey responses were analyzed, 354 from wheelchair users and 127 from healthcare professionals. The most highly rated reason for potential use or recommendation of an exoskeleton was health benefits. Of the design features, 4 had a median rating of very important: minimization of falls risk, comfort, putting on/taking off the device, and purchase cost. Factor analysis identified two main categories of design features: Functional Activities and Technology Characteristics. Qualitative findings indicated that health and physical benefits, use for activity and access reasons, and psychosocial benefits were important considerations in whether to use or recommend an exoskeleton.This study emphasizes the importance of developing future exoskeletons that are comfortable, affordable, minimize fall risk, and enable functional activities. Findings from this study can be utilized to inform the priorities for future development of this technology.
Project description:A recent study identified patients in six distinct response groups based on their evaluations of outcomes related to overall satisfaction, malpractice and benefit of treatment. This study validates the response clusters by analysing and comparing open-ended comments from the extreme positive and extreme negative response groups.Qualitative content analysis.Data from open-ended comment fields provided by patients who completed a national patient-experience survey carried out in Norway in 2011. 10?514 patients responded to the questionnaire and 3233 provided comments. A random sample of 50 open-ended comments from respondents representing cluster 1 ('excellent services'), cluster 5 ('services have clear improvement needs') and outliers ('very poor services') was reviewed.3 distinct patient profiles were identified. More than half of the comments in cluster 1 included descriptions of positive healthcare experiences, one addressed patient safety issues. Only 1 of the comments in cluster 5 was positive, and 12 were related to safety. All comments from the outliers were negative, and more than three-quarters reported experiences related to malpractice or adverse events. Recurring themes did not differ significantly between the three respondent groups, but significant differences were found for the descriptions and severity of the experiences.Patients in negative response groups had distinct and much poorer healthcare descriptions than those in the extreme positive group, supporting the interpretation of quality differences between these groups. Further research should assess ways of combining statistical cluster information and qualitative comments, which could be used for local quality improvement and public reporting.
Project description:<h4>Objectives</h4>Abandonment of vision, hearing or mobility aids suggests common barriers and facilitators to ongoing device use. However, the possible interactive effects of combined hearing and vision disabilities on device use by those living with deafblindness are unclear. Here we summarise existing knowledge on variables influencing assistive technology use from the perspective of persons living with deafblindness. We used the WHO's International Classification of Functioning, Disability and Health (ICF) framework to contextualise the findings, asking 'What is currently known about variables influencing the (non-)use of assistive devices recommended for persons with deafblindness?'<h4>Design</h4>A scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist.<h4>Data sources</h4>PubMed; ProQuest: ERIC; ProQuest Dissertation; ProQuest: Sociological Thesaurus; Web of Science; Scientific Electronic Library Online; Bielefeld Academic Search Engine; Pascal & Francis; APA PsycINFO and Ebsco for CINAHL were searched through 9 November 2020.<h4>Eligibility criteria</h4>We included peer-reviewed studies that reported on assistive technology, device abandonment/utilisation and provided data from persons living with deafblindness.<h4>Data extraction and synthesis</h4>Four team members independently scored 83 studies for eligibility.<h4>Results</h4>Ten articles were chosen for data extraction. The emerging variables replicated established categories of barriers and facilitators: personal, device-related, environmental and intervention variables. The use of the ICF highlighted how an intermediate variable (eg, device acceptability) was necessary in order for a variable to become a barrier or a facilitator to device use.<h4>Conclusions</h4>The variables influencing device use by persons with deafblindness followed the same categories described for single impairments. Usability was challenged in devices that rely on the 'other' sense. Haptic and tactile aids are rarely studied. The limited available information and the dire need for assistive technologies for people with deafblindness emphasises the urgency of research and technology development for this marginalised population.
Project description:BACKGROUND:Support walkers are a type of assistive device that may enable non-ambulant children with disabilities to walk independently and promote improvements in bowel function, bone mineral density (BMD), mobility, independence, participation and social function. However, there is little evidence to support these benefits and there is a lack of research describing the use of support walkers in clinical practice. This study aimed to examine the use of support walkers for children with disabilities in clinical practice. METHOD:A survey was distributed via professional organisations, charities and schools associated with paediatric disabilities in the UK. Participants were recruited between January and March 2018. Populations of interest were those who prescribe support walkers to children with disabilities and those who work with children who use them. RESULTS:In total, 125 people were included in the analysis; 107 responders prescribed support walkers and 18 responders worked with children who used support walkers. The population of children who use support walkers ranged from 6?months to 18?years and included children with cerebral palsy, chromosomal abnormalities and other medical conditions. Use of these devices was also reported in schools, at home and in the community for varying lengths of time. Numerous perceived benefits were noted, most frequent of which were increases in physical activity and enjoyment. By comparison, fewer perceived problems were identified but centred on lack of space and difficulty with transfers. CONCLUSIONS:This study provides insight into the use of support walkers in the UK, particularly surrounding current practices, which may help to improve consistency in clinical settings. Perceived benefits and problems may provide a basis for identification of appropriate outcome measures to monitor effectiveness. These results should also provide a basis for designing future studies to examine effectiveness of support walkers for paediatric disabilities.
Project description:<h4>Unlabelled</h4><h4>Background</h4>About half a billion people with disabilities in developing countries have limited access to assistive technology. The Convention on the Rights of persons with Disabilities requires governments to take measures to ensure provision of such technologies. To guide implementation of these measures there is a need for understanding health outcomes from a human rights perspective. The objective of this study was therefore to explore the relation between assistive technology use and enjoyment of human rights in a low-income country.<h4>Methods</h4>Data was collected in eight districts of Bangladesh through interviews of people with hearing impairments using and not using hearings aids, and people with ambulatory impairments using and not using manual wheelchairs (N?=?583). Using logistic regression, self-reported outcomes on standard of living, health, education, work, receiving information and movement were analyzed.<h4>Results</h4>The adjusted likelihood of reporting greater enjoyment of human rights was significantly higher among people using hearing aids compared to non-users for all outcomes except working status. Compared to non-users, users of wheelchairs reported a significantly higher adjusted likelihood of good ambulatory performance and a significantly lower adjusted likelihood of reporting a positive working status. Further analyses indicated that physical accessibility to working places and duration of wheelchair use had a statistically significant impact on the likelihood of reporting positive work outcomes.<h4>Conclusions</h4>The findings support the notion that assistive technology use increases the likelihood of human rights enjoyment, particularly hearing aid use. Physical accessibility should always be addressed in wheelchair provision.
Project description:The internet is the fastest growing source of nutrition information for consumers. Massive Open Online Courses (MOOCs) provide and avenue for nutrition professionals' urgent need to respond to consumer demand for low-cost, accessible and engaging information. This research aimed to evaluate learner participation and perceptions in an evidence-based nutrition MOOC and provide recommendations for engaging international online lay audiences. Learners completed pre and post course surveys including quantitative and open-ended questions. Pre-course surveys collected demographic data, prior nutrition knowledge and motivations for doing the course. Post-course surveys evaluated their preferred learning modes and learners' opinions of the course. Quantitative were analyzed using descriptive statistics. Conventional content analysis was conducted on learners' responses to open-ended survey questions using an inductive approach. Learners represented 158 countries from a range of educational backgrounds. There were 3799 qualitative comments related to learners' learning and course content preferences. Qualitative analysis identified key themes related to (1) online interaction, the (2) value of the evidence presented by nutrition experts and (3) the course structure and practical aspects. Divergent opinions were expressed within these themes. Satisfying the needs of large international audiences with diverse backgrounds is challenging in promoting sound evidence-based nutrition messages. MOOCs provide a means for delivering evidence based global nutrition education in the online space crowded with food advertising and nutrition conjecture. Recommendations are made as to how to construct and engage diverse on-line audiences.
Project description:Assistance dogs' roles have diversified to support people with various disabilities, especially in the U.S. Data presented here are from the U.S. and Canada non-profit facilities (including both accredited and candidate members that fulfilled partial requirements: all here termed "accredited") of Assistance Dogs International (ADI) and the International Guide Dog Federation (IGDF), and from non-accredited U.S. assistance dog training facilities, on the numbers and types of dogs they placed in 2013 and 2014 with persons who have disabilities. ADI categories of assistance dogs are for guide, hearing, and service (including for assistance with mobility, autism, psychiatric, diabetes, seizure disabilities). Accredited facilities in 28 states and 3 provinces responded; accredited non-responding facilities were in 22 states and 1 province (some in states/provinces with responding accredited facilities). Non-accredited facilities in 16 states responded. U.S./Canada responding accredited facilities (55 of 96: 57%) placed 2,374 dogs; non-accredited U.S. facilities (22 of 133: 16.5%) placed 797 dogs. Accredited facilities placed similar numbers of dogs for guiding (n = 918) or mobility (n = 943), but many more facilities placed mobility service dogs than guide dogs. Autism service dogs were third most for accredited (n = 205 placements) and U.S. non-accredited (n = 72) facilities. Psychiatric service dogs were fourth most common in accredited placements (n = 119) and accounted for most placements (n = 526) in non-accredited facilities. Other accredited placements were for: hearing (n = 109); diabetic alert (n = 69), and seizure response (n = 11). Responding non-accredited facilities placed 17 hearing dogs, 30 diabetic alert dogs, and 18 seizure response dogs. Non-accredited facilities placed many dogs for psychiatric assistance, often for veterans, but ADI accreditation is required for veterans to have financial reimbursement. Twenty states and several provinces had no responding facilities; 17 of these states had no accredited facilities. In regions lacking facilities, some people with disabilities may find it inconvenient living far from any supportive facility, even if travel costs are provided. Despite accelerated U.S./Canada placements, access to well-trained assistance dogs continues to be limited and inconvenient for many people with disabilities, and the numerous sources of expensive, poorly trained dogs add confusion for potential handlers.