Home medical equipment receipt in a home care appropriate population

Measuring stigma across neurological conditions: the development of the stigma scale for chronic illness (SSCI)

PURPOSE

Most measures of stigma are illness specific and do not allow for comparisons across conditions. As part of a study of health-related quality of life for people with neurological disorders, our team developed an instrument to assess the stigma for people with chronic illnesses.

METHODS

We based item content on literature review, responses from focus groups, and cognitive interviews. We then administered the items to people with neurological disorders for psychometric testing.

RESULTS

Five hundred eleven participants completed items of the stigma scale. Exploratory factor analysis produced two factors that were highly correlated (r = 0.81). Confirmatory factor analysis produced high standardized loadings on an overall stigma factor (0.68-0.94), with poorer loadings on the two sub-domains (-0.12 to 0.53). These results demonstrated a sufficiently unidimensional scale that corresponded with the bifactor model. Item response theory modeling suggested good model fit, and differential item functioning analyses indicated that the 24-item scale showed potential for measurement equivalence across conditions.

CONCLUSIONS

Our efforts produced a stigma scale that had promising psychometric properties. Further study can provide additional information about the SSCI and its benefit in measuring the impact of stigma across conditions.

Methodological challenges confronting researchers of wheeled mobility aids and other assistive technologies

PURPOSE

To identify gaps in assistive technology (AT) research and solutions, with a focus on wheeled mobility.

METHODS

Literature review.

RESULTS

AT researchers have identified a need to move beyond determining whether a device works well in the laboratory or is perceived favorably by users. The vital next step in AT research is to determine the effects of AT when used for day-to-day activities by typical consumers. Four challenges affect AT research on everyday mobility: (1) the heterogeneity of the population using AT, the environments in which AT is used, and the devices themselves; (2) the dependency of empirical research on objective data for valid causal inference; (3) the need for detailed information to capture the interaction between the person, the device, and the environment in which it is used; and (4) the extent to which success or failure of AT is dependent on the personal perspectives of the individual using the device. These challenges are being addressed by AT researchers through use of new measures, novel data collection methods, and by linking quantitative with qualitative data.

CONCLUSIONS

AT researchers are adapting traditional research designs and analytic methods to examine that effects of AT on everyday life.