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Jahan AM, Guitard P, Jutai JW. Assistive devices non-use, abandonment, or non-adherence? Toward standard terminology for assistive devices outcomes. Assist Technol 2024:1-11. [PMID: 38838098 DOI: 10.1080/10400435.2024.2362139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2024] [Indexed: 06/07/2024] Open
Abstract
For individuals with disabilities, failure to use prescribed assistive technology devices (ATDs) according to professional recommendations can have detrimental health consequences. The literature has employed various terms to describe this phenomenon such as nonuse, abandonment, and non-adherence to characterize this behavior, lacking clear and standardized definitions. Consistent use of a standardized language is critical for advancing research in this area. This study aims to identify and describe the concepts related to the failure to use prescribed ATDs, along with the associated contexts, and proposes a framework for standardizing terminology in this domain. A narrative literature review encompassing studies from inception to June 2023 was conducted to elucidate these concepts. Out of 1029 initially identified articles, 27 were retained for in-depth analysis. The review unveiled a significant inconsistency in the use of terms like nonuse, abandonment, noncompliance, and non-adherence. Some articles even employed these terms interchangeably without clear definitions. Only 10 of the 27 reviewed articles provided definitions for the terminology they used. This highlights the crucial need for adopting valid conceptual models to select appropriate terms. Researchers are strongly encouraged to furnish operational definitions aligned with theoretical models and relevant to their research context to advance this field consistently.
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Affiliation(s)
- Alhadi M Jahan
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Paulette Guitard
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeffrey W Jutai
- School of Interdisciplinary Health Sciences and Life Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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Nuri RP, Xu X, Aldersey HM. Users' satisfaction and experiences in using assistive devices distributed by a rehabilitation centre in Bangladesh: a cross-sectional study. Disabil Rehabil Assist Technol 2024; 19:868-877. [PMID: 36215415 DOI: 10.1080/17483107.2022.2129849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 09/18/2022] [Accepted: 09/22/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE This study aimed to understand Bangladeshi users' satisfaction with their assistive devices, including (a) device characteristics, e.g., size, weight, safety, ease of use, comfort, and effectiveness, and (b) availability of parts and repair services. We also described how frequently individuals with disabilities living in the community used assistive devices in their daily activities and how the use of assistive devices promoted individuals' wellbeing. METHOD We conducted a cross-sectional survey with assistive device users or their guardians (if under 18) in Bangladesh about their experience and satisfaction with their assistive device 6 months after receiving it. The research team developed a survey questionnaire consisting of both closed and open-ended questions. All data were collected via telephone interviews. We employed descriptive statistics to analyse quantitative data and inductive analysis for the qualitative data. RESULTS We found that out of the 376 participants, nearly 95% used assistive devices on a regular basis, and their satisfaction with the devices was high. Participants reported that assistive devices improved mobility, independence, and wellbeing of persons with disabilities. A few participants (6.4%) reported that their devices were damaged. Some participants identified concerns with their assistive devices, including (i) inappropriate size of ankle-foot orthoses, manual self-propelled wheelchairs, and prostheses, (ii) back slabs (a type of brace) being too short, and (iii) walking frames being too large. Several participants noted pain and discomfort when they used their assistive device. Additionally, some participants stated that environmental factors (e.g., muddy roads) contributed to the disrepair of their assistive devices. Finally, participants recounted that repair services were limited in rural areas of Bangladesh. CONCLUSION These findings indicate that the provision of assistive devices requires accommodating individuals' needs and ensuring appropriate environments in which to function. The results support the need for follow-up services after distributing assistive devices. Further research could explore the impact of assistive devices on the family quality of life of persons with disabilities.IMPLICATIONS FOR REHABILITATIONIt is essential for rehabilitation professionals to conduct follow-up services after distributing assistive devices among persons with disabilities.There is a need for the government of Bangladesh to revisit the Rights and Protection of Persons with Disability Act of 2013 and provide further clarity about their commitment to the provision of assistive devices and associated services (e.g., repair services) and its subsequent implementation.Policymakers in Bangladesh must be proactive to translate policy commitments into practice, as it relates to building an accessible environment for people using assistive devices. Further, government efforts are needed to educate policy implementers in all relevant ministries so that all responsible bodies are fully familiar with their national and international commitments regarding the rights of persons with disabilities.Future research could (i) include user's satisfaction with the service delivery process and (ii) measure the impact of assistive devices on family quality of life of persons with disabilities.
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Affiliation(s)
| | - Xiaolin Xu
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
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Goodarzi F, Khoshravesh S, Ayubi E, Bashirian S, Barati M. Psychosocial determinants of functional independence among older adults: A systematic review and meta-analysis. Health Promot Perspect 2024; 14:32-43. [PMID: 38623346 PMCID: PMC11016145 DOI: 10.34172/hpp.42354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/11/2023] [Indexed: 04/17/2024] Open
Abstract
Background In current years, the increase in older population has led to creating one of the main public health challenges, worldwide. Because of the special characteristics of older adults, this age group is exposed to possible problems, such as mental and physical disorders, that usually affect their functional independence. The study aimed to determine the psychosocial determinants (e.g., depression, social support, and self-efficacy) affecting functional independence among older population. Methods Our search was conducted on three international databases (Web of Sciences, PubMed/Medline, and Scopus) for all the observational studies (cross-sectional, cohort or longitudinal designs) on the social and psychological determinants of functional independence among older adults. Papers published in English without limitation of time were reviewed from inception to 26 August 2023. The quality assessment tool was the Newcastle-Ottawa Scale (NOS). The I2 index was used to quantify the degree of heterogeneity among the studies. In the case of heterogeneity higher than 50%, the random effects model has been used for overall estimation of the effects; otherwise, the fixed effects model was used. The pooled associations were expressed as odds ratio (OR) and 95% confidence intervals (CIs). Stata version 14 software (StataCorp LP) was used for data analysis. The significance level was considered at 0.05. Results In the initial search, 6978 articles were retrieved, and finally, considering the inclusion criteria, 46 articles were examined. Finally, 18 articles were eligible for meta-analysis. The findings indicated that among all the determinants affecting functional independence among older adults, depression could lead to a 76% increase in functional dependence. Conclusion The findings provide a statistically significant relationship between psychosocial factors and functional independence. Depression was the strongest determinant of functional dependence among older adults.
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Affiliation(s)
- Fataneh Goodarzi
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sahar Khoshravesh
- Department of Nursing, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Erfan Ayubi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeid Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Goodarzi F, Barati M, Bashirian S, Ayubi E, Rahbar S, Cheraghi P. The experiences of the elderly regarding the use of rehabilitation assistive technologies: a directed qualitative content analysis. Disabil Rehabil Assist Technol 2024:1-12. [PMID: 38329221 DOI: 10.1080/17483107.2024.2313081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE The elderly population faces reduced levels of health and performance, which necessitates the use of rehabilitation assistive technologies to maximize functional independence in daily activities. This study aimed to explain the experiences of the elderly regarding the use of rehabilitation assistive technologies based on the Unified Theory of Acceptance and Use of Technology. METHODS The present study was a qualitative study of the type of content analysis that was conducted in the city of Hamadan in 2022. Participants included 20 elderly aged 60 years or above who were selected as a purposive sample and subjected to individual semi-structured in-depth interviews. Data were analyzed using directed qualitative content analysis based on Hsieh and Shannon's approach. Data were coded using MAXQDA software (MAXQDA Analytics Pro 2020, VERBI GmbH Berlin). RESULTS According to the results, 260 primary codes were extracted, and they were classified into five predetermined categories of the Unified Theory of Acceptance and Use of Technology, including performance expectancy, effort expectancy, social influence, facilitating conditions, and behavioral intention, as well as two new categories of technology anxiety and perceived need for technology. After extracting 260 primary codes based on the Unified Theory of Acceptance and Use of Technology, 75 sub-categories were identified in 14 main categories. CONCLUSION The themes obtained from the study indicate the necessity of providing the required conditions to maintain the complete independence and health of the elderly and strengthen their morale. The results can be helpful in the development of support strategies for family members, healthcare providers, and policymakers.
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Affiliation(s)
- Fataneh Goodarzi
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeid Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Erfan Ayubi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Soulmaz Rahbar
- Department of Physiotherapy, School of Rehabilitation Sciences, Hamadan university of medical sciences, Hamadan, Iran
| | - Parvin Cheraghi
- Department of Health Education and Promotion, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Zhang B, Ma M, Wang Z. Promoting active aging through assistive product design innovation: a preference-based integrated design framework. Front Public Health 2023; 11:1203830. [PMID: 37404280 PMCID: PMC10315631 DOI: 10.3389/fpubh.2023.1203830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/31/2023] [Indexed: 07/06/2023] Open
Abstract
Background With the accelerating trend of global aging, over one billion people need to use one or more types of assistive products. However, the high abandonment rate of current assistive products is affecting the quality of life of the older adults, posing challenges to public health. Accurately capturing the preference factors of the older adults in the design process is an important way to improve the acceptance of assistive products. In addition, a systematic approach is needed to translate these preference factors into innovative product solutions. These two issues are less addressed in existing research. Methods First, the evaluation grid method was used to conduct in-depth interviews with users and extract the structure of preference factors for assistive products. Quantification theory type I was used to calculate the weight of each factor. Secondly, universal design principles, TRIZ theory's contradiction analysis techniques, and invention principles were used to translate the preference factors into design guidelines. Then, finite structure method (FSM), morphological chart, and CAD techniques were used to visualize the design guidelines as alternatives. Finally, Analytic Hierarchy Process (AHP) was used to evaluate and rank the alternatives. Results A Preference-based Assistive Product Design Model (PAPDM) was proposed. The model includes three stages: definition, ideation, and evaluation. A case study on walking aid demonstrated the execution of PAPDM. The results show that 28 preference factors influence the four psychological needs of the older adults: sense of security, sense of independence, self-esteem, and sense of participation. These psychological needs were reflected in the shape, color, material, universality, user-friendly, reliability, and smart functions of assistive products. The preference factors were transformed into five design guidelines, and three alternatives were generated. Finally, the evaluation concludes that solution C was the optimal solution. Conclusion The PAPDM framework provides designers with a transparent, progressive approach to designing assistive products that meet unique needs and preferences of older adults. This enhances objectivity and scientific rigor in assistive product development, avoiding blind design and production. By considering the perspective of older adults from the outset, we can avoid high abandonment rates of assistive products and contribute to promoting active aging.
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Affiliation(s)
- Baoyi Zhang
- School of Design Art, Xiamen University of Technology, Xiamen, China
- Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan
| | - Minyuan Ma
- Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan
| | - Zongsheng Wang
- School of Design Art, Xiamen University of Technology, Xiamen, China
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The Complexities of Prescribing Assistive Equipment at the End of Life—Patient and Caregivers’ Perspectives. Healthcare (Basel) 2022; 10:healthcare10061005. [PMID: 35742056 PMCID: PMC9222988 DOI: 10.3390/healthcare10061005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 02/01/2023] Open
Abstract
Ongoing participation in valued and essential everyday activities remains a priority for people with advanced disease. This study sought to understand factors influencing patients with advanced disease and caregivers’ utilisation of assistive equipment that enable this participation. Employing a pragmatic approach, purposive sampling identified participants who were interviewed in their homes. A semi-structured interview guide was employed to elicit community dwelling patients’ and caregivers’ perspectives about assistive equipment utilisation. Recorded interviews were analysed inductively and themes were constructed from the data. Fourteen interviews were conducted with patients and caregivers. Patients had a range of cancers and COPD. Three empirically developed themes demonstrate the complexities associated with the use of assistive equipment at the end of life: 1. Enabling engagement in everyday activities; 2. Dependency—a two-way street; 3. The pragmatics of choosing, using or declining assistive equipment. Participants were motivated to use assistive equipment when it optimised their function, enabled participation and supported their values, roles and interests. Conversely, use of assistive equipment could be met with ambivalence as it represented deterioration or could cause conflict within relationships. Caregivers found assistive equipment made it easier for them to provide physical care. Skilled proactive assistive equipment prescription and training by allied health professionals enhanced patient and caregiver confidence and capacity to engage in everyday activities.
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ShahAli S, ShahAli S, Ebrahimi Takamjani I, Shahabi S. COVID-19 and Iranian older people: rehabilitation perspective. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1783112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Shabnam ShahAli
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shiva ShahAli
- Medical Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ismail Ebrahimi Takamjani
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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De-Rosende-Celeiro I, Torres G, Seoane-Bouzas M, Ávila A. Exploring the use of assistive products to promote functional independence in self-care activities in the bathroom. PLoS One 2019; 14:e0215002. [PMID: 30958846 PMCID: PMC6453482 DOI: 10.1371/journal.pone.0215002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 03/25/2019] [Indexed: 11/29/2022] Open
Abstract
In homes, problems in daily functioning of older people often occur in the bathroom, especially in the transfers to the toilet and/or shower/bath. Assistive products have the potential to maximise functional independence (i.e. performance without assistance from another person) in everyday activities; however, more research is needed to better understand the impact of this technology on independence in the transfers in the bathroom. Additionally, little is known about the role of the environmental factors in the process of implementing bathroom adaptations. Therefore, this cross-sectional study aimed to examine the relationship between the use of assistive products and independence in the transfers in the bathroom. The secondary objective was to determine the role of the environmental factors in predicting the implementation of bathroom adaptations. 193 community-dwelling older adults with disabilities in the basic activities of daily life, who requested public long-term care services in Spain, were included. Data was collected in the participant´s homes using a standardised assessment procedure. There was no significant association between the number of categories of assistive products used in the toilet transfer and the independent performance of this task. In a multivariate model, the number of categories of assistive products used in the transfer to shower/bath was positively associated with the independent performance of this transfer (OR = 2.59, 95%CI = 1.48–4.53; p = 0.001). A multivariate analysis revealed that social functioning was significantly associated with the implementation of a bathroom adaptation; social risk was lower in participants who made an adaptation (OR = 0.76, 95%CI = 0.63–0.93; p = 0.006). Assistive products may play an important role in promoting independence in the bathroom. Assistive product needs should be addressed when planning community-based interventions aimed at improving daily life. Moreover, social functioning had a strong influence on the installation of bathroom adaptations, suggesting the importance of paying special attention to social factors in the home adaptations planning process.
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Affiliation(s)
| | - Gabriel Torres
- Department of Physical and Sports Education, University of A Coruña, A Coruña, Spain
| | | | - Adriana Ávila
- Department of Health Sciences, University of A Coruña, A Coruña, Spain
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Moxham LJ, Stutchbury TK, Spinks G, de Vet E, Ikutegbe V, Traynor V, Taylor L, Michielin N. Understanding the assistive technology needs of people over 55: The future of mobility aids. Australas J Ageing 2019; 38:e127-e134. [PMID: 30950196 DOI: 10.1111/ajag.12648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 02/18/2019] [Accepted: 03/01/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To understand mobility issues not adequately serviced by assistive technology (AT). METHODS A two-stage mixed-methods research project that forms the basis of future AT design and manufacture. Stage 1: a focus group comprising 46 participants (people aged 55 years or older with mobility issue/s) and their support networks. Stage 2: a sample of 413 people over 55 completed a purpose-designed survey informed by stage 1, regarding mobility issues and perceived desirability of suggested AT mobility aids. RESULTS Two core themes emerged: (a) functionality issues relating to existing AT designs and (b) identified mobility issues encountered during activities of daily living that could potentially be resolved by developing new AT. Importance was placed on certain features of AT mobility aids with cost, transportability and aesthetics being primary issues. CONCLUSION Consulting end-users and their networks ensures valuable insight into how future AT can better address and target mobility needs.
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Affiliation(s)
- Lorna J Moxham
- University of Wollongong, Wollongong, New South Wales, Australia
| | | | - Geoffrey Spinks
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Eliza de Vet
- University of Wollongong, Wollongong, New South Wales, Australia
| | | | - Victoria Traynor
- University of Wollongong, Wollongong, New South Wales, Australia
| | | | - Nicole Michielin
- University of Wollongong, Wollongong, New South Wales, Australia
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Bergem S. Knowledge among important actors in the field of adaptive equipment for young people with disabilities. Disabil Rehabil Assist Technol 2019; 15:109-118. [PMID: 30663447 DOI: 10.1080/17483107.2018.1538393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Access to adaptive equipment is a crucial factor that can determine if a child or youth with disabilities is going to participate in physical activities, sports and play in different local settings. A prerequisite for success is awareness of and specific knowledge concerning the equipment and its use among relevant actors. The aim of this paper is to explore how important groups of actors working with young people with disabilities perceive their level of knowledge concerning adaptive equipment and discuss these actors' role in children and youths' opportunities to obtain relevant equipment to participate in activities.Methods: An online, population-based national survey was distributed to: (1) occupational therapists and physiotherapists, (2) teachers, and (3) leaders and coaches in sports clubs in Norway.Results: The findings generally indicate that overall knowledge concerning adaptive equipment among the three groups is limited. However, significant statistical difference is found, indicating that occupational therapists and physiotherapists have higher levels of general knowledge, about the accessibility of equipment, regulations and legislation and that they are more familiar with adaptive equipment than teachers, leaders and coaches.Conclusions: A practical implication of the results is that the actors' varying knowledge and experiences need to be brought together to form a coherent picture of how the equipment will be used and by whom. This can contribute to an increased understanding concerning adaptive equipment and its importance among different actors, which could help more young people with disabilities to participate.Implications for RehabilitationImportant actors must utilize the knowledge and experience possessed by young people with disabilities concerning adaptive equipment.Improved access to knowledge concerning adaptive equipment among important actors is required.Increased collaboration between different actors relating to adaptive equipment and participation is needed.
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Affiliation(s)
- Svein Bergem
- Norwegian National Advisory Unit on Disabilities in Children, Valnesfjord, Nord University, Bodø, Norway
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Antos SA, Danilovich MK, Eisenstein AR, Gordon KE, Kording KP. Smartwatches Can Detect Walker and Cane Use in Older Adults. Innov Aging 2019; 3:igz008. [PMID: 31025002 PMCID: PMC6476414 DOI: 10.1093/geroni/igz008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Clinicians commonly prescribe assistive devices such as walkers or canes to reduce older adults' fall risk. However, older adults may not consistently use their assistive device, and measuring adherence can be challenging due to self-report bias or cognitive deficits. Because walking patterns can change while using an assistive device, we hypothesized that smartphones and smartwatches, combined with machine-learning algorithms, could detect whether an older adult was walking with an assistive device. RESEARCH DESIGN AND METHODS Older adults at an Adult Day Center (n = 14) wore an Android smartphone and Actigraph smartwatch while completing the six-minute walk, 10-meter walk, and Timed Up and Go tests with and without their assistive device on five separate days. We used accelerometer data from the devices to build machine-learning algorithms to detect whether the participant was walking with or without their assistive device. We tested our algorithms using cross-validation. RESULTS Smartwatch classifiers could accurately detect assistive device use, but smartphone classifiers performed poorly. Customized smartwatch classifiers, which were created specifically for one participant, had greater than 95% classification accuracy for all participants. Noncustomized smartwatch classifiers (ie, an "off-the-shelf" system) had greater than 90% accuracy for 10 of the 14 participants. A noncustomized system performed better for walker users than cane users. DISCUSSION AND IMPLICATIONS Our approach can leverage data from existing commercial devices to provide a deeper understanding of walker or cane use. This work can inform scalable public health monitoring tools to quantify assistive device adherence and enable proactive fall interventions.
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Affiliation(s)
- Stephen A Antos
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois
- Department of Bioengineering, University of Pennsylvania, Philadelphia
| | - Margaret K Danilovich
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois
| | - Amy R Eisenstein
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
- CJE SeniorLife, Leonard Schanfield Research Institute, Chicago, Illinois
| | - Keith E Gordon
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois
- Research Service, Edward Hines Jr. VA Hospital, Hines, Illinois
| | - Konrad P Kording
- Department of Bioengineering, University of Pennsylvania, Philadelphia
- Department of Neuroscience, University of Pennsylvania, Philadelphia
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Hip fractures - Treatment and functional outcome. The development over 25 years. Injury 2018; 49:2209-2215. [PMID: 30366830 DOI: 10.1016/j.injury.2018.10.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 10/08/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Nearly 18,000 individuals suffer from hip fracture in Sweden each year. The choice in operation method for femoral neck fractures has changed over the years as well as the overall management. Functional outcome after hip fracture is affected by several factors and the overall functional level for old people in Sweden has improved over the last decades. OBJECTIVE To describe and analyse the functional outcome and choice of operation method for hip fracture patients between 1988 and 2012. PATIENTS AND METHODS All patients with cervical or trochanteric hip fracture treated at Lund University Hospital from 1988 until 2012 were collected from the National Quality Register for hip fracture patients, RIKSHÖFT. Patients younger than 50 years and those with pathological fractures were excluded. Data regarding patient characteristics, fracture type, operation method and housing, walking ability and use of walk aids prefracture and at 4-months follow-up was retrieved and analysed. RESULTS For this study 8723 patients were included with a mean age of 81.6 (men 79.3, women 82.5). The mean age significantly increased over the period studied. Sliding hip screw dominates as method of choice for the trochanteric fractures. For the cervical fractures there is a clear shift from osteosynthesis to arthroplasty. There is a significant decrease in functional outcome at follow-up compared to prefracture. No significant trend change can be seen over 25 years. Functional outcome are worse for the patients with trochanteric fracture. CONCLUSION Although there have been changes in operation methods for hip fractures and the management has developed, our study does not show any effect on functional outcome over a 25-year period. The medical condition of these patients with increasing age seems to counteract efforts to improve the care.
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Larsen SM, Mortensen RF, Kristensen HK, Hounsgaard L. Older adults' perspectives on the process of becoming users of assistive technology: a qualitative systematic review and meta-synthesis. Disabil Rehabil Assist Technol 2018; 14:182-193. [PMID: 29683014 DOI: 10.1080/17483107.2018.1463403] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To identify, synthesize, and evaluate existing literature concerning the process of becoming a user of assistive technology (AT). METHOD A systematic review and meta-synthesis were carried out. Five bibliographic databases (MEDLINE via PubMed, CINAHL, Web of Science, PsycINFO and SocINDEX) were systematically searched up to 13th of March 2017, using two sets of search terms: (i) elderly and synonyms and (ii) assistive technology and similar words, and combined with a qualitative research filter. Articles were screened, read and critically assessed. The meta-synthesis was guided by Ricoeur's theory of interpretation. RESULTS Seventeen out of 4645 articles were included. Five phases emerged relating to the process of becoming a user of AT: phase A: Evaluating need, phase B: Acknowledging need, phase C: Incorporating the AT into daily life, phase D: Using the AT, and phase E: Future use. Three transitions, describing factors essential to moving from one phase to the next, were identified; from phase A-B: Valued activities are threatened, from phase B-C: Obtaining the AT and from phase C-D: Trust in the AT. No transition was identified from phase D-E. CONCLUSION The meta-synthesis led to a deeper understanding of the process of older adults becoming users of AT, by exploring findings across the included articles. The identified phases and transitions in the systematic review serve as an analytical framework for understanding the process from the older adult's perspective. This review advocates for using a client-centred approach throughout the entire delivery process. Implications for rehabilitation The process of the older adult becoming a user of AT involves an individualized time factor, and this supports the practice of individualized follow-up. The process of becoming a user of AT is closely related to self-image; healthcare professionals should support not only the use of AT but also the older adult's emotional adjustment to a new self-image. The process is highly influenced by the older adult's social context; healthcare professionals should consider involving the client's social network in the AT delivery process.
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Affiliation(s)
- Stina Meyer Larsen
- a Unit of Rehabilitation, Department of Clinical Research , University of Southern Denmark , Odense , Denmark.,b Health Sciences Research Centre , University College Lillebaelt , Odense , Denmark
| | | | - Hanne Kaae Kristensen
- a Unit of Rehabilitation, Department of Clinical Research , University of Southern Denmark , Odense , Denmark.,b Health Sciences Research Centre , University College Lillebaelt , Odense , Denmark
| | - Lise Hounsgaard
- b Health Sciences Research Centre , University College Lillebaelt , Odense , Denmark.,d Department of Clinical Research , University of Southern Denmark, Odense Patient Data Explorative Network , Odense , Denmark.,e Centre for Psychiatric Nursing and Health Research, Department of Regional Health Research , University of Southern Denmark , Odense , Denmark.,f Department of Nursing and Health Science , University of Greenland , Nuuk , Greenland
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Bontje P, Alsaker S, Asaba E, Kottorp A, Josephsson S. (Re-)Establishing familiarity: Resumption of occupations by older adults with physical disabilities. Scand J Occup Ther 2018; 26:423-432. [DOI: 10.1080/11038128.2018.1441324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Peter Bontje
- Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo, Japan
- Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Sissel Alsaker
- Department of Occupational Therapy, Sør-Trøndelag University College, Trondheim, Norway
| | - Eric Asaba
- Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo, Japan
- Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Anders Kottorp
- Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo, Japan
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Staffan Josephsson
- Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
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Abstract
Purpose of the Study Examine patterns of cane and walker use as related to falls and fall injuries. Hypotheses Among people who fall at home, most do not have an assistive device with them when they fall. Nonusers who fall sustain more severe injuries. Design and Methods This was a cross-sectional study using a self-administered written survey completed by 262 people aged 60 and older who were community dwelling, cognitively intact, and current cane/walker users with a history of falls. They were recruited through clinical practice sites, churches, and senior housing in central Michigan. Outcomes of interest included patterns of device use, reasons for nonuse, device use at time of fall, and fall-related injuries. Results Seventy-five percent of respondents who fell were not using their device at the time of fall despite stating that canes help prevent falls. Reasons for nonuse included believing it was not needed, forgetfulness, the device made them feel old, and inaccessibility. Perceived risk was not high enough to engage in self-protective behavior. However, nonuse led to a significantly higher proportion of falls resulting in surgery than among device users. Among respondents requiring surgery, 100% were nonusers. Most respondents never received a home safety evaluation (68%) and only 50% received training on proper device use. Implications Providers must place increased emphasis on the importance of cane/walker use for injury prevention through patient education to promote personal relevance, proper fitting, and training. New strategies are needed to improve device acceptability and accessibility.
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Affiliation(s)
- Clare Luz
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing
| | - Tamara Bush
- Department of Mechanical Engineering, College of Engineering, Michigan State University, East Lansing
| | - Xiaoxi Shen
- Department of Statistics and Probability, Michigan State University, East Lansing
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Hooper B, Verdonck M, Amsters D, Myburg M, Allan E. Smart-device environmental control systems: experiences of people with cervical spinal cord injuries. Disabil Rehabil Assist Technol 2017; 13:724-730. [PMID: 28875740 DOI: 10.1080/17483107.2017.1369591] [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: 10/18/2022]
Abstract
BACKGROUND Environmental control systems (ECS) are devices that enable people with severe physical limitations to independently control household appliances. Recent advancements in the area of environmental control technology have led to the development of ECS that can be controlled through mainstream smart-devices. There is limited research on ECS within Australia and no known research addressing smart-device ECS. The current study sought to explore users' experiences with smart-device ECS within Australia. METHODS The study followed a single embedded case study method. Participants (n = 5) were existing ECS users with a cervical spinal cord injury. Data were collected through semi-structured interviews with participants, reflexive journals and field notes. An inductive approach was used to analyze the data thematically. RESULTS AND CONCLUSIONS The experience of using a smart-device ECS presented both opportunities and costs to users. The opportunities included: independent control, choice, peace of mind, connection, effective resource use, and control over smart-phone functions and applications. The associated costs included: financial, time, frustration, and technical limitations. While findings are similar to previous research into traditional ECS this study indicates that smart-device ECS also offered a new opportunity for users to access mainstream smart-device functions and applications. Future research should investigate methods and resources that practitioners could utilize to better support new users of smart-device ECS. Implications for Rehabilitation As with traditional environmental control systems, users of smart environmental control systems report increased independence, choice and control. Smart-device environmental control systems provide users with access to mainstream smart-device functions and applications, which facilitate connection to family and the outside world. The costs to the user of smart-device environmental control systems include monetary and time investment, dealing with technical limitations and resulting frustration. Prescribers and installers must consider ways to mitigate these costs experienced by users.
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Affiliation(s)
- Bethany Hooper
- a Discipline of Occupational Therapy, School of Health and Sport Science , University of the Sunshine Coast , Maroochydore , Australia
| | - Michele Verdonck
- a Discipline of Occupational Therapy, School of Health and Sport Science , University of the Sunshine Coast , Maroochydore , Australia.,b Cluster for Health Improvement , University of the Sunshine Coast , Maroochydore , Australia
| | - Delena Amsters
- c Spinal Outreach Team, Metro South Hospital & Health Service , Brisbane , Australia
| | - Michelle Myburg
- c Spinal Outreach Team, Metro South Hospital & Health Service , Brisbane , Australia
| | - Emily Allan
- c Spinal Outreach Team, Metro South Hospital & Health Service , Brisbane , Australia
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Orellano-Colón EM, Rivero-Méndez M, Lizama M, Jutai JW. Assistive technology unmet needs of independent living older Hispanics with functional limitations. Disabil Rehabil Assist Technol 2017; 13:194-200. [PMID: 28326905 DOI: 10.1080/17483107.2017.1300693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To identify: (1) the most frequently used assistive technology (AT) by a sample of community-living older Hispanics; (2) their AT needs; (3) the AT that would not be used by the simple; and (4) the factors associated with the willingness to use AT. MATERIALS AND METHODS We used a cross-sectional descriptive study design with a purposive sample of 60 individuals 70 years and older living in Puerto Rico. Data collection tools included a socio-demographic questionnaire and the Assistive Technology Card Assessment. We used descriptive statistics to identify the sample AT use and needs, χ2 to determine the frequency distribution of the socio-demographic variables and the Spearman's rank correlation coefficient (rho) to describe the strength of the association between these variables and the willingness to use AT devices. RESULTS The sample had unmet needs for AT devices for cooking, home tasks and home safety. A higher number of health conditions as well as having low educational levels were associated with willingness to use AT devices. CONCLUSIONS Policy implications are discussed supporting the role of rehabilitation professionals, state government and community-based programmes, including the Area Agencies on Aging, in providing culturally relevant AT education and accessibility to assistive devices. Implications for rehabilitations Hispanic older adults with functional limitations living independently in Puerto Rico have unmet needs for AT devices to compensate for physical limitations and increase safety performance, predominantly in instrumental activities of daily living. New policies need to be developed to advocate for increased healthcare coverage of low tech AT devices that could be highly beneficial to older people with functional limitations. Community-based programs administered by the state government, the Area Agencies of Aging, or operated through Medicare need to be developed to provide education, training, loans, purchasing, and delivery of low AT devices that can compensate for older people functional limitations.
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Affiliation(s)
- Elsa M Orellano-Colón
- a Occupational Therapy Program, School of Health Professions , Medical Sciences Campus, University of Puerto Rico , San Juan , Puerto Rico.,b Puerto Rico Assistive Technology Program, Research and Technology Vice-Presidency , San Juan , Puerto Rico
| | - Marta Rivero-Méndez
- c School of Nursing, Medical Sciences Campus, University of Puerto Rico , San Juan , Puerto Rico
| | - Mauricio Lizama
- b Puerto Rico Assistive Technology Program, Research and Technology Vice-Presidency , San Juan , Puerto Rico
| | - Jeffrey W Jutai
- d Faculty of Health Sciences , University of Ottawa , Ottawa , ON , Canada
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Abstract
BACKGROUND This interview study is a part of a project that evaluated sensor technology as a support in everyday activities for patients with memory impairment. AIM To explore patients with memory impairment and their partners' experiences of using sensor technology in their homes. METHODS AND MATERIAL Five patients with memory impairment after stroke and three partners were interviewed. Individual semi-structured interviews were analyzed with qualitative content analysis. RESULTS Installing sensor technology with individually prerecorded voice reminders as memory support in the home had a broad impact on patients' and their families' lives. These effects were both positive and negative. The sensor technology not only supported activities but also influenced the patients by changing behavior, providing a sense of security, independence and increased self-confidence. For the partners, the sensor technology eased daily life, but also gave increased responsibility for maintenance. Technical problems led to frustration and stress for the patients. CONCLUSION The results indicate that sensor technology has potential to increase opportunities for persons with memory impairment to perform and participate in activities and to unburden their partners. The results may promote an understanding of how sensor technology can be used to support persons with memory impairment in their homes.
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Affiliation(s)
- Anna Olsson
- a Division of Rehabilitation Medicine , Danderyd Hospital , Stockholm , Sweden
| | | | - Aniko Bartfai
- a Division of Rehabilitation Medicine , Danderyd Hospital , Stockholm , Sweden.,b Department of Clinical Sciences , Danderyd Hospital, Karolinska Institutet , Stockholm , Sweden
| | - Inga-Lill Boman
- a Division of Rehabilitation Medicine , Danderyd Hospital , Stockholm , Sweden.,b Department of Clinical Sciences , Danderyd Hospital, Karolinska Institutet , Stockholm , Sweden
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Kylberg M, Löfqvist C, Horstmann V, Iwarsson S. Leisure activities and mobility device use among very old people in Latvia and in Sweden. Br J Occup Ther 2017. [DOI: 10.1177/0308022616681795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Opportunities for leisure activities and physical mobility are important for the ageing population. Therefore, we aim to describe leisure activities outside the home among very old (over 80 years of age) users and non-users of mobility devices in two European countries. Method Survey data on mobility device use, self-rated physical mobility and leisure activities outside the home were utilised for a Latvian ( n = 225) and Swedish ( n = 314) sample. Differences in type and number of leisure activities were studied between the countries and for four groups of participants according to use/non-use of and level of physical mobility. Results Significant differences in type and number of leisure activities were seen between the national samples and among the participant groups. In general, each participant group in the Swedish sample reported more leisure activities than did those in the Latvian sample. Non-users with good physical mobility reported significantly more leisure activities than all other participant groups. Conclusion There are differences between the two national contexts in the type and number of leisure activities reported. To support very old people’s participation in outdoor leisure activities, we need more knowledge as to how physical, institutional and sociocultural environments affect very old people’s opportunities to engage in and perform such activities.
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Affiliation(s)
- Marianne Kylberg
- Lecturer, Department of Health Sciences, Faculty of Medicine, Lund University, Sweden
| | - Charlotte Löfqvist
- Senior Lecturer, Department of Health Sciences, Faculty of Medicine, Lund University, Sweden
| | - Vibeke Horstmann
- Statistician, Department of Health Sciences, Faculty of Medicine, Lund University, Sweden
| | - Susanne Iwarsson
- Professor, Department of Health Sciences, Faculty of Medicine, Lund University, Sweden
- Doctor Honoris Causa, Department of Rehabilitation, Riga Stradins University, Riga, Latvia
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20
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Orellano-Colón EM, Jutai J, Santiago A, Torres V, Benítez K, Torres M. Assistive Technology Needs and Measurement of the Psychosocial Impact of Assistive Technologies for Independent Living of Older Hispanics: Lessons Learned. TECHNOLOGIES 2016; 4:21. [PMID: 27695688 PMCID: PMC5045238 DOI: 10.3390/technologies4030021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
(1) Knowledge about the assistive technology (AT) needs and psychosocial impact of AT in different populations is needed because the adoption, retention, or abandonment of AT may be influenced by the psychosocial impact that AT has on its users. The aims of this study were to: (a) identify the AT needs of a sample of Hispanic older adults with functional limitations, (b) describe the psychosocial impact of these technologies on the sample's quality of life, and (c) describe the methodological challenges in using the Puerto Rican version of the Psychosocial Impact of Assistive Device Scale (PR-PIADS) with a Hispanic sample. (2) Methods: This study used a cross-sectional design conducted with a sample of 60 participants. Data was collected using the Assistive Technology Card Assessment Questionnaire (ATCAQ) and the PR-PIADS. Data analyses included descriptive statistics and bivariate analysis. (3) Results: The sample's most frequently reported needs for AT devices were in the areas of cooking, home tasks, and home safety activities. The sample reported a positive impact of AT use in their quality of life. Several methodological challenges of the PIADS were identified. (4) Conclusions: The sample has unmet needs for using AT devices to overcome difficulties in daily living activities.
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Affiliation(s)
- Elsa M. Orellano-Colón
- Occupational Therapy Program, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00926-1117, Puerto Rico
- Puerto Rico Assistive Technology Program, Office of the Vice President for Research and Technology, University of Puerto Rico, San Juan, PR 00926-1117, Puerto Rico
| | - Jeffrey Jutai
- Interdisciplinary School of Health Sciences, University of Ottawa, 25 University St., Ottawa, K1N 6N5, Ontario, ON, Canada
| | - Angélica Santiago
- Occupational Therapy Program, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00926-1117, Puerto Rico
| | - Víctor Torres
- Occupational Therapy Program, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00926-1117, Puerto Rico
| | - Keyla Benítez
- Occupational Therapy Program, School of Health Professions, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00926-1117, Puerto Rico
| | - Mayra Torres
- Puerto Rico Assistive Technology Program, Office of the Vice President for Research and Technology, University of Puerto Rico, San Juan, PR 00926-1117, Puerto Rico
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Boerema ST, van Velsen L, Vollenbroek-Hutten MMR, Hermens HJ. Value-based design for the elderly: An application in the field of mobility aids. Assist Technol 2016; 29:76-84. [PMID: 27532436 DOI: 10.1080/10400435.2016.1208303] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
In the aging society, the need for the elderly to remain mobile and independent is higher than ever. However, many aids supporting mobility often fail to target real needs and lack acceptance. The aim of this study is to demonstrate how value-based design can contribute to the design of mobility aids that address real needs and thus, lead to high acceptance. We elicited values, facilitators, and barriers of mobility of older adults via ten in-depth interviews. Next, we held co-creation sessions, resulting in several designs of innovative mobility aids, which were evaluated for acceptance via nine in-depth interviews. The interviews resulted in a myriad of key values, such as "independence from family" and "doing their own groceries." Design sessions resulted in three designs for a wheeled walker. Their acceptance was rather low. Current mobility device users were more eager to accept the designs than non-users. The value-based approach offers designers a close look into the lives of the elderly, thereby opening up a wide range of innovation possibilities that better fit their actual needs. Product service systems seem to be a promising focus for targeting human needs in mobility device design.
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Affiliation(s)
- Simone T Boerema
- a Telemedicine Group , Roessingh Research and Development, Roessingsbleekweg , Enschede , The Netherlands.,b Telemedicine Group, Faculty of Electrical Engineering, Mathematics and Computer Science , University of Twente, Drienerlolaan , Enschede , The Netherlands
| | - Lex van Velsen
- a Telemedicine Group , Roessingh Research and Development, Roessingsbleekweg , Enschede , The Netherlands.,b Telemedicine Group, Faculty of Electrical Engineering, Mathematics and Computer Science , University of Twente, Drienerlolaan , Enschede , The Netherlands
| | - Miriam M R Vollenbroek-Hutten
- a Telemedicine Group , Roessingh Research and Development, Roessingsbleekweg , Enschede , The Netherlands.,b Telemedicine Group, Faculty of Electrical Engineering, Mathematics and Computer Science , University of Twente, Drienerlolaan , Enschede , The Netherlands
| | - Hermie J Hermens
- a Telemedicine Group , Roessingh Research and Development, Roessingsbleekweg , Enschede , The Netherlands.,b Telemedicine Group, Faculty of Electrical Engineering, Mathematics and Computer Science , University of Twente, Drienerlolaan , Enschede , The Netherlands
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22
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Tomsone S, Haak M, Löfqvist C. Experiences of mobility device use over time: A multiple case study among very old Latvian women. Scand J Occup Ther 2015. [PMID: 26200247 DOI: 10.3109/11038128.2015.1068850] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To explore the experiences over time of using mobility devices (MDs) among very old women in the context of everyday life in Latvia. METHODS This study utilized a multiple case-study design that employed an explanatory mixed-methods approach. A combination of quantitative survey data on home and health and qualitative interview data for each participant were used to create three narratives to describe the experiences of MD use in everyday life over time, followed by a cross-case analysis. RESULTS The three cases illustrate that very old women accept and use MDs due to walking difficulties and related needs. Over time, functional decline combined with physical environmental barriers and changes in their social networks limited the supportive role that available MDs could offer these women. CONCLUSIONS The findings contribute to the understanding of the complexity of MD use in everyday life among very old women in Latvia and the need for different kinds of MDs. These findings illustrate the importance of considering the interaction between people's everyday life situation and their physical environment for their optimal use of MDs. This is important information for policy-makers who can optimize the services for old people in Latvia and support the need for occupational therapists' professional competence for the planning and development of MD provision.
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Affiliation(s)
- Signe Tomsone
- a a Department of Health Sciences, Faculty of Medicine, Lund University , Lund, Sweden ;,b b Department of Rehabilitation, Faculty of Rehabilitation, Rīga Stradiņš University , Riga, Latvia
| | - Maria Haak
- a a Department of Health Sciences, Faculty of Medicine, Lund University , Lund, Sweden
| | - Charlotte Löfqvist
- a a Department of Health Sciences, Faculty of Medicine, Lund University , Lund, Sweden
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Kylberg M, Löfqvist C, Tomsone S, Phillips J, Liepina Z, Iwarsson S. A European Perspective on the Service Delivery Systems for Assistive Technology – Differences and Similarities Between Latvia and Sweden. J Cross Cult Gerontol 2014; 30:51-67. [DOI: 10.1007/s10823-014-9255-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Goh CH, Muslimah Y, Ng SC, Subramanian P, Tan MP. The Use of the Self-Standing Turning Transfer Device to Perform Bed-To-Chair Transfers Reduces Physical Stress among Caregivers of Older Patients in a Middle-Income Developing Country. Front Med (Lausanne) 2014; 1:32. [PMID: 25593906 PMCID: PMC4292054 DOI: 10.3389/fmed.2014.00032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 09/11/2014] [Indexed: 11/13/2022] Open
Abstract
Manual transfer of elderly patients remains commonplace in many developing countries because the use of lifting equipment, such as hoists, is often considered unaffordable luxuries. The aim of this study was, therefore, to evaluate the usage and potential benefits of a low-cost, mechanical turning transfer device among elderly patients and their caregivers on a geriatric ward in a developing country in South East Asia. Fifty-six inpatients, aged 66–92 years, on a geriatric ward, and their caregivers were recruited. Participants were asked to transfer from bed-to-chair transfer with manual assistance, and the task was repeated using the Self-standing Turning Transfer Device (STurDi). The time taken to perform manual transfers and STurDi-assisted transfers was recorded. Physical strain was assessed using the perceived physical stress-rating tool for caregivers with and without the use of the device. User satisfaction was evaluated using the usefulness, satisfaction, and ease of use questionnaire. There was a significant reduction in transfer-time with manual transfers compared to STurDi-assisted transfers [mean (SD) = 48.39 (13.98) vs. 36.23 (10.96); p ≤ 0.001]. The physical stress rating was significantly lower in STurDi-aided transfers compared to manual transfers, shoulder [median (interquartile range) = 0 (1) vs. 4 (3); p = 0.001], upper back [0 (0) vs. 5 (4); p = 0.001], lower back [0 (1) vs. 5 (3), p = 0.001], whole body [1 (2) vs. 4 (3), p = 0.001], and knee [0 (1) vs. 1 (4), p = 0.001]. In addition, majority of patients and caregivers definitely or strongly agreed that the device was useful, saved time, and was easy to use. We have therefore demonstrated in a setting where manual handling was commonly performed that a low-cost mechanical transfer device reduced caregiver strain and was well received by older patients and caregivers.
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Affiliation(s)
- Choon Hian Goh
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya , Kuala Lumpur , Malaysia
| | - Muslimah Y
- Institute for Public Health , Kuala Lumpur , Malaysia ; Department of Nursing Studies, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | - Siew-Cheok Ng
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya , Kuala Lumpur , Malaysia
| | - Pathmawathi Subramanian
- Department of Nursing Studies, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia ; Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia ; Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia
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Gramstad A, Storli SL, Hamran T. Older individuals' experiences during the assistive technology device service delivery process. Scand J Occup Ther 2014; 21:305-12. [DOI: 10.3109/11038128.2013.877070] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dong HJ, Wressle E, Marcusson J. Multimorbidity patterns of and use of health services by Swedish 85-year-olds: an exploratory study. BMC Geriatr 2013; 13:120. [PMID: 24195643 PMCID: PMC3840694 DOI: 10.1186/1471-2318-13-120] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 10/18/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As life expectancy continues to rise, more elderly are reaching advanced ages (≥80 years). The increasing prevalence of multimorbidity places additional demands on health-care resources for the elderly. Previous studies noted the impact of multimorbidity on the use of health services, but the effects of multimorbidity patterns on health-service use have not been well studied, especially for very old people. This study determines patterns of multimorbidity associated with emergency-room visits and hospitalization in an 85-year-old population. METHODS Health and living conditions were reported via postal questionnaire by 496 Linköping residents aged 85 years (189 men and 307 women). Diagnoses of morbidity were reviewed in patients' case reports, and the local health-care register provided information on the use of health services. Hierarchical cluster analysis was applied to evaluate patterns of multimorbidity with gender stratification. Factors associated with emergency-room visits and hospitalization were analyzed using logistic regression models. RESULTS Cluster analyses revealed five clusters: vascular, cardiopulmonary, cardiac (only for men), somatic-mental (only for men), mental disease (only for women), and three other clusters related to aging (one for men and two for women). Heart failure in men (OR = 2.4, 95% CI = 1-5.7) and women (OR = 3, 95% CI = 1.3-6.9) as a single morbidity explained more variance than morbidity clusters in models of emergency-room visits. Men's cardiac cluster (OR = 1.6; 95% CI = 1-2.7) and women's cardiopulmonary cluster (OR = 1.7, 95% CI = 1.2-2.4) were significantly associated with hospitalization. The combination of the cardiopulmonary cluster with the men's cardiac cluster (OR = 1.6, 95% CI = 1-2.4) and one of the women's aging clusters (OR = 0.5, 95% CI = 0.3-0.8) showed interaction effects on hospitalization. CONCLUSION In this 85-year-old population, patterns of cardiac and pulmonary conditions were better than a single morbidity in explaining hospitalization. Heart failure was superior to multimorbidity patterns in explaining emergency-room visits. A holistic approach to examining the patterns of multimorbidity and their relationships with the use of health services will contribute to both local health care policy and geriatric practice.
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Affiliation(s)
- Huan-Ji Dong
- Department of Clinical and Experimental Medicine, Division of Geriatrics, Faculty of Health Sciences, Linköping University, 581 85 Linköping, Sweden.
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Hofmann B. Ethical challenges with welfare technology: a review of the literature. SCIENCE AND ENGINEERING ETHICS 2013; 19:389-406. [PMID: 22218998 DOI: 10.1007/s11948-011-9348-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 12/20/2011] [Indexed: 05/31/2023]
Abstract
Demographical changes in high income counties will increase the need of health care services but reduce the number of people to provide them. Welfare technology is launched as an important measure to meet this challenge. As with all types of technologies we must explore its ethical challenges. A literature review reveals that welfare technology is a generic term for a heterogeneous group of technologies and there are few studies documenting their efficacy, effectiveness and efficiency. Many kinds of welfare technology break with the traditional organization of health care. It introduces technology in new areas, such as in private homes, and it provides new functions, e.g. offering social stimuli and entertainment. At the same time welfare technology is developed for groups that traditionally have not been extensive technology users. This raises a series of ethical questions with regard to the development and use of welfare technologies, which are presented in this review. The main challenges identified are: (1) Alienation when advanced technology is used at home, (2) conflicting goals, as welfare technologies have many stakeholders with several ends, (3) respecting confidentiality and privacy when third-party actors are involved, (4) guaranteeing equal access and just distribution, and (5) handling conflicts between instrumental rationality and care in terms of respecting dignity and vulnerability. Addressing these issues is important for developing and implementing welfare technologies in a morally acceptable manner.
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Affiliation(s)
- Bjørn Hofmann
- Center for Medical Ethics, University of Oslo, PO Box 1130, Blindern, 0318, Oslo, Norway.
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Kylberg M, Löfqvist C, Phillips J, Iwarsson S. Three very old men's experiences of mobility device use over time. Scand J Occup Ther 2013; 20:397-405. [DOI: 10.3109/11038128.2013.779321] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mortenson WB, Demers L, Fuhrer MJ, Jutai JW, Lenker J, DeRuyter F. How assistive technology use by individuals with disabilities impacts their caregivers: a systematic review of the research evidence. Am J Phys Med Rehabil 2012; 91:984-98. [PMID: 22955027 PMCID: PMC5668128 DOI: 10.1097/phm.0b013e318269eceb] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Informal caregivers are a critical yet frequently unacknowledged part of the healthcare system. It is commonly presumed that providing assistive technology will decrease the burden of their care provision; however, no review has evaluated the evidence behind this assumption. Therefore, a systematic review was undertaken to evaluate evidence of the impact of assistive technology use by care recipients on their informal caregivers. Data sources included EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Web of Science, PsychINFO, PubMed, and active researchers in this area. Twenty-two studies met the specified inclusion criteria. Collectively, the findings suggest that assistive technology use helps caregivers by diminishing some of the physical and emotional effort entailed in supporting individuals with disability. However, confidence in this causal connection is limited because of the study designs that were used. This undermines the understanding of the impacts of assistive technology use on the users' informal caregivers.
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Affiliation(s)
- W Ben Mortenson
- Centre de recherche de l'institut universitaire de gériatrie de Montréal, Montreal, Canada
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Gramstad A, Storli SL, Hamran T. “Do I need it? Do I really need it?” Elderly peoples experiences of unmet assistive technology device needs. Disabil Rehabil Assist Technol 2012; 8:287-93. [DOI: 10.3109/17483107.2012.699993] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kylberg M, Löfqvist C, Horstmann V, Iwarsson S. The use of assistive devices and change in use during the ageing process among very old Swedish people. Disabil Rehabil Assist Technol 2012; 8:58-66. [DOI: 10.3109/17483107.2012.699585] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Spiliotopoulou G, Atwal A. Is occupational therapy practice for older adults with lower limb amputations evidence-based? A systematic review. Prosthet Orthot Int 2012; 36:7-14. [PMID: 22089164 DOI: 10.1177/0309364611428662] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although occupational therapists are integral to the rehabilitation process of people with amputations, the effectiveness of the occupational therapy intervention for older adults with lower limb amputations has not been investigated. OBJECTIVES To identify the effectiveness of the occupational therapy interventions with older adults aged 65 years and older with lower limb amputations. STUDY DESIGN Systematic review. METHODS A systematic search was conducted in CINAHL, PUBMED, OTSEEKER and OTDBASE from January 1985 to January 2011. The eligible papers were critiqued using a typology, which involved designation of levels of evidence and quality markers. RESULTS The databases yielded 2,664 potential publications. Of these, only two were included in the final review. These studies suggested that the frequency of the occupational therapy sessions was found to be statistically significantly related to prosthesis use and that service users perceived positive benefits about the provision of stump boards. Both studies had limitations resulting in a need for further investigation in these areas. CONCLUSION Research evidence on the occupational therapy interventions with this population is limited and scarce. Occupational therapists need to take urgent action to address the identified evidence-based gaps in order to devise informed targeted rehabilitation programmes for this client group.
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Patrick M, Ditunno P, Ditunno JF, Marino RJ, Scivoletto G, Lam T, Loffree J, Tamburella F, Leiby B. Consumer preference in ranking walking function utilizing the walking index for spinal cord injury II. Spinal Cord 2011; 49:1164-72. [PMID: 21788954 DOI: 10.1038/sc.2011.77] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Blinded rank ordering. OBJECTIVE To determine consumer preference in walking function utilizing the walking Index for spinal cord injury II (WISCI II) in individuals with spinal cord injury (SCI)from the Canada, the Italy and the United States of America. METHOD In all, 42 consumers with incomplete SCI (25 cervical, 12 thoracic, 5 lumbar) from Canada (12/42), Italy (14/42) and the United States of America (16/42) ranked the 20 levels of the WISCI II scale by their individual preference for walking. Subjects were blinded to the original ranking of the WISCI II scale by clinical scientists. Photographs of each WISCI II level used in a previous pilot study were randomly shuffled and rank ordered. Percentile, conjoint/cluster and graphic analyses were performed. RESULTS All three analyses illustrated consumer ranking followed a bimodal distribution. Ranking for two levels with physical assistance and two levels with a walker were bimodal with a difference of five to six ranks between consumer subgroups (quartile analysis). The larger cluster (N=20) showed preference for walking with assistance over the smaller cluster (N=12), whose preference was walking without assistance and more devices. In all, 64% (27/42) of consumers ranked WISCI II level with no devices or braces and 1 person assistance higher than multiple levels of the WISCI II requiring no assistance. These results were unexpected, as the hypothesis was that consumers would rank independent walking higher than walking with assistance. CONCLUSION Consumer preference for walking function should be considered in addition to objective measures in designing SCI trials that use significant improvement in walking function as an outcome measure.
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Affiliation(s)
- M Patrick
- Thomas Jefferson University, Regional SCI Center of the Delaware Valley, Department of Rehabilitation Medicine, Philadelphia, PA 19107, USA.
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Skymne C, Dahlin-Ivanoff S, Claesson L, Eklund K. Getting used to assistive devices: ambivalent experiences by frail elderly persons. Scand J Occup Ther 2011; 19:194-203. [PMID: 21534712 DOI: 10.3109/11038128.2011.569757] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim was to learn how frail elderly people experienced becoming assistive device users and how assistive devices affected their independence in daily activities. Focus-group methodology was used, including people 80 and older with multiple health problems. Five group discussions were conducted with a total of 18 people including 14 women and four men. Each group met once, for 90-120 minutes, and all discussions were audiotaped. Two themes emerged: Confidence in knowledge and experience and getting used to assistive devices in daily activities. Confidence in knowledge and experience was formed by two categories of experiences from the prescription procedure: trust the expert and trust yourself, and to have confidence in having the right information about assistive devices. Getting used to assistive devices in daily activities was formed by five categories of ambivalent experiences when using assistive devices in daily activities: creates opportunities and limitations; provides security but also raises concerns; the need is seen as transient or permanent; the social environment both encourages and restricts; the physical environment both facilitates and complicates, with less extreme experiences in between. This study indicates that frail elderly people need specifically developed support in the process of becoming assistive device users.
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Affiliation(s)
- Carina Skymne
- Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy at University of Gothenburg, Sweden
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