Test-retest reliability of the Quebec user evaluation of satisfaction with assistive technology 2.0-Korean version for individuals with spinal cord injury

A systematic review of the psychometric properties of Quebec user evaluation of satisfaction with assistive technology (QUEST)

PURPOSE

The aim of this systematic review was to evaluate the psychometric properties of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST).

MATERIALS AND METHODS

Searches were conducted in August 2021 on four electronic databases: MEDLINE, CINAHL, Scopus, and Web of Science. Eligible papers included cross-sectional validation studies evaluating the psychometric properties of all QUEST versions. Cronbach's alpha, intraclass correlation coefficient, and comparison tools were reported. Study quality and risk of bias were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.

RESULTS

Nineteen studies were included in this systematic review. Results showed that the QUEST and QUEST 2.0 were available in 10 languages, and most validation studies analysed this tool in patients using mobility devices in various clinical conditions. One article analysed the child version (QUEST 2.1) in English. The most analysed psychometric property was Cronbach's alpha for internal consistency in 14 out of 19 studies, with values ranging between 0.74 and 0.79. Overall, 17 out of 19 studies were of adequate quality, though responsiveness was never studied.

CONCLUSION

Our systematic review showed that the QUEST and its subsequent versions are reliable and valid measurement instruments to evaluate satisfaction in patients with different disabilities using various assistive technologies. This study provides useful information on the instrument's psychometric properties in different populations and cultures.

Iranian translation and psychometric of the Quebec user evaluation of satisfaction with Assistive technology (QUEST2.0) on wheelchair users

PURPOSE

QUEST2.0 is a practical tool specifically applied to assessing the satisfaction for awide array of assistive technology in a standard manner. Therefore, this study set to translate and evaluate the validity and reliability of the Iranian version of the QUEST2.0in Persian-speaking users of manual and electronic wheelchairs in Iran.

METHODS

The present study recruited 130 users of manual and electric wheelchairs. Psychometric properties, including; content validity and construct validity and internal consistency and test-retest reliability, were testified.

RESULTS

The content validity index of the questionnaire was 92%. The internal consistency was determined to be 0.89,0.88 and 0.74, respectively, for the whole questionnaire and dimensions of the device, and services. The test-retest reliability was 0.85, 0.80, and 0.94, respectively, for the whole questionnaire and dimensions of the device and services. Factor analysis confirmed the two-factor structure of the questionnaire. In the two-factor model, 57.75% of the total variance was explained by these two factors, of which 45.8% pertained to the first factor (device) and 11.95% to the second factor (service).

CONCLUSIONS

The results showed that QUEST2.0 had both valid and reliable for measuring satisfaction with assistive technology among wheelchair users. The assessment will also help facilitate the quality improvement processes in using assistive technology devices.

Customised joystick-making and training service of power wheelchair using rapid prototyping in rehabilitation centre for people with cervical spinal cord injury: findings from two case studies

PURPOSE

This study aimed to evaluate the clinical applicability of a customised power wheelchair joystick using rapid prototyping with 3D modeling and printing technology within a rehabilitation centre for patients with cervical spinal cord injury.

MATERIALS AND METHODS

Two male participants with tetraplegia following cervical-level spinal cord injury who had difficulty operating a powered wheelchair were recruited. The procedure of the joystick-making and training service consists of four steps: (1) driving evaluation; (2) digital fabrication; (3) functional test; and (4) driving training. K-QUEST 2.0 (Korean-Quebec User Evaluation of Satisfaction version 2.0) was used to measure the usability of the off-the-shelf and customised joystick.

RESULTS

During the application process, several redesign stages were required to obtain the final customised joystick. After participants attended a 30-min driving training five times per week for 8 weeks, the usability of the customised joystick was higher than that of the off-the-shelf one.

CONCLUSION

Providing the customised joystick-making and training service can be used in hospitalised rehabilitation centre before the hospital discharge of patients and returns to their everyday lives.

Ability to detect history of falls among individuals with spinal cord injury using upper limb loading during a seated push-up test

BACKGROUND

A history of falls is an important risk factor for future falls, including for individuals with spinal cord injury (SCI) who often experience falls and subsequent injuries. This may be even more pronounced during the current COVID-19 pandemic because of the extreme shortage of hospital admission and restricted access to important services. Therefore, the ability of detecting a history of falls that can be applied to wheelchair users and ambulatory individuals with SCI in various settings are essential.

AIM

To investigate the discriminative ability of three clinical measures-the handgrip (HG) test, Spinal Cord Independence Measure (SCIM) III and Upper Limb Loading During a Seated Push-Up Test (ULL-SPUT)-in discriminating individuals with SCI with and without a history of falls over the past six months.

DESIGN

A 6-month retrospective observational cohort study.

SETTING

Inpatient tertiary rehabilitation center.

POPULATION

One hundred and fourteen wheelchair users and ambulatory individuals with SCI.

METHODS

The participants were interviewed and assessed for their demographics, SCI characteristics and fall data over the past six months, with data confirmation from related events, their caregivers and medical records. Subsequently, they were assessed using the HG test, SCIM III, and ULL-SPUT.

RESULTS

In total, 29 participants (25%) fell during the past six months (with the number of falls ranging from 1-20, with minor consequences after the falls). Among the three clinical measures assessed in this study, the ULL-SPUT data of faller participants were significantly higher than those of non-fallers (P<0.05).

CONCLUSIONS

The limited rehabilitation length and increased staying home and social isolation prompted by the COVID-19 pandemic may have reduced the fall rates of the participants. The findings suggest a higher likelihood of falls among wheelchair users and ambulatory individuals with SCI who have good mobility as determined using ULL-SPUT data.

CLINICAL REHABILITATION IMPACT

Apart from being an important rehabilitation strategy, the present findings suggest an additional benefit of ULL-SPUT to identify individuals with SCI with a likelihood of future falls. The measurement can be done easily using digital bathroom scales placing over a flat and smooth surface. Therefore, it would enable the timely initiation of fall prevention strategies in various clinical, community, home and research settings; particularly in this COVID-19 pandemic of limited beds and hospital services for these individuals.

Athletes with disability' satisfaction with sport wheelchairs: an Italian cross sectional study

PURPOSE

Physical activity is essential for health and well-being. People with physical disability often experience barriers in performing sports due to the lack of appropriate assistive technologies. The present research aimed to investigate athletes with disability satisfaction when using sports wheelchairs and to explore clinometric properties of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST).

MATERIALS AND METHODS

One hundred and twenty-eight athletes were involved in the present study. Data on sport discipline and wheelchair provision were collected with qualitative approach. Internal consistency and reliability of QUEST were respectively analyzed with Cronbach's Alpha and Intraclass Correlation Coefficient. Validity was investigated with the correlation of the Wheelchair Use Confidence Scale for Manual users.

RESULTS

Results revealed good internal consistency (.858) and moderate inter-rater reliability for service subscale (.664) and for the total score (.675), while for device subscale (.802) reliability was high. Validity revealed moderate correlation (.300) with a p < 0.05. Qualitative analysis highlighted economic barriers as primary social determinant who affect participation in sport activities.

CONCLUSIONS

The present study confirms preliminary evidence of the QUEST for athletes with disability. The research group also recommends an international effort to promote a comprehensive evaluation of sports wheelchair involving rehabilitation professionals, sport technicians and people with disability.Implications for rehabilitationEconomic factors linked to the purchase of a wheelchair seem being the main barrier for practising sportThe Quebec User Evaluation of Satisfaction with Assistive Technology is a useful tool to measure athletes' satisfaction using a wheelchairRehabilitation professionals and sport technicians should collaborate together with people with disability in determining how choose appropriate sport wheelchairs.

Evaluation of satisfaction with geospatial assistive technology (ESGAT): a methodological and usability study

Purpose: Manual wheelchair users are more vulnerable, in situations such as road crossings, hazardous sidewalks or curbs and crossing of buildings and facilities threshold. Geospatial assistive technology (GAT) can help with route planning. However, it is important to ensure the usability of such products, as well as the satisfaction of persons with reduced mobility. The study's aim was (1) to develop and validate a questionnaire on the satisfaction of GAT, in English and French, and to (2) assess satisfaction, efficacy and efficiency of a GAT with manual wheelchair users following a filmed trial in a dense urban area.Method: A methodological study was conducted (development of the questionnaire, assessment of its content validity, feasibility and practicability) followed by a trial and post-observations with the videos. Two questionnaires (English, French) were concurrently validated by two groups of experts (n = 8), and then field-tested by wheelchair users (n = 8), using Google Maps Pedestrian routeing tool.Results: The Evaluation of satisfaction with geospatial assistive technology (ESGAT) consists in a user profile and their experience with the technology, followed by 12 satisfaction criteria rated from 1-not satisfied to 5-very satisfied. Both questionnaires were rated as feasible and practicable to complete. The usability of Google Maps Pedestrian routeing tool was measured as "moderate" by manual wheelchairs since the total satisfaction score at the ESGAT was 3.9/5 (quite satisfied). The items with the lowest score were navigation assistance, hands-free function and security. The GAT was effective (87.5% have completed their destination) but not efficient (37.5% needed help).IMPLICATIONS FOR REHABILITATIONFor manual wheelchair users paired with geospatial assistive technology:• A 10 minutes questionnaire was developed and validated to assess their satisfaction after testing aid in an urban area.• Satisfaction criteria to address are ease of access (service), learnability, hands-free function, ease of use for planning as well for navigating, transportability/ appearance, content, geographic information, effectiveness, efficiency, navigation assistance and security• A field test is necessary to ensure the effectiveness of the technology in avoiding or announcing potential obstacles such as sidewalk crossing ramp, damaged and congested sidewalk; sidewalk tilt (side slopes); thresholds at destination; verbal indication too soon or too late; incorrect indication; the arrow does not indicate the right direction; readjustment of the route needed; a lack of indication; and human intervention needed.

Quality of life, concern of falling and satisfaction of the sit-ski aid in sit-skiers with spinal cord injury: observational study

STUDY DESIGN

Observational study.

OBJECTIVE

To describe (1) user satisfaction, (2) the Quality of Life (QoL) and (3) fear of falling in individuals with tetraplegia or paraplegia who used a mono-ski for sit-skiing.

SETTING

Spinal units and Sport associations.

METHODS

An observational study of people with spinal cord injury (SCI) who used a sit-ski. Participants were recruited in various SCI rehabilitation centers and sport associations. Participants completed three assessment tools: the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0); the World Health Organization Quality of Life (WHOQoL-BREF); the Spinal Cord Injury Fall Concern Scale (SCI-FCS). Results were evaluated with chi-squared test and Kolmogorov-Smirnov's test and the significance was set for p values < 0.05.

RESULTS

Fifteen participants were included. Results showed positive and statistically significant values for all the items of the SCI-FCS related to fear of falling, and for most of the items of the WHOQoL-BREF related to QoL and the QUEST 2.0 related to satisfaction with the device.

CONCLUSIONS

This study highlights that sit skiing is correlated with high levels of satisfaction with the mono-ski, increases in QoL, and low levels of fear of falling. In adding these findings to the existent literature, it can be stated with more certainty that sit-skiing is a sport that can be recommended in rehabilitation and sports therapy programs.

A survey of client experiences with orthotics using the QUEST 2.0

INTRODUCTION

Hand orthoses are designed to relieve pain, immobilize a body part and protect the injury site, prevent or correct deformity, and promote healing in the body. Practitioners who prescribe and create orthoses are reliant on patient adherence to achieve desired outcomes in treatment. Understanding client preferences may promote better orthotic intervention outcomes.

PURPOSE OF THE STUDY

The purpose of this cross-sectional study was to determine the level of client satisfaction with device characteristics and service provision of custom-fabricated hand orthotics using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) version 2.0 questionnaire.

METHODS

After approval from an institutional review board, participants for this study were obtained through a convenience sample from a hand rehabilitation clinic. Seventy-two participants were administered the QUEST 2.0 to evaluate their satisfaction regarding various aspects of their orthotic devices. The 12 satisfaction categories in the QUEST are dimensions, weight, adjustments, safety, durability, easy to use, comfort, effectiveness, service delivery, repairs/services, professional service, and follow-up service. Each question was scored on a 5-point Likert scale and then recorded in the following 3 sections: device, service, and total score. The mean and standard deviation were calculated for each of the 12 items to determine the primary determinants of orthotic satisfaction.

RESULTS

The top 3 categories for a participant's orthotic device characteristics were comfort (81%), effectiveness (75%), and ease of use (74%). The participants' mean score for the device section was 4.53. The mean service score was 4.71. The total mean score was 4.61.

CONCLUSION

Therapists who are fabricating prescribed orthotic devices for individuals should consider comfort, effectiveness, and ease of use as they fabricate and adjust the device for their client. Identifying the client's desired aspects of the device can help the therapist create a better therapeutic relationship with the client and may improve their overall experience receiving orthotic intervention.