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Khosravi S, Khayyamfar A, Shemshadi M, Koltapeh MP, Sadeghi-Naini M, Ghodsi Z, Shokraneh F, Bardsiri MS, Derakhshan P, Komlakh K, Vaccaro AR, Fehlings MG, Guest JD, Noonan V, Rahimi-Movaghar V. Indicators of Quality of Care in Individuals With Traumatic Spinal Cord Injury: A Scoping Review. Global Spine J 2022; 12:166-181. [PMID: 33487062 PMCID: PMC8965305 DOI: 10.1177/2192568220981988] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
STUDY DESIGN Scoping review. OBJECTIVES To identify a practical and reproducible approach to organize Quality of Care Indicators (QoCI) in individuals with traumatic spinal cord injury (TSCI). METHODS A comprehensive literature review was conducted in the Cochrane Central Register of Controlled Trials (CENTRAL) (Date: May 2018), MEDLINE (1946 to May 2018), and EMBASE (1974 to May 2018). Two independent reviewers screened 6092 records and included 262 full texts, among which 60 studies were included for qualitative analysis. We included studies, with no language restriction, containing at least 1 quality of care indicator for individuals with traumatic spinal cord injury. Each potential indicator was evaluated in an online, focused group discussion to define its categorization (healthcare system structure, medical process, and individuals with Traumatic Spinal Cord Injury related outcomes), definition, survey options, and scale. RESULTS A total of 87 indicators were identified from 60 studies screened using our eligibility criteria. We defined each indicator. Out of 87 indicators, 37 appraised the healthcare system structure, 30 evaluated medical processes, and 20 included individuals with TSCI related outcomes. The healthcare system structure included the impact of the cost of hospitalization and rehabilitation, as well as staff and patient perception of treatment. The medical processes included targeting physical activities for improvement of health-related outcomes and complications. Changes in motor score, functional independence, and readmission rates were reported as individuals with TSCI-related outcomes indicators. CONCLUSION Indicators of quality of care in the management of individuals with TSCI are important for health policy strategists to standardize healthcare assessment, for clinicians to improve care, and for data collection efforts including registries.
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Affiliation(s)
- Sepehr Khosravi
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran,Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirmahdi Khayyamfar
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran,Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Shemshadi
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran,Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Pourghahramani Koltapeh
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran,Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Sadeghi-Naini
- Neurosurgery Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Shokraneh
- King’s Technology Evaluation Centre, London Institute of Healthcare Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK,The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Pegah Derakhshan
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran,Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Khalil Komlakh
- Neurosurgery Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alex R. Vaccaro
- The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
| | - Michael G. Fehlings
- Department of Surgery, University of Toronto and Division of Neurosurgery, Krembil Neuroscience Centre, University Health Network, Toronto, Ontario, Canada
| | - James D. Guest
- Department of Neurological Surgery, University of Miami, Miami, FL, USA
| | - Vanessa Noonan
- Rick Hansen Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran,Universal Scientific Education and Research Network (USERN), Tehran, Iran,Vafa Rahimi-Movaghar, Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, Iran.
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Martinez CI, Sanchez AN, Stampas A, Woo J, Verduzco-Gutierrez M. Demographics and Durable Medical Equipment Needs of Persons With Disabilities in a Charitable Rehabilitation Clinic. Am J Phys Med Rehabil 2021; 100:288-291. [PMID: 33595942 DOI: 10.1097/phm.0000000000001553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT This study characterizes the demographics and durable medical equipment needs of persons with disabilities to improve utilization and management of resources at a philanthropic rehabilitation clinic. Paper charts from all encounters between 2013 and 2018 were reviewed. Data collected include sex, age, ethnicity, insurance status, diagnoses, and durable medical equipment requested/received. Paper charts that were incomplete or illegible were excluded. Among 763 individuals, there were 1157 encounters for durable medical equipment requests. Forty-six percent of individuals were uninsured. Thirty-seven percent had federal insurance such as Medicare or Medicaid, and 6% private insurance. Fifty-five percent of individuals were Hispanic, 28% African American, and 14% White. Fifty-six percent of encounters were with individuals with a neurological diagnosis, 18% medical diagnosis, 17% musculoskeletal/autoimmune diagnosis, 6% amputation diagnosis, and 3% cancer diagnosis. Of the 2680 items distributed, 34% were wheelchair parts and repair, 30% personal hygiene/incontinence supplies, 25% mobility equipment, and 11% bathroom equipment. Of the 513 unmet items requested, 49% were mobility equipment, 24% wheelchair parts and repair, 17% personal hygiene/incontinence supplies, and 11% bathroom equipment. More than a third (43%) of durable medical equipment requests were from individuals with either private insurance or federal payers, which implies lack of adequate coverage on durable medical equipment to maintain mobility and independence.
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Affiliation(s)
- Claudia I Martinez
- From the McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas (CIM, ANS); Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas (AS); H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas (JW); and Department of Rehabilitation Medicine, Long School of Medicine at the University of Texas Health Science Center at San Antonio, San Antonio, Texas (MV-G)
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Candoni G, Coronel E, Sanchez-Correa C, Tomadín R, Valdez M. [Psychometric properties of observational instruments to evaluate wheelchair skills in persons with a spinal cord injury: A systematic review]. Rehabilitacion (Madr) 2020; 55:125-137. [PMID: 33272607 DOI: 10.1016/j.rh.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 11/18/2022]
Abstract
A total of 60% of people with a spinal cord injury are completely dependent on a wheelchair. There is a wide variety of instruments that assess wheelchair skills, but they are not specific for this population. OBJECTIVE: To identify, assess, compare and summarize the psychometric properties of instruments that assess wheelchair skills in persons with a spinal cord injury. A systematic review was conducted and observational instruments were included that assessed wheelchair skills in persons with spinal cord injury. Eleven articles were identified that evaluated eight instruments. Most of them reported activities according to the International Classification of Functioning, Disability and Health. Reliability was the most frequently evaluated psychometric property. The Queensland Evaluation of Wheelchair Skills and the Adapted Manual Wheelchair Circuit had the best degrees of confidence in the evidence, and their application could guide the selection of pertinent therapeutic strategies. PROSPERO registration: CRD42020161430.
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Affiliation(s)
- G Candoni
- División de Kinesiología, Hospital de Rehabilitación Manuel Rocca, Buenos Aires, Argentina.
| | - E Coronel
- División de Kinesiología, Hospital de Rehabilitación Manuel Rocca, Buenos Aires, Argentina
| | - C Sanchez-Correa
- División de Kinesiología, Hospital de Rehabilitación Manuel Rocca, Buenos Aires, Argentina
| | - R Tomadín
- División de Kinesiología, Hospital de Rehabilitación Manuel Rocca, Buenos Aires, Argentina
| | - M Valdez
- División de Kinesiología, Hospital de Rehabilitación Manuel Rocca, Buenos Aires, Argentina
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Frasuńska J, Tederko P, Wojdasiewicz P, Mycielski J, Turczyn P, Tarnacka B. Compliance with prescriptions for wheelchairs, walking aids, orthotics, and pressure-relieving devices in patients with traumatic spinal cord injury. Eur J Phys Rehabil Med 2019; 56:160-168. [PMID: 31797659 DOI: 10.23736/s1973-9087.19.05920-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The use of adaptive equipment (AE) is the basic indication for patients with spinal cord injury (SCI). Inappropriate decisions concerning the use of AE imply treatment results, patient confidence, and patient and state costs. The present study is the first analysis of the causes of non-compliance conducted in Europe with the provision of AE in SCI patients using Wielandt and Strong's classification. AIM The aim of this study is to analyze of the causes of non-compliance in the process of providing AE to SCI patients. DESIGN Retrospective observational study. SETTING "STOCER" Masovian Rehabilitation Centre, Konstancin-Jeziorna, Poland. POPULATION Seventy-two patients with traumatic SCI 10 months after the completion of the acute and post-acute phases of inpatient rehabilitation. METHODS Wielandt and Strong's classification was used to determine the causes of non-compliance with AE provisions and the present authors' questionnaire with the World Health Organisation Quality of Life (WHOQOL-BREF) were used to identify the risk factors of non-compliance with AE provisions. RESULTS Non-compliance with prescribed AE provisions was reported in 34 (49.3%) of 69 study participants. Non-compliance was due to medical-related factors in 44.1%, client-related factors in 20.6%, equipment-related factors in 11.8%, and unspecific factors in 17.8% of cases. Non-compliance with AE provisions correlated with complete neurological deficit, preserved ability to walk (in case of wheelchairs), the presence of bedsores (in cases of lower extremity devices), low financial status, and lost ability to walk (in cases of AE for standing and walking). The highest percentage of non-compliance was noted for the provision of knee-ankle-foot orthosis (50%). CONCLUSIONS The most common causes of non-compliance with AE provisions include health status improvement in the patient and high cost of the device. CLINICAL REHABILITATION IMPACT These results can be helpful for more effective treatment planning and the avoidance of unnecessary reimbursement costs covered by the state and users.
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Affiliation(s)
- Justyna Frasuńska
- Department of Rehabilitation, First Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland - .,Department of Rehabilitation, Eleonora Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland - .,Department of Rehabilitation, Mazovian Rehabilitation Center (STOCER), Konstancin-Jeziorna, Poland -
| | - Piotr Tederko
- Department of Rehabilitation, First Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.,Department of Rehabilitation, Eleonora Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Piotr Wojdasiewicz
- Department of Rehabilitation, Eleonora Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.,Department of General and Experimental Pathology, Center for Preclinical Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Jerzy Mycielski
- Department of Economics, University of Warsaw, Warsaw, Poland
| | - Paweł Turczyn
- Department of Rehabilitation, First Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.,Department of Rehabilitation, Eleonora Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Beata Tarnacka
- Department of Rehabilitation, First Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.,Department of Rehabilitation, Eleonora Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
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Steel EJ. Content analysis to locate assistive technology in Queensland's motor injury insurance rehabilitation legislation and guidelines. Assist Technol 2018; 32:74-78. [PMID: 29883264 DOI: 10.1080/10400435.2018.1485780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION Reforms to Australia's disability and rehabilitation sectors have espoused the potential of assistive technology as an enabler. As new insurance systems are being developed it is timely to examine the structure of existing systems. This exploratory study examined the policies guiding assistive technology provision in the motor accident insurance sector of one Australian state. METHODS Policy documents were analyzed iteratively with a set of qualitative questions to understand the intent and interpretation of policies guiding assistive technology provision. Content analysis identified relevant sections and meaningful terminology, and context analysis explored the dominant perspectives informing policy. RESULTS AND DISCUSSION The concepts and language of assistive technology are not part of the policy frameworks guiding rehabilitation practice in Queensland's motor accident insurance sector. The definition of rehabilitation in the legislation is consistent with contemporary international interpretations that focus on optimizing functioning in interaction with the environment. However, the supporting documents are focused on recovery from injuries where decisions are guided by clinical need and affordability. CONCLUSION The policies frame rehabilitation in a medical model that separates assistive technology provision from the rehabilitation plan. The legislative framework provides opportunities to develop and improve assistive technology provision as part of an integrated approach to rehabilitation.
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Affiliation(s)
- Emily J Steel
- School of Health and Wellbeing, The University of Southern Queensland, Ipswich, Australia.,TC Beirne School of Law, The University of Queensland, St Lucia, Australia
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Wäckerlin S, Gemperli A, Sigrist-Nix D, Arnet U. Need and availability of assistive devices to compensate for impaired hand function of individuals with tetraplegia. J Spinal Cord Med 2018; 43:77-87. [PMID: 29863967 PMCID: PMC7006670 DOI: 10.1080/10790268.2018.1479054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Context/Objective: To evaluate the availability and self-declared unmet need of assistive devices to compensate for impaired hand function of individuals with tetraplegia in Switzerland.Design: Cross-sectional survey.Setting: Community.Participants: Individuals with tetraplegia, aged 16 years or older, living in Switzerland.Interventions: not applicable.Outcome Measures: The self-report availability and unmet need of 18 assistive devices for impaired hand function was analyzed descriptively. The availability of devices was further evaluated stratified by sex, age, SCI severity, independence in grooming, time since injury, living situation, working status, and income. Associations between availability of devices and person characteristics were investigated using logistic regression analysis.Results: Overall 32.7% of participants had any assistive device for impaired hand function at their disposal. The most frequent devices were adapted cutlery (14.8%), type supports (14.1%), environmental control systems (11.4%), and writing orthosis (10.6%). In the bivariate analysis several factors showed significant associations with at least one assistive device. Nevertheless, when controlling for potential confounding in multivariate analysis only independence in grooming (adapted cutlery, environmental control systems, type support, speech recognition software), SCI severity (writing orthosis, type support), and sex (adapted kitchenware) remained significantly associated with the availability of the mentioned assistive devices. The self-declared unmet need was generally low (0.7% - 4.3%), except for adapted kitchenware with a moderate unmet need (8.9%).Conclusion: This study indicates that most individuals with tetraplegia in Switzerland are adequately supplied with assistive devices to compensate for impaired hand function. The availability depends mainly on SCI severity and independence in grooming.
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Affiliation(s)
- Stephanie Wäckerlin
- Swiss Paraplegic Research, Nottwil, Switzerland,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne
| | - Armin Gemperli
- Swiss Paraplegic Research, Nottwil, Switzerland,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne
| | | | - Ursina Arnet
- Swiss Paraplegic Research, Nottwil, Switzerland,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne,Correspondence to: Ursina Arnet, Swiss Paraplegic Research, Guido A. Zäch Strasse 4, CH-6207 Nottwil, Switzerland.
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Friesen EL, Theodoros D, Russell TG. Usability of mobile shower commodes for adults with spinal cord injury. Br J Occup Ther 2017. [DOI: 10.1177/0308022616676817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction This paper describes the usability of mobile shower commodes for adults with spinal cord injury, as measured by the new electronic Mobile Shower Commode Assessment Tool Version 1.0 (eMAST 1.0). Method A retrospective analysis of data collected for a cross-sectional validation study with adults aged 18 years or older, living with spinal cord injury, who use mobile shower commodes for toileting and/or showering ( n = 32), was conducted. Usability was measured using the eMAST 1.0. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using directed content analysis. Results Overall usability on both the features and performance subscales was rated as high to very high. Ratings of very low to low usability were reported for portability/foldability/packability (41%, n = 13), mobile shower commode stability (25%, n = 8), positioning and repositioning (25%, n = 8), seat cushioning (25%, n = 8), and lower leg supports (22%, n = 7). Items receiving the highest number of qualitative comments included lower leg supports, seating, propelling and manoeuvring, cleaning and maintenance, and stability. Conclusion Results across the eMAST 1.0’s subscales showed high to very high usability. However, analysis of individual items and qualitative comments showed specific areas of reduced usability for individual users. Item-level responses and qualitative comments suggest research is urgently needed in the areas of stability, portability, durability, and seating. Studies exploring use of the eMAST 1.0 during initial provision, and after short- and long-term mobile shower commode use, are also needed.
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Affiliation(s)
- Emma L Friesen
- PhD Candidate, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Deborah Theodoros
- Professor of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Trevor G Russell
- Professor of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
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Florio J, Arnet U, Gemperli A, Hinrichs T. Need and use of assistive devices for personal mobility by individuals with spinal cord injury. J Spinal Cord Med 2016; 39:461-70. [PMID: 26666510 PMCID: PMC5102298 DOI: 10.1080/10790268.2015.1114228] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To investigate the provision, use, and unmet need of assistive devices for personal mobility in the Swiss population with spinal cord injury (SCI). DESIGN Community survey 2012 of the Swiss Spinal Cord Injury Cohort Study. PARTICIPANTS Individuals aged 16 or older with traumatic or non-traumatic SCI residing in Switzerland. INTERVENTIONS Not applicable. OUTCOME MEASURES Provision, frequency of use, and unmet need (i.e. perceiving the need of a device but it not being provided) of 11 mobility devices were assessed by self-report and analyzed descriptively. Provision of devices was further analyzed by sex, age, SCI etiology, SCI severity, and time since SCI. RESULTS Devices reported highest for provision (N = 492; mean age 55.3 ± 15.1 years; 28.9% female) were adapted cars (78.2%) and manual wheelchairs (69.9%). Provision of various devices markedly varied with age and SCI severity (e.g. 34.6% of those aged 76+ had a walking frame compared to 3.1% of those aged 31-45; 50.0% of participants with complete tetraplegia had a power wheelchair compared to 7.6% of those with complete paraplegia). Many devices were mostly used daily (e.g. manual wheelchair) while others were mostly used less frequently (e.g. handbikes). Unmet need was highest for arm braces (53.2% of those in need) and power assisted wheelchairs (47.3%), and lowest for crutches (11.4%) and manual wheelchairs (4.8%). CONCLUSION The devices individuals have or use is largely dependent on their age and SCI severity. While most participants have access to basic mobility devices, there is still a considerable degree of unmet need for certain devices.
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Affiliation(s)
- Jordanne Florio
- Swiss Paraplegic Research, Nottwil, Switzerland,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Ursina Arnet
- Swiss Paraplegic Research, Nottwil, Switzerland,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Armin Gemperli
- Swiss Paraplegic Research, Nottwil, Switzerland,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Timo Hinrichs
- Swiss Paraplegic Research, Nottwil, Switzerland,Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland,Correspondence to: Timo Hinrichs, Department of Sport, Exercise and Health, University of Basel, Birsstr. 320 B, CH-4052 Basel, Switzerland.
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Friesen EL, Theodoros DG, Russell TG. Development, construction, and content validation of a questionnaire to test mobile shower commode usability. Top Spinal Cord Inj Rehabil 2016; 21:77-86. [PMID: 25762862 DOI: 10.1310/sci2101-77] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Usability is an emerging domain of outcomes measurement in assistive technology provision. Currently, no questionnaires exist to test the usability of mobile shower commodes (MSCs) used by adults with spinal cord injury (SCI). OBJECTIVE To describe the development, construction, and initial content validation of an electronic questionnaire to test mobile shower commode usability for this population. METHODS The questionnaire was constructed using a mixed-methods approach in 5 phases: determining user preferences for the questionnaire's format, developing an item bank of usability indicators from the literature and judgement of experts, constructing a preliminary questionnaire, assessing content validity with a panel of experts, and constructing the final questionnaire. RESULTS The electronic Mobile Shower Commode Assessment Tool Version 1.0 (eMAST 1.0) questionnaire tests MSC features and performance during activities identified using a mixed-methods approach and in consultation with users. It confirms that usability is complex and multidimensional. The final questionnaire contains 25 questions in 3 sections. The eMAST 1.0 demonstrates excellent content validity as determined by a small sample of expert clinicians. CONCLUSION The eMAST 1.0 tests usability of MSCs from the perspective of adults with SCI and may be used to solicit feedback during MSC design, assessment, prescription, and ongoing use. Further studies assessing the eMAST's psychometric properties, including studies with users of MSCs, are needed.
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Affiliation(s)
- Emma L Friesen
- School of Health and Rehabilitation Sciences, The University of Queensland , St. Lucia, Australia ; Centre for Research Excellence in Telehealth, The University of Queensland , St. Lucia, Australia ; NSW Paediatric Spinal Outreach Service , Northcott, North Parramatta, Australia
| | - Deborah G Theodoros
- School of Health and Rehabilitation Sciences, The University of Queensland , St. Lucia, Australia ; Centre for Research Excellence in Telehealth, The University of Queensland , St. Lucia, Australia
| | - Trevor G Russell
- School of Health and Rehabilitation Sciences, The University of Queensland , St. Lucia, Australia ; Centre for Research Excellence in Telehealth, The University of Queensland , St. Lucia, Australia
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Taylor S, Gassaway J, Heisler-Varriale LA, Kozlowski A, Teeter L, Labarbera J, Vargas C, Natale A, Swirsky A. Patterns in Wheeled Mobility Skills Training, Equipment Evaluation, and Utilization: Findings from the SCIRehab Project. Assist Technol 2015; 27:59-68. [PMID: 26132349 DOI: 10.1080/10400435.2014.978511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Patients with traumatic spinal cord injury (SCI) participate in manual and power wheelchair (WC) skills training during inpatient rehabilitation; wheeled mobility evaluations aim to optimize use, fit, and function of equipment following discharge. Occupational and physical therapists documented treatment sessions during inpatient rehabilitation to describe types and quantity of WC skills training and adaptive equipment (AE) provided by neurological level of injury. Most patients participated in WC skills training; variation in type and frequency exists. Propulsion/driving skills were practiced most frequently. A majority of patients participated in equipment evaluations; assessment/prescription and fitting were performed frequently; mat evaluations were done infrequently. Most patients received mobility equipment in a timely manner; they continued to use their WC and were satisfied with its fit and function at the one-year injury anniversary. High levels of respondent satisfaction with fit and function of WCs suggest clinicians are prescribing mobility devices adequately and accurately supplementing information obtained during equipment assessment and fitting sessions with information from general treatment sessions. Variation in type and frequency of WC training provided by level of SCI and in types of WC prescribed use provides a foundation for future research to relate treatment modalities with functional and participation outcomes.
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Affiliation(s)
- Sally Taylor
- a Rehabilitation Institute of Chicago , Chicago , Illinois , USA
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Friesen EL, Theodoros D, Russell TG. Assistive technology devices for toileting and showering used in spinal cord injury rehabilitation - a comment on terminology. Disabil Rehabil Assist Technol 2014; 11:1-2. [PMID: 25399923 DOI: 10.3109/17483107.2014.984779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A review of assistive technologies, products and devices for toileting and showering identified at least 15 separate terms across all studies, with another two identified in subsequent studies. Terms are often used interchangeably, and are often not defined or described. Inconsistencies in terminology affect the quality of evidence available to policy makers, researchers and clinicians. Researchers are encouraged to provide clear definitions and descriptions of assistive technologies, products and devices for toileting and showering under investigation. Implications for Rehabilitation At least 17 different terms have been identified for assistive technologies, products and devices for toileting and showering. Inconsistencies in terminology make comparisons between studies difficult, and therefore affect the quality of evidence available to policy makers, researchers and clinicians. Providing clear definitions and descriptions of assistive technologies, products and devices for toileting and showering under investigation is encouraged.
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Affiliation(s)
- Emma L Friesen
- a School of Health and Rehabilitation Sciences and.,b Centre of Research Excellence in Telehealth, The University of Queensland , St Lucia , Queensland , Australia
| | - Deborah Theodoros
- a School of Health and Rehabilitation Sciences and.,b Centre of Research Excellence in Telehealth, The University of Queensland , St Lucia , Queensland , Australia
| | - Trevor G Russell
- a School of Health and Rehabilitation Sciences and.,b Centre of Research Excellence in Telehealth, The University of Queensland , St Lucia , Queensland , Australia
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Friesen EL, Theodoros D, Russell TG. Use, performance and features of mobile shower commodes: perspectives of adults with spinal cord injury and expert clinicians. Disabil Rehabil Assist Technol 2013; 10:38-45. [PMID: 24003959 DOI: 10.3109/17483107.2013.832413] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The purpose of this article is to explore the use of Mobile Shower Commodes (MSCs) by adults with Spinal Cord Injury (SCI) and to understand how adults with SCI and expert clinicians identify and select MSC designs and features. METHOD Semi-structured interviews were conducted with seven adults with SCI and eight expert clinical prescribers using semi-structured guides. Transcripts were analysed thematically using the Policy, Human, Activity, Assistance and Technology, and Environment (PHAATE) model as the underpinning theoretical framework. RESULTS Analysis of the interview transcripts revealed 3 themes and 12 sub-themes. The main themes were: (1) Activities, routines and interacting factors, (2) Features for functioning and (3) Getting it right. Substantial links existed between and across the themes and subthemes. CONCLUSIONS The use of MSCs by adults with SCI is complex. MSC performance varies across activities, and during interactions between the user, the MSC, other assistive technologies, assistance and physical environments. Future studies should explore service delivery processes and develop validated clinical assessment instruments and outcome measures for MSC provision. Implications for Rehabilitation Mobile shower commode use is complex, involving nine distinct activities and three types of routines. Mobile shower commodes used by Australian adults with SCI are individualised to users and include customisations and custom-made components. Trialling individualised mobile shower commodes prior to funding is problematic and not reflected in assistive service delivery models. Validated clinical instruments for assessing and selecting mobile shower commode features are needed.
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Affiliation(s)
- Emma L Friesen
- Telerehabilitation Research Unit, School of Health and Rehabilitation Sciences, University of Queensland , St Lucia, Qld , Australia
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