Perceived difficulty in the use of everyday technology: relationships with everyday functioning in people with acquired brain injury with a special focus on returning to work

Accessing public space in the digital society: relationship between the use of everyday technology and places visited outside the home after acquired brain injury

PURPOSE

In the digital society, people need to make use of a range of everyday technology (ET) when engaging in activities in various places outside home. The aim of this study was to describe and compare the use of ET and places visited outside the home and, also, to describe the relationship between them in people with different severity of disability after acquired brain injury (ABI).

MATERIALS AND METHODS

Instruments addressing ET use, places visited outside the home and severity of disability were used to assess 74 individuals with ABI. Relationships were analyzed statistically.

RESULTS

A significantly higher use of personal ET related to public space and public space ET, a higher ability to use ET and more places visited outside the home was found in those with good recovery (GR) compared to those with moderate disability/severe disability (MD/SD). The use of ET was significantly correlated with places visited in the total sample and in those with MD/SD, but for those with GR, no significant correlations were found.

CONCLUSIONS

To facilitate participation after ABI, the relationship between the use of ET and places visited outside the home needs to be assessed in rehabilitation.Implications for rehabilitationDigitalization has increased the need of everyday technology (ET) when visiting various places in society.The use of ET was positively significantly correlated with the total number of places visited outside the home in the sample of people with acquired brain injury (ABI).Those with severe or moderate disability after their ABI used significantly fewer ET and visited fewer places compared to those with good recovery.Evaluation of the use of ET and places visited outside the home is important in rehabilitation to support participation after ABI.

Strategies for Empowering activities in Everyday life (SEE 1.0): study protocol for a feasibility study of an Internet-based occupational therapy intervention for people with stroke

Background

Rehabilitation after stroke seldom focuses on needs related to an active everyday life and the process of change that people must undergo to adapt to an altered capacity and life situation. In particular, occupational therapy in the late phase needs to support clients in adopting sustainable self-initiated management strategies to regain daily activities and an active everyday life. To improve access to rehabilitation, the use of digital solutions has been suggested. This study aims to evaluate the feasibility of the Internet-based occupational therapy intervention “Strategies for Empowering activities in Everyday life” (SEE, version 1.0). We will investigate the feasibility of the intervention process in terms of acceptability and adherence as well as the most suitable outcome measures to evaluate SEE and improve the knowledge about the potential changes and outcomes of SEE for clients with stroke.

Methods

This feasibility study is based on a pretest posttest design without a control group. Quantitative and qualitative data will be collected from clients and staff concurrently embedded in a mixed-method design during the entire study.

Discussion

The project is a first test of a novel Internet-based occupational therapy intervention, and the research will contribute to the continued development and evaluation of the SEE programme. SEE can provide people with strategies in daily activities that can support them to live an active everyday life despite changed capacity and to improve access to rehabilitation interventions.

Trial registration

NCT04588116. Name of the registry: Strategies Empowering Activities in Everyday Life (SEE 1.0). A Web-based Occupational Therapy Intervention. URL of trial registry record. Date of registry: Trial first posted: October 19, 2020; first submitted: October 2, 2020

Exploring future possibilities of using information and communication technology in multidisciplinary rehabilitation after stroke - a grounded theory study

Background: Using Information and Communication Technology (ICT) could increase the intensity of rehabilitation, the level of patient activity and participation in everyday life after stroke and is in line with having a person-centred approach.Aim: To explore how healthcare professionals use and could potentially use ICT to enable a person-centred rehabilitation process after stroke.Methods: Six individual and two focus group interviews were conducted with a group of healthcare professionals working within rehabilitation after stroke. A grounded theory approach was used to collect and analyze the data.Results: The professionals described their current use of ICT as well as their vision of how ICT could be incorporated as a tool in rehabilitation for sharing in four categories: (1) Sharing of information, (2) Collaborating from a distance, (3) Having transparency in the documentation and (4) Supporting patients' use of ICT.Conclusion: Professionals state that using ICT solutions in rehabilitation after stroke could increase sharing between professionals and their patients and increase patient participation in the rehabilitation process.Significance: This study highlights the importance of developing ICT that healthcare professionals could use along with a person-centred approach. The results will be used to develop an ICT-supported multidisciplinary intervention for rehabilitation after stroke.

Activity Engagement and Everyday Technology Use Among Older Adults in an Urban Area

OBJECTIVE

We investigated associations among activity engagement (AE), number of available and relevant everyday technologies, ability to use everyday technologies, and cognitive status among older adults in an urban area.

METHOD

This cross-sectional study included 110 participants and used three assessments: the Frenchay Activities Index to measure AE, the Everyday Technology Use Questionnaire to measure the number of and ability to use available and relevant everyday technologies, and the Montreal Cognitive Assessment to measure cognitive status. Data analyses used a one-way analysis of variance and a multiple linear regression model.

RESULTS

The number of available and relevant everyday technologies was significantly different (p < .001) among groups that varied in level of AE. Ability to use everyday technologies did not significantly differ among groups. Cognitive status did not explain level of AE when the number of available and relevant everyday technologies was considered.

CONCLUSION

Increasing the accessibility of available and relevant everyday technologies among older adults in an urban area may increase AE.

Patterns of everyday technology use and activity involvement in mild cognitive impairment: a five-year follow-up study

OBJECTIVES

The aims were to describe longitudinal patterns in terms of perceived ability to use everyday technology (ET) and involvement in everyday activities over five years in older adults with mild cognitive impairment (MCI), and to examine the predictive value of these patterns regarding diagnostic outcomes.

METHOD

Thirty older adults diagnosed with MCI at inclusion, reported their perceived ability in using ET and involvement in everyday activities on seven occasions over five years. Individual longitudinal case plots and a pattern-oriented analysis were used to compare the participants' distribution in earlier identified stable/ascending, fluctuating and descending patterns of functioning (year 0-2). Fisher's exact test was used for testing the relation between pattern and diagnostic outcomes.

RESULTS

An initial descending pattern of functioning tended to continue; none of these participants later developed a more stable pattern. More congruent trajectories of change appeared over time. Pattern affinity years 0-2 and diagnostic outcome were significantly related (p = .05), with a dementia diagnosis being more likely for those initially displaying an early descending pattern Conclusion: These findings point to a need for early support focusing on the use of ET for persons with MCI who early after diagnosis descend in functioning.

Inter-rater and test-retest reliability of the Danish version of the everyday technology use questionnaire

BACKGROUND

Everyday technologies are naturally integrated in people's daily life. For older adults and adults living with a chronic disease like chronic obstructive pulmonary disease (COPD), the ability to use technologies for health management has become increasingly important. The aim of this study was to investigate inter-rater and test-retest reliability of the Danish version of the Everyday Technology Use Questionnaire (ETUQ) in a sample of older adults with (n = 23) and without (n = 24) COPD.

MATERIAL AND METHOD

The ETUQ was initially translated in accordance with the dual panel approach and then administered to a sample of 47 participants. Svensson's method for paired ordinal data was utilized to calculate and analyze reliability.

RESULTS

Overall, inter-rater and test-retest reliability of the Danish version of the ETUQ demonstrated excellent percentage agreement (PA) (>75%), although for test-retest reliability, nine items demonstrated fair (53%) to good (73%) agreement.

CONCLUSION

This study supports the use of the Danish version of the ETUQ in a sample of older adults with or without COPD. Application to practice: The Danish version of the ETUQ is an evidence-based evaluation that can reliably contribute to clinical occupational therapy and research in Denmark focusing on everyday technology use.

Skill clusters of ability to manage everyday technology among people with and without cognitive impairment, dementia and acquired brain injury

BACKGROUND

In order to develop supporting interventions for people demonstrating problems ET use, a detailed level of description of strengths and deficits is needed.

AIMS

To explore clusters of specific performance skill required when using ET, and to evaluate if and in what way such clusters are associated with age, gender, diagnosis, and types of ETs managed.

MATERIALS AND METHODS

A secondary analysis of 661 data records from 203 heterogeneous samples of participants using the Management of Everyday Technology Assessment (META) was used. Ward's method and a hierarchical tree cluster analysis were used to determine and define the skill clusters.

RESULTS

Four distinct clusters of performance skill item profiles were found, across the 661 data records. These were then, based on each individuals' cluster profiles in managing ET, categorized into two groups. The two groups were associated with, diagnosis and type of ETs managed.

CONCLUSIONS AND SIGNIFICANCE

The findings support a more dyadic person-ET approach in evaluation of ET management. The information from the skill clusters can be used to develop targeted intervention guides for occupational therapy and healthcare.

How attention to everyday technology could contribute to modern occupational therapy: A focus group study

Introduction

Everyday technologies such as mobile phones and ticket vending machines have become increasingly indispensable, profoundly influencing daily life activities. Yet this has been given little attention in occupational therapy. The aim of this study was to explore occupational therapists’ views on everyday technologies’ relevance, meaning and potential applicability in practice.

Method

Focus groups were undertaken with 42 occupational therapists who had been introduced to an assessment of people’s ability to use everyday technologies. Data comprised eight focus groups and were analysed with a constant comparative approach.

Findings

The findings show how the participants’ fields of vision expanded when they discovered new ways of using information related to their clients’ everyday technology use, and new roles as therapists that would help make occupational therapy ‘modern’, that is, more timely and up-to-date. However, this also implied a risk of receiving information that was considered potentially unethical if the detected problems could not be dealt with.

Conclusion

Attending to clients as everyday technology users could give occupational therapists new expert roles, and allow clients to be seen as more complete persons. However, as this opportunity also involves priority conflicts and ethical dilemmas, the issue can inspire critical discussion about client-centred occupational therapy.

The match between everyday technology in public space and the ability of working-age people with acquired brain injury to use it

Introduction

In today's society, the access to and use of everyday technology, such as cell phones and internet-based services, can be claimed as a condition for participation in many tasks in everyday life. This study aims to determine and compare levels of perceived access to and difficulties in the use of common everyday technologies in public space, among people with acquired brain injury compared with controls.

Methods

The perceived access to and difficulty in the use of 14 everyday technologies were investigated in a sample with acquired brain injury ( n = 59; returned to work, n = 28; not returned to work, n = 31) and matched controls ( n = 52) using the everyday technology use questionnaire.

Findings

Perceived access to the everyday technologies was generally high. The potential to use each of the everyday technologies independently or with minor difficulties significantly differed between controls and persons with acquired brain injury in eight of the 14 everyday technologies. In particular, difficulties were found among those persons with acquired brain injury who had not returned to work.

Conclusion

People with acquired brain injury perceive that they have access to everyday technologies commonly used in public space, but the everyday technology difficulty is not always satisfactorily matched to their ability to use it. To enable participation in society, it is important to consider both the accessibility and usability of everyday technology.

Engagement in Instrumental Activities of Daily Living, Social Activities, and Use of Everyday Technology in Older Adults with and without Cognitive Impairment

Introduction:

Little is known about how subtle activity limitations may be manifested and clinically detected in people with mild cognitive impairment, but these people have been found to experience greater challenges with everyday technology use. The aim of this study was to investigate levels and profiles of engagement in activities, and their associations with perceived difficulty in technology use, for people with mild cognitive impairment, and to compare this group to people with Alzheimer's disease and to controls.

Method:

Samples with mild cognitive impairment (n = 37), Alzheimer's disease (n = 37), and controls (n = 44) were included. Based on raw data from the Frenchay Activity Index, a Rasch model was used to generate linear measures. Analysis of variance and differential item functioning were used.

Results:

The analysis yielded a profile of decreased engagement in specific activities even in mild cognitive impairment. The association between activity engagement and difficulty with everyday technology use was stronger in people with mild cognitive impairment and Alzheimer's disease than in controls.

Conclusion:

Taken together, engagement in outdoor activities showed the greatest decrease of all activity types for the group with mild cognitive impairment, suggesting that participation in life outside the home is threatened. The results also suggest that challenges in managing technology are restricting people with cognitive impairment more than they restrict controls.