Training and learning support for people with vision impairment in the use of smartphones and applications (apps): an exploratory Australasian survey

INTRODUCTION

Occupational therapists working in low vision rehabilitation make recommendations for assistive technology (AT) and provide training in AT use for people with vision impairment (PVI) to support participation and independence. Smartphones and apps are an important AT for PVI, yet little is known about the training needs of PVI or what training is currently provided. Research exploring PVI's learning and training experiences is required to inform training development.

PURPOSE

This study aimed to explore the perspectives, needs, and recommendations of PVI from Australia and Singapore on smartphone training methods.

METHODS

An online survey collected data between November 2020 to February 2021. Participants were recruited from Australia and Singapore using purposeful sampling. The survey had three sections: (i) demographics, (ii) use of smartphones and apps, and (iii) training. It consisted of 26 closed and open-ended questions. The quantitative results from the survey were analysed descriptively, and responses to open-ended questions were analysed using content analysis.

RESULTS

Sixty-eight PVI responded to the survey, with 34 (50%) participants from each country. There were more Australians (n = 19/34, 55.9%) who had accessed formal training compared to Singaporeans (n = 11/34, 32.3%). Participants valued both formal and informal training, and self-training was the most used method for informal training (Australia: n = 29/34, 85%, Singapore: n = 22/34, 64.7%). Participants stated they preferred individualised formal training that caters to their learning needs and is provided by patient and knowledgeable trainers. They also preferred formal training, which is flexible and convenient to access, including online training with peers.

CONCLUSION

Findings such as providing individualised training, ensuring increased awareness of formal training, and using both formal and informal training methods can be considered by occupational therapists to enhance and develop training for PVI in the use of smartphones and apps.

CONSUMER AND COMMUNITY CONSULTATION

Consumers were involved at the development stage. Three people with vision impairment reviewed and provided feedback on the survey's accessibility and content.

A scoping review of the use of intelligent assistive technologies in rehabilitation practice with older adults

PURPOSE

There is growing interest in intelligent assistive technologies (IATs) in the rehabilitation and support of older adults, however, the factors contributing to or preventing their use in practice are not well understood. This study aimed to develop an overview of current knowledge on barriers and facilitators to the use of smart technologies in rehabilitative practice with older adults.

MATERIALS AND METHODS

We undertook a scoping review following guidelines proposed by Arksey and O'Malley (2005) and Levac et al. (2010). A computerised literature search was conducted using the Scopus and Ovid databases, yielding 7995 citations. Of these, 94 studies met inclusion criteria. Analysis of extracted data identified themes which were explored in semi-structured interviews with a purposefully selected sample of seven clinical rehabilitation practitioners (three physical therapists, two occupational therapists, and two speech-language pathologists).

RESULTS

Barriers and facilitators to using these technologies were associated with accessibility, reported effectiveness, usability, patient-centred considerations, and staff considerations.

CONCLUSIONS

Collaborative efforts of policy-makers, researchers, manufacturers, rehabilitation professionals, and older persons are needed to improve the design of technologies, develop appropriate funding and reimbursement strategies, and minimise barriers to their appropriate use to support independence and quality of life. Any strategies to improve upon barriers to prescribing smart technologies for older people should leverage the expertise of rehabilitation professionals operating at the interface between older people; their health/mobility; their families; and technology-based solutions.

Technology Use Among Older Adults and Their Caregivers: Cross-Sectional Survey Study

Background

Informal caregivers are called upon to provide substantial care, but more needs to be known about technology use among older adult and caregiver dyads.

Objective

This study described technology use among older adults and their caregivers, explored potential correlates of technology use, and highlighted implications for practice.

Methods

A cross-sectional survey was conducted among unpaid caregivers of older adults (n=486). Primary outcomes were self-reported technology (devices and functions) use among caregivers and their oldest care recipient. The concordance of technology use among caregivers and care recipients was also examined. Multivariable regression models were conducted separately for caregivers and care recipients.

Results

Greater proportions of caregivers used all examined technologies, except for the medication alerts or tracking function, than care recipients. Caregivers used an average of 3.4 devices and 4.2 functions, compared to 1.8 devices and 1.6 functions used by their care recipients. Among caregivers, younger age, higher income, and higher education were associated with more technology use (P<.05). Among care recipients, younger age, not having cognitive dysfunction, and caregiver's technology use were associated with more technology use (P<.05).

Conclusions

Understanding technology use patterns and device adoption across diverse caregiver and care recipient populations is increasingly important for enhancing geriatric care. Findings can guide recommendations about appropriate technology interventions and help providers communicate and share information more effectively with patients and their caregivers.

Barriers and enablers to low vision care and rehabilitation in sub-Saharan Africa within a global context

Low vision is an uncorrectable form of visual impairment that affect millions of people worldwide. Low vision care and rehabilitation are essential to improving the independence of affected individuals. Even though sub-Saharan Africa has one of the highest burdens of low vision globally, there are inadequate care and rehabilitation services in most countries and in some cases they are non-existent This scoping review aimed to identify the barriers and enablers to low vision care and rehabilitation in sub-Saharan Africa and assess these within the global context. The review was conducted using the five-step Arksey and O'Malley framework. Search terms were formulated based on the research questions and a search strategy was designed to search for eligible research articles from electronic databases; Pubmed, Ovid, Medline, and Embase. The data was screened by two members of the research team in accordance with set inclusion and exclusion criteria. Twenty-five out of 260 articles satisfied the inclusion criteria for the study. Inadequate low vision care infrastructure and supplies, non-standardised training of low vision care providers, health system failure and poor awareness of low vision care were the main barriers noted by eye care practitioners. Patients living with low vision cited the cost and availability of low vision aids, societal stigma, and poor awareness of services as the main barriers. No direct enablers were identified in sub-Saharan Africa; however, practitioners suggested improved training in low vision as a potential enabler. The barriers to low vision care and rehabilitation services identified were not unique to sub-Saharan Africa when viewed within a global context. Adopting and adapting solutions from other countries may therefore assist in improving low vision care and rehabilitation in sub-Saharan Africa.

Drawing on critical disability and universal design perspectives within occupational therapy

BACKGROUND

Critical perspectives which focus on socio-political influences on occupation have gained increased attention within the occupational therapy profession. Critical disability studies (CDS) question prevailing assumptions about disability and how disabling ideologies and practices are perpetuated in society. Universal Design (UD) is a design approach that aims to operationalise issues of inclusion and justice.

AIM

To identify and discuss how the tenets of CDS and UD can contribute to occupational therapy practice and research.

METHODS AND RESULTS

Drawing on the writings of leading scholars within CDS, UD and occupational therapy, we demonstrate the intertwined barriers faced by disabled children, youth, and adults who have participated in our studies and provide ideas on how practice can be guided by the tenets of CDS and UD to promote social equity.

CONCLUSIONS

Incorporating CDS and UD perspectives in occupational therapy practice and research requires a change in mindset and ways of working. Occupational therapy knowledge needs to be expanded to scrutinise disabling hindrances hidden within social and structural spaces, and implemented in services. We recommend working with disability communities to raise awareness and combat disabling barriers at various level of society, as mandated by policy.

Implicit, Explicit, and Structural Barriers and Facilitators for Information and Communication Technology Access in Older Adults

Older adults’ usage of information and communication technology (ICT) is challenged or facilitated by perception of usefulness, technology design, gender, social class, and other unspoken and political elements. However, studies on the use of ICT by older adults have traditionally focused on explicit interactions (e.g., usability). The article then analyzes how symbolic, institutional, and material elements enable or hinder older adults from using ICT. Our ethnographic methodology includes several techniques with Spanish older adults: 15 semi-structured interviews, participant observation in nine ICT classes, online participant observation on WhatsApp and Jitsi for 3 months, and nine phone interviews due to COVID-19. The qualitative data were analyzed through Situational Analysis. We find that the elements hindering or facilitating ICT practice are implicit-symbolic (children’s surveillance, paternalism, fear, optimism, low self-esteem, and contradictory speech-act), explicit-material (affordances, physical limitations, and motivations), and structural-political (management, the pandemic, teaching, and media skepticism). Furthermore, unprivileged identities hampered the ICT practices: female gender, blue-collar jobs, illiteracy, and elementary education. However, being motivated to use ICT prevailed over having unprivileged identities. The study concludes that society and researchers should perceive older adults as operative with technologies and examine beyond explicit elements. We urge exploration of how older adults’ social identities and how situatedness affects ICT practice. Concerning explicit elements, Spanish authorities should improve and adapt ICT facilities at public senior centers and older adults’ homes, and ICT courses should foster tablet and smartphone training over computers.

An Evaluation of a Clinic-Based Low Vision Device Lending Library

As the efficacy of low vision service provision is facilitated by clients' access to and proper use of low vision devices, the objective of this study was to evaluate an outpatient clinic-based low vision device lending library program and the functional and psychosocial impact that device use had upon clients. Twenty individuals borrowed portable video magnifiers during the study period. Line items from the Revised-Self-Report Assessment of Functional Visual Performance and the Reading Behavior Inventory were analyzed before and after device loan at two months. The Psychosocial Impact of Assistive Devices Scale-10 and a semi-structured interview were also completed at two months. Reported improvements in reading performance and satisfaction levels on the Reading Behavior Inventory were significant (p<.001). The Revised-Self-Report Assessment of Functional Visual Performance indicated improved independence in reading medications, bills and labels. Higher scores in happiness, independence, sense of control and adaptability on the Psychosocial Impact of Assistive Devices Scale-10 indicated device retention at two months. Qualitative themes included improved independence, time needed to acclimate to the device, personal appraisal impacting motivation and challenges specific to low vision. This article provides occupational therapists a model to facilitate access, person-device fit and successful use of low vision devices to promote therapy outcomes.

Assistive Technology Use among Older Adults with Vision Loss: A Critical Discourse Analysis of Canadian Newspapers

Low vision assistive devices are often positioned as enabling continued social participation and engagement by older adults in everyday activities; however, previous research suggests that the use of such technologies is restricted by various environmental factors. With little attention previously paid to the discursive environment, this critical discourse analysis critically examined how aging persons with vision loss and assistive technology (AT) were constructed and the occupational possibilities promoted and marginalized through technology use in six Canadian newspapers. In total, 7,289 articles were screened, 1,867 articles underwent a full-text review, and 51 articles were selected for data analysis. Results highlight four key discursive threads related to the framing of disability and AT, positioning of seniors with vision loss, and the ideals and occupations to be attained through AT, and point to the importance of re-configuring discourses addressing AT for seniors with vision loss to expand occupational possibilities and embrace collaborative design approaches.