Are Functional Measures Sufficient to Capture Acceptance? A Qualitative Study on Lower Limb Exoskeleton Use for Older People

Lower limb exoskeletons (LLE) are robotic devices developed to assist walk. In the field of healthcare, this technology has been available for almost a decade, yet it still faces important acceptance issues. While LLE were first developed for patients with spinal cord injuries, we expect their use to expand to everyday settings to benefit other populations, namely that of older people with reduced mobility (RM). We propose a qualitative approach to unearth key psychosocial themes on the acceptance of LLE in daily living for older people. The study analyses perceptions of older people with RM, as well as their entourage, including informal and professional caregivers. Using a grounded theory approach we analysed 12 semi-structured interviews with older people with RM; 2 focus groups with informal caregivers, and 2 focus groups with professional caregivers. LLE were introduced to participants through photo-elicitation. Older people with RM believed that LLE would increase their autonomy. They also perceived that using LLE would make them feel less of a burden for their entourage. Beyond these expected benefits, results captured participants’ ambivalence, dependent on their experiences of the ageing process and perceptions on the human–machine interaction. Informal caregivers highlighted that LLE could provide important relief related to the burden of care. Nonetheless, professional caregivers raised the fear of LLE leading to dehumanization of care. While each group had specific concerns on how LLE use would impact their lives, psychosocial considerations played a key role in LLE acceptance.

Affective modulation in positive psychology’s regime of happiness

Over the last decade, positive psychology has reified happiness as the key to achieving an understanding of human psychological experience and development. According to positive psychology, happiness can be understood as a measurable object of self-cultivation and psychological enhancement. This conceptualization has provoked multiple critiques, focusing on the power effects invested in these psychological discourses, with a special emphasis on the governmentality practices they exercise on subjectivity formation, in the context of neoliberal capitalism. Less attention has been paid to the ways in which specific technologies, derived from this “turn to happiness,” have had an influence on subjects’ bodies and embodied experiences beyond discursive means. In this article, we borrow insights from affect studies to contribute to and expand the critique of positive psychology. We do this by analyzing a positive psychology-based app called “Happify.” Our analysis consists of identifying and describing three mechanisms through which this technology modulates the capacities of human bodies by producing preemptive habits that result in what we call the positive psychology regime of happiness.

A model of well-being for children with neurodevelopmental disorders: Parental perceptions of functioning, services, and support

BACKGROUND

Both child function and supports and services have been found to impact the well-being of parents of children with neurodevelopmental disorders (NDD). The relationship between function and services and the well-being of children with NDD is less well-understood and is important to clarify in order to effect program and service change.

METHODS

The current project assessed whether child function as well as the adequacy of formal supports and services provided to children and their families were predictive of child well-being. Well-being was assessed using a measure of quality of life developed for use with children with NDD. Data from 234 parents were analysed using structural equation modelling.

RESULTS

Each predictor was found to load significantly on the overall outcome variable of well-being. Parent concerns about child function were significantly related to child well-being; parents who reported more concerns about their children's functioning reported lower levels of child well-being. Unmet needs for formal supports and services were also significantly related to child well-being; parents who reported that more of their children's and family's service needs were unmet reported lower child well-being. An indirect relationship was also found between child function and child well-being. When parents reported that their formal support needs were adequately met, their children's functional difficulties had a lower impact on parent perceptions of their children's overall well-being.

CONCLUSIONS

Taken together, the results of the current study enrich our understanding of well-being for children with NDD. Discussion focuses on the service implications for children with NDD and their families.