Design and evaluation of a software prototype for participatory planning of environmental adaptations

Information and communication technology use within occupational therapy home assessments: A scoping review

Introduction

Home assessments conducted by occupational therapists can identify hazards and prevent falls. However, they may not be conducted because of limited time or long distances between the therapist’s workplace and the person’s home. Developments in technologies may overcome such barriers and could improve the quality of the home assessment process.

Method

This scoping review synthesises the findings of studies evaluating information and communication technology use within occupational therapy home assessments.

Results

Fourteen studies were included and revealed the two main approaches to technology use: the development of new applications and the use of existing and readily available technologies. Facilitators and barriers to use were also identified. Facilitators included usefulness, ease of use and the potential for cost-effectiveness. Barriers to use included poor usability, unsuitability for some populations and perceived threat to the role of occupational therapy. The synthesis revealed that traditional in-home assessments conducted by therapists are more sensitive in identifying hazards.

Conclusion

The availability of new technologies offers potential to improve service delivery; however these technologies are underutilised in clinical practice. Technologies may offer advantages in the conduct of home assessments, especially regarding efficiency, but have not yet been shown to be superior in terms of patient outcome.

Development of a wheelchair skills home program for older adults using a participatory action design approach

Restricted mobility is the most common impairment among older adults and a manual wheelchair is often prescribed to address these limitations. However, limited access to rehabilitation services results in older adults typically receiving little or no mobility training when they receive a wheelchair. As an alternative and novel approach, we developed a therapist-monitored wheelchair skills home training program delivered via a computer tablet. To optimize efficacy and adherence, principles of self-efficacy and adult learning theory were foundational in the program design. A participatory action design approach was used to engage older adult wheelchair users, care providers, and prescribing clinicians in an iterative design and development process. A series of prototypes were fabricated and revised, based on feedback from eight stakeholder focus groups, until a final version was ready for evaluation in a clinical trial. Stakeholder contributions affirmed and enhanced the foundational theoretical principles and provided validation of the final product for the target population.

Adaptation Planning Guideline and Constrained Outline for Shower Chairs and other Four-Caster Vehicles

Introduction:

No research-based guidelines for adaptation planning for shower chairs and other vehicles with four casters exist, despite the manual handling nature of the manoeuvring task and the occupational therapy responsibility to plan for such vehicles.

Method:

It was determined from theory that changes in direction for these vehicles, such as from a passageway through a door, could be represented by 13 manoeuvres. Participants (n = 17) carried out 11 (maximum) manoeuvres based on this theory, each with the maximum comfortable occupant weight of their choice (weights represented the occupant).

Findings:

The maximum occupant weight selected as comfortable varied substantially between some of the 11 manoeuvres: there was a 100% difference between the lowest and highest weight selections. This indicated that four-caster vehicles (such as shower chairs) should not be treated as omni-directional for high occupant weights, or for floor materials with high motion resistance, because the manoeuvre direction substantially affects maximum comfortable weight selection.

Conclusion:

The manoeuvre with the highest weight selection is proposed as a guideline when manual handling concerns exist for these vehicles. The guideline can be modified for individual vehicles sizes, occupant and carer anatomy.

Occupational therapists' perceptions about the clinical utility of the 3D interior design software

PURPOSE

The 3D interior design software (3DIDS) is a technology, which primarily allows users to simulate their homes and visualize any changes prior to implementing them. This feasibility study aimed to examine occupational therapists' perceptions about the clinical utility of the 3DIDS. A secondary aim was to explore the attitudes of occupational therapists towards technology in general.

METHOD

Three focus groups were conducted with 25 occupational therapists working with older people in the UK. The qualitative data were analysed using inductive thematic analysis.

RESULTS

The three main themes that were identified were usage and attitudes of technology, opportunities for realistic application of the 3DIDS and related threats and benefits for the occupational therapy profession. Occupational therapists had a positive attitude towards technology. They suggested that the 3DIDS could be used in discharge planning and in rehabilitation. They viewed it as a tool that could enhance their status within the health care profession and improve communication, but not as a tool that should replace the role of the occupational therapist.

CONCLUSIONS

This research offers new and important findings about the utilization of the 3DIDS by occupational therapists and provides information as to where this technology should be trialled.