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Smith EM, Huff S, Bukania R, Chiira B, Holloway C, MacLachlan M. The Kenyan assistive technology ecosystem: a network analysis. Glob Health Action 2024; 17:2302208. [PMID: 38224051 PMCID: PMC10791081 DOI: 10.1080/16549716.2024.2302208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Assistive technology is central to the realization of the rights of persons with disabilities. However, there remains limited access to assistive technology throughout much of the world, with particularly poor access in lower- and middle-income countries. Evaluating stakeholder engagement in assistive technology networks has been used as a successful strategy to understand and address gaps in the assistive technology ecosystem. OBJECTIVE The objective of this research was to provide an overview of the Kenyan Assistive Technology Ecosystem, including available assistive products and related services, and an understanding of the nature and strength of relationships between stakeholders. METHODS In this study, we employed an online qualitative stakeholder survey (2021) with representatives of organizations involved in assistive technology in Kenya. RESULTS The assistive technology network in Kenya is distributed, with Government Ministries and Agencies and Organizations of persons with disabilities central to the network. The strength of relationships is concentrated on awareness and communication, with fewer organizations actively collaborating. Innovation training organizations are not yet well integrated into the network. CONCLUSIONS Improving access to assistive technology in Kenya will benefit from greater collaboration amongst all assistive technology stakeholders.
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Affiliation(s)
- Emma M. Smith
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Stephanie Huff
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Rose Bukania
- Ministry of Labour and Social Protection, Government of Kenya, Nairobi, Kenya
| | - Bernard Chiira
- Global Disability Innovation Hub, University College London, Nairobi, Kenya
| | | | - Malcolm MacLachlan
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
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MacNeil M, Hirslund E, Baiocco-Romano L, Kuspinar A, Stolee P. A scoping review of the use of intelligent assistive technologies in rehabilitation practice with older adults. Disabil Rehabil Assist Technol 2024; 19:1817-1848. [PMID: 37498115 DOI: 10.1080/17483107.2023.2239277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 05/30/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
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.
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Affiliation(s)
- Maggie MacNeil
- School of Nursing, McMaster University, Hamilton, Canada
| | - Emily Hirslund
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | | | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Ardianuari S, Pasaribu E, Amannullah G, Prana A, Widiyanta E. Assistive technology unmet need in Indonesia: challenges and opportunities for enhancing equitable access. Disabil Rehabil Assist Technol 2024; 19:2026-2037. [PMID: 37610101 DOI: 10.1080/17483107.2023.2244996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE To analyze the rapid Assistive Technology Assessment (rATA) data and identify challenges and opportunities for improving access to assistive technology products (AP) in Indonesia. MATERIALS AND METHODS An explanatory sequential mixed-methods design consisting of a quantitative survey and a qualitative interview study was used. The rATA survey was administered to households in two randomly sampled provinces to collect data on AP met and unmet need. Descriptive statistics was used to analyze the survey data. Qualitative data were collected from unstructured videorecorded interviews with rATA policymakers. Interview transcripts were coded and analyzed using thematic analysis. RESULTS On average, data from rATA respondents (n = 11,300) revealed 60% of AP unmet need. A high proportion of funding sources came from the private sector, and contributions from the government remained low. Affordability and funding were the main barriers to access. From the policymaker interviews (n = 5), four essential themes emerged, i.e., "resources and workforce", "funding", "laws and policies", and "guidelines and standards". From each theme, key challenges and opportunities were identified. CONCLUSIONS Affordability remained a major challenge, in part because government-sponsored funding was still inadequate, forcing people with low financial status to self-produce AP. One potential opportunity would be to localize AP production and improve local workforce training. Integrated national funding schemes and intersectoral coordination could accelerate improvement in meeting AP unmet need. This study may provide evidence of current challenges and opportunities to help improve the field of rehabilitation through enhanced access to AP services in Indonesia.
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Affiliation(s)
- Satria Ardianuari
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
| | - Ester Pasaribu
- Public Health and Health Promotion, Griffith University, Gold Coast, Australia
| | | | - Adhi Prana
- Ministry of National Development Planning (BAPPENAS), Jakarta, Indonesia
| | - Eka Widiyanta
- Association of Health Services (ADINKES), Jakarta, Indonesia
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Kibret AK, Yilma TM, Davies TC, Alemayehu Genetu Z, Mekonone ST, Alene BM, Addis BM, Nigussie K, Ayele RG, Mekonnen Araya B. Assistive technology and daily living challenges among students with disabilities at University of Gondar, Ethiopia: a qualitative study. Disabil Rehabil Assist Technol 2024:1-10. [PMID: 38949131 DOI: 10.1080/17483107.2024.2362248] [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: 12/04/2023] [Accepted: 05/25/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Disability influences activities of daily living, leading to unsafe conditions, poor quality of life, and dependence on others and assistive technologies. Despite limited access and unmet needs, assistive technology enables users to participate in education and be independent members of their community. Students with disabilities in higher education face many challenges in their day-to-day activities and evidence is limited in the study area. Therefore, this study aimed to explore assistive technology experience and daily living challenges among students with disabilities in higher education. METHOD A descriptive qualitative study design was employed at the University of Gondar, Gondar, Ethiopia, between December 20, 2022, and January 20, 2023. A purposive sampling method was employed to recruit 14 students with disabilities. An in-depth interview was employed using semi-structured questionnaires. Open Code version 4 software for coding and reflexive thematic analysis approach was employed for the analysis. RESULT A total of 14 students with disabilities were included in an in-depth interview. Four main themes emerged, which included activities of daily living, attitudes toward people with disabilities, barriers to accessibility, and access to assistive technology. CONCLUSION Barriers to activities of daily living among students with disabilities were poor accessibility of infrastructural facilities, lack of teaching/learning materials in an accessible format, and negative attitudes. The present study's finding is needed to support students in higher education for their academic achievement and to design appropriate rehabilitation strategies and policies on the accessibility of physical infrastructures, inclusive education, and the provision of assistive technology.
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Affiliation(s)
- Alemu Kassaw Kibret
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfahun Melese Yilma
- Department of Health Informatics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Theresa Claire Davies
- Department of Mechanical and Materials Engineering, Faculty of Engineering and Applied Science, Queen's University, Kingston, Canada
| | - Zelalem Alemayehu Genetu
- Department of Sociology, College of Social Sciences and Humanities, University of Gondar, Gondar, Ethiopia
| | - Samuel Tesfaye Mekonone
- Department of Mechanical Engineering, Institute of Technology, University of Gondar, Gondar, Ethiopia
| | - Bruhtesfa Mouhabew Alene
- Department of Biomedical Engineering, Institute of Technology, University of Gondar, Gondar, Ethiopia
| | - Birhanu Mulat Addis
- Department of Mechanical Engineering, Institute of Technology, University of Gondar, Gondar, Ethiopia
- Mechanical and Materials Engineering, Queen's University, Kingston, Canada
| | - Kalkidan Nigussie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Rehabilitation Science, School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Rediet Getachew Ayele
- Depeartment of Occupational Therapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bilen Mekonnen Araya
- Department of Rehabilitation Science, School of Rehabilitation Therapy, Queen's University, Kingston, Canada
- School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Arumuganathan A, Shah I, Coutinho F, Krishna D, Venkatachalapathy N, Brien M, Duncan A. Exploring rehabilitation providers' perspectives of assistive technology access after the implementation of a paediatric AT provision program in rural South India. Disabil Rehabil Assist Technol 2024:1-12. [PMID: 38832519 DOI: 10.1080/17483107.2024.2360125] [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: 10/09/2023] [Accepted: 05/21/2024] [Indexed: 06/05/2024]
Abstract
A paediatric Assistive Technology (AT) Provision Program was implemented by a non-governmental rehabilitation facility in rural South India to support rehabilitation providers in providing needed AT access for children with disabilities. Capacity-building measures for providers and other supports based on the AT needs, barriers, and facilitators to AT access were implemented that aligned with the AT global report for low-middle income countries (LMIC). This study explores how the initiatives from the AT Provision Program have influenced the perspectives of rehabilitation providers on AT access. Using a qualitative design eight paediatric rehabilitation providers were purposively sampled for virtual semi-structured interviews. Findings were analysed using thematic analysis. Six overarching themes were identified: (1) Stigma associated with AT use, (2) Organisational response to changing needs, (3) Financial factors related to family socioeconomic status and the organisation providing AT services, (4) Inequity of AT service access in rural areas, (5) Provider AT awareness and confidence and, (6) Quality assurance. Rehabilitation providers' experiences informed future AT capacity-building strategies within a low-resource context. Our findings provide valuable insights for the development of comprehensive AT Provision Program initiatives to provide AT access for children with disabilities in LMIC settings.
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Affiliation(s)
- Alakshiya Arumuganathan
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Iqra Shah
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | | | - Dinesh Krishna
- Enabling Inclusion Program, Amar Seva Sangam, Tamil Nadu, India
| | | | - Marie Brien
- Enabling Inclusion Program, Amar Seva Sangam, Tamil Nadu, India
| | - Andrea Duncan
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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Munthali AC, Ebuenyi ID, Jamali M, Kafumba J, Chiyamwaka J, Chinguo D, Smith EM, McAuliffe E, Maclachlan M. Development of the national priority assistive product list in Malawi. Disabil Rehabil Assist Technol 2024; 19:1502-1510. [PMID: 37086307 DOI: 10.1080/17483107.2023.2201305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/04/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE In 2016 WHO launched the priority assistive products list (APL) consisting of 50 products and recommended that using this as a reference, countries should develop their own contextually relevant national APLs. This paper describes the development of Malawi's APL. METHODS Two hundred and ninety-six persons with disabilities participated in a rapid Assistive Technology Assessment (rATA) survey. Six focus group discussions (FGDs) with people with various types of disabilities were conducted. The rATA questionnaire and FGDs collected data on assistive products (APs) participants used, APs they needed and the challenges they experienced. Data collection was done in six districts spread across the three regions in Malawi. All age groups were included in the survey. Persons with disabilities aged less than 18 participated but went with their guardians. All persons who participated in this study provided consent. Survey and FGDs results were presented at an APL consensus meeting with policymakers, service providers, disabled peoples' organizations and development partners in the disability sector. Based on the results and further discussions, a consensus was reached on the priority APs for Malawi. RESULTS More than a third of respondents used wheelchairs (32%), followed by auxiliary crutches (25%), walking sticks (13%), reading glasses (11%), prosthesis (10%), elbow crutches (9%) and orthosis (8%). There is also a high demand for products such as pull-up underwear (incontinence products) (79%), hearing aids (70%), reading glasses (59%) and diapers (63%). After intensive discussions during a consensus meeting, an agreement was reached on the 22 priority APs for Malawi. CONCLUSION There is a wide range of APs being used by people with different functional limitations in Malawi. There is also a demand for APs that are not readily available. When developing an APL, the list should include products in use, those in demand, and those recommended by service providers.
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Affiliation(s)
| | - Ikenna D Ebuenyi
- ALL Institute and Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Monica Jamali
- Centre for Social Research, University of Malawi, Zomba, Malawi
| | - Juba Kafumba
- Centre for Social Research, University of Malawi, Zomba, Malawi
| | - Jessie Chiyamwaka
- Ministry of Gender, Community Development and Social Welfare, Lilongwe, Malawi
| | - Dorothy Chinguo
- Ministry of Health, Directorate of Clinical Services, Lilongwe, Malawi
| | - Emma M Smith
- ALL Institute and Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Eilish McAuliffe
- IRIS Centre, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Malcolm Maclachlan
- ALL Institute and Department of Psychology, Maynooth University, Maynooth, Ireland
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Thawisuk C, Inoue K, Kaunnil A, Suyama N, Kim M, Ito Y. Factors influencing implementation of assistive technology services for older adults from the perspectives of Thai occupational therapists: a mixed methods study. Disabil Rehabil Assist Technol 2024; 19:859-867. [PMID: 36215421 DOI: 10.1080/17483107.2022.2129847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Occupational therapists are crucial in providing assistive technology (AT) services for older adults. However, evidence has shown limited provision of such services in Thailand. This study aimed to investigate the factors that influence the implementation of AT services for older adults from the perspectives of Thai occupational therapists. METHODS An explanatory sequential mixed-methods design was guided by the measurement instrument for determinants of innovations and literature review. This study was conducted in two phases: quantitative and qualitative. During the quantitative phase, an adapted version of the Measurement Instrument for Determinants of Innovations was administered to 96 occupational therapists (OTs). A subsample of 5 OTs completed a semi-structured interview during the qualitative phase to explain the findings in the quantitative one. RESULTS Factors were categorized into three sections: personal, organizational and socio-political context levels. At the personal level, integrating knowledge and experience could contribute to awareness and professional competency. Client satisfaction influenced OTs to utilize AT, based on a client centred manner. With coordinator and performance feedback within the organization, OTs indicated that consultants supported them in their decision-making. In contrast, availability of AT for older adults is determined by time and resources. Moreover, at the socio-political context level, legislation and regulations may permit or prohibit accessibility of assistive devices. CONCLUSION In order to address current challenges, education or training programmes are needed to increase the awareness and competence of OTs. In addition, collaboration with other professionals in community settings is necessary to improve access to AT services.IMPLICATIONS FOR REHABILITATIONAT service for older adults is limited by the availability of time and resources. To handle with these challenges, occupational therapists could advocate for village health volunteers to be a part of the AT services for older adults in the community to increase AT accessibility for older adults.Additional education or training programs should be developed to build competencies and increase occupational therapists' awareness of providing AT services to older adults, as well as to strengthen their roles in AT services.Future research and health policies should focus on access to sufficient funding, and resources for occupational therapists relative to their role in implementing AT services.
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Affiliation(s)
- Chirathip Thawisuk
- Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo, Japan
| | - Kaoru Inoue
- Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo, Japan
| | - Anuchart Kaunnil
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Natsuka Suyama
- Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo, Japan
| | - Minjoon Kim
- Department of Rehabilitative and Assistive Technology, National Rehabilitation Center, Seoul, Republic of Korea
| | - Yuko Ito
- Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo, Japan
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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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Brien M, Krishna D, Borish M, Coutinho F, Bernardo A, Shah SR, Venkatachalaphy N. Enabling local provision of assistive products in rural South India: an organisational survey of needs, barriers, and facilitators. Disabil Rehabil Assist Technol 2024:1-11. [PMID: 38419594 DOI: 10.1080/17483107.2024.2321601] [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: 04/14/2023] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
Objective: Access to assistive products (APs) is essential to maximising function, participation, and inclusion of persons with disabilities. Challenges to AP access in low- and middle-income countries include stigma, costs, supply, and rehabilitation capacity gaps. This study aimed to examine AT access in the context of a low-resource setting in rural South India. Objectives were to examine rehabilitation professionals' perceptions of AP needs, barriers and facilitators of AP provision, and AT knowledge.Methods: A descriptive study design with a 2-part online survey methodology was utilized. This study was conducted in April-September 2020 at a non-governmental organization (NGO) serving children and adults with disabilities in 3 districts of rural South India. Purposive sampling of NGO's multidisciplinary rehabilitation professionals (N=62) was used. The survey was developed based on WHO's Assistive Products List (APL). Barriers and facilitators were classified according to the principles of AT access. Analyses revealed acceptability, affordability, and availability as the top three barrier themes across disciplines, including poor acceptance by clients/families due to stigma, high AP costs, and a long waitlist for government-provided devices. Acceptability, affordability, and accessibility were the top three facilitator themes, including community awareness, availability of AP funding, client/family education, and AT service provision training.Impact: Our study identified key enabling strategies for AT access, aimed at reducing reported barriers. Enabling AP provision was determined to be multi-factorial, aimed at users/ families, service providers, organizations, communities, and policymakers. Local stakeholder groups are crucial to understanding challenges and opportunities to AP provision within a low-resource context.
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Affiliation(s)
- Marie Brien
- Amar Seva Sangam, Ayikudy, Tamil Nadu, India
| | - Dinesh Krishna
- Amar Seva Sangam, Ayikudy, Tamil Nadu, India
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Margo Borish
- Faculty of Social Sciences, Applied Disability Studies, Brock University, St Catharines, Canada
| | - Franzina Coutinho
- Amar Seva Sangam, Ayikudy, Tamil Nadu, India
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Abigail Bernardo
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Syeda Rafia Shah
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Domingues CDA, Laplane ALF. Assistive technology in public policies: trends in the international debate and implications for Brazil. Disabil Rehabil Assist Technol 2024:1-13. [PMID: 38372271 DOI: 10.1080/17483107.2024.2316896] [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: 03/31/2021] [Accepted: 02/06/2024] [Indexed: 02/20/2024]
Abstract
PURPOSE The objectives of this study(1) were threefold: to identify the main topics related to the international debate on Assistive Technology (AT) public policies, to analyze the Brazilian case in light of these topics, and to extract lessons that could be applied in Brazil and other countries to advance progress in the field. METHODOLOGY A qualitative study was conducted through a critical literature review, involving the search for, selection, and analysis of articles indexed in two information source portals and four databases from 2007 to 2023. International and Brazilian laws, reports, and other publications specifically related to AT policies were also included. RESULTS The analysis of 186 articles and Brazilian documents facilitated the examination of four themes: AT policies from a human rights perspective, public procurement, service delivery systems, and national plans. A subset of 107 publications was then selected for detailed analysis. DISCUSSION Initiatives such as implementing a national plan, establishing an AT research center, and creating a product catalog are considered virtuous. Enhancing the freedom of choice for products and developing public procurement mechanisms are identified as additional strategies to reinforce protections of human rights in Brazil. CONCLUSIONS Policy dynamics and national and international experiences suggest the potential for expanding initiatives and creating new solutions in Brazil. Universities and other scientific institutions emerge as promising loci for generating new knowledge to support the formulation of AT policies and facilitate their debate and further development.
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Raj H, Prasad R, Muntode Gharde P, Chakole S, Sharma P. Rehabilitation Engineering: A Narrative Review on Recent Advances in Mobility Aids in India. Cureus 2024; 16:e53722. [PMID: 38455824 PMCID: PMC10919445 DOI: 10.7759/cureus.53722] [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: 10/09/2023] [Accepted: 02/05/2024] [Indexed: 03/09/2024] Open
Abstract
Mobility has been characterized as the capacity to move across an environment safely, pleasantly, elegantly, and autonomously. India's current population is 1.4 billion, out of which 2.3%, i.e., 32 million people, are suffering from some kind of disability. With the rise in the geriatric population, the incidence of non-communicable and communicable diseases also rises and presents the risk of disorders that may progress to disability. People often neglect their disability and learn to live with it, even when most of them can use rehabilitation programs in conjunction with various mobility aids. Affordable access to adequate healthcare and assistive devices is limited, contributing to the challenges faced by disabled adults. Despite the potential for many disabled individuals to engage in productive work, their employment rates remain significantly lower. Mobility aids can provide significant benefits to individuals affected by a range of medical conditions, including arthritis, cerebral palsy, developmental disabilities, diabetic ulcers and wounds, fractures or broken bones, injuries, and walking impairments resulting from brain injury or stroke. Each person is different and may require help in a certain way for their disability, so choosing the most appropriate aid is crucial for the individual's well-being. Commonly used mobility aids are canes, walking sticks, walkers, and wheelchairs, with prostheses being used less commonly. With the advent of techniques such as state-of-the-art 3D printing and challenging surgeries, various Indian tech companies, along with non-governmental organizations (NGOs), have brought about many significant changes in the world of prosthesis by making it better, affordable, and accessible.
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Affiliation(s)
- Himanshu Raj
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Roshan Prasad
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pramita Muntode Gharde
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swarupa Chakole
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Prachi Sharma
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Senjam SS, Mannan H. Assistive technology: The current perspective in India. Indian J Ophthalmol 2023; 71:1804-1809. [PMID: 37203033 PMCID: PMC10391423 DOI: 10.4103/ijo.ijo_2652_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
The world, today, recognizes the increasing importance of assistive technology (AT) that can reduce the functional limitations of persons with disabilities, individuals with chronic debilitating diseases, and elders. This indicates that at some point, everyone, either temporary or permanent, will require AT to improve their physical and functional abilities, thus contributing to independent living, social inclusion, and education. Besides this, the need for AT will be growing with a majority from low-middle-income countries. The same is true for India though we are not sure how many people have met a need, and unmet need for AT to date, but the requirement will continue to increase. There is a significant gap between needs and access to AT. Recently, the WHO has led many initiatives related to AT services after the 71st World Health Assembly's resolution in 2018, to improve access to AT for its member states. The UN Sustainable Development Goals (SDGs) have pledged that no one should be left behind irrespective of personal characteristics. India, a ratified member state, needs to align with various initiatives undertaken by the WHO and the UN. Despite many challenges, India needs to formulate evidence-based AT policy, planning within the purview of the healthcare delivery system in collaboration with various government and nongovernment sectors, including industries. This article explores the need, access, and potential challenges associated with AT services in India. Finally, we discussed various initiatives on AT in the country and possible recommendations to improve AT services across.
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Affiliation(s)
- Suraj S Senjam
- Assistive Technology, Vision Rehabilitation, Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Hasheem Mannan
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Psychometric properties of the Smartphone Addiction Inventory - Short Form (SPAI-SF) in Brazilian adolescents. Psychiatry Res 2023; 319:115001. [PMID: 36528960 DOI: 10.1016/j.psychres.2022.115001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 11/29/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022]
Abstract
The Smartphone Addiction Inventory - Short Form (SPAI-SF) is shorter version (10 items) of the original version of SPAI (26 items). In this study, we aimed to: (i) adapt and test the internal structure of the SPAI-SF, using confirmatory factor analysis (CFA), multigroup confirmatory factor analysis (MGCFA), and network analysis; (ii) analyze the internal consistency, temporal stability, criterion, predictive and construct validities of the SPAI-SF. A total of 392 adolescents (M = 12.76; SD = 1.00) completed the following measures: demographic questionnaire, SPAI-SF, Smartphone Addiction Scale - Short Version (SAS-SV), and the Internet Addiction Test (IAT). The CFA showed good fit indices with the original four factors, and MGCFA indicated measurement invariance for gender. Network analysis provided an understanding of the core symptoms of problematic smartphone use (PSU) for both boys and girls. The intraclass correlation coefficient (ICC) was 0.865 (95% CI: 0.841 - 0.887) and indicated a robust temporal stability. The instrument demonstrated acceptable overall reliability measured by Cronbach's alpha and McDonald's Omega criteria (α = 0.722; ω = 0.725) and did not show floor and ceiling effects. The scale's significant correlations demonstrated convergent and criterion validities of the SPAI-SF with SAS-SV, IAT, and Smartphone usage data. The SPAI-SF is a reliable instrument to detect PSU in adolescents.
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Karki J, Rushton S, Bhattarai S, De Witte L. Access to assistive technology for persons with disabilities: a critical review from Nepal, India and Bangladesh. Disabil Rehabil Assist Technol 2023; 18:8-16. [PMID: 33651968 DOI: 10.1080/17483107.2021.1892843] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE The purpose of this paper is to analyse and critically reflect on access to Assistive Technology (AT) for persons with disabilities (PWD) in Nepal, India and Bangladesh. This analysis aims to guide the development of a contextualised generic AT service delivery model suitable for these countries, based on the best practices identified. MATERIALS AND METHODS This paper is based on a comprehensive study conducted in Nepal, India and Bangladesh, observing mobility and hearing-related AT service delivery centres run by the government, as well as private and nongovernmental organisations, and interviews with key informants: policymakers (5), AT service providers (20) and AT service users (20) between December 2019 to February 2020. A descriptive, qualitative exploratory study design was followed. A quality assessment framework was used to structure the analysis and interpret the findings. RESULTS AT service provisions are poorly developed in all three countries. On all quality indicators assessed, the systems show major weaknesses. AT users have very limited awareness about their rights to these services and the availability of AT services, the range of services available is very limited, and eligibility is dependent on medical criteria related to visible and severe disabilities. CONCLUSIONS Lack of accessibility, eligibility, reachability and affordability are the main barriers to access AT services for PWD in Nepal, India and Bangladesh. Increased community level awareness, increased Government funding and a community based, medically informed flexible social model of AT services is a way forward to ensure access to AT services for PWD in these countries.IMPLICATIONS FOR REHABILITATIONIncreased community awareness is necessary to increase access to Assistive Technology Services for Persons with Disabilities.Increased and flexible funding from the Government and philanthropists will improve rehabilitation.Establishment of community based Assistive Technology Services centres will increase access and improve rehabilitation.
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Affiliation(s)
- Jiban Karki
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Simon Rushton
- Department of Politics and International Relations, The University of Sheffield, Sheffield, UK
| | | | - Luc De Witte
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
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15
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Luo J, Gama Z, Gesang D, Liu Q, Zhu Y, Yang L, Bai D, Xiao M. Real-life experience of accepting assistive device services for Tibetans with dysfunction: A qualitative study. Int J Nurs Sci 2022; 10:104-110. [PMID: 36860713 PMCID: PMC9969061 DOI: 10.1016/j.ijnss.2022.12.005] [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: 10/02/2022] [Revised: 11/17/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Objective This study aimed to understand the real-life experiences of Tibetans in China with dysfunction in the process of accepting assistive device services and to provide a reference for service quality improvement and policy formulation. Methods Semi-structured personal interviews were used to collect data. Ten Tibetans with dysfunction representing three categories of different economic level areas in Lhasa, Tibet were selected to participate in the study by purposive sampling method from September to December 2021. The data were analyzed using Colaizzi's seven-step method. Results The results present three themes and seven sub-themes: identification of tangible benefits from assistive devices (enhancing self-care ability for persons with dysfunction, assisting family members with caregiving and promoting harmonious family relationships), problems and burdens (difficulty in accessing professional services and cumbersome processes, not knowing how to use it correctly, psychological burden: fear of falling and stigmatization), and needs and expectations (providing social support to reduce the cost of use, enhancing the accessibility of barrier-free facilities at the grassroots level and improving the environment for the use of assistive devices). Conclusion A proper understanding of the problems and challenges faced by Tibetans with dysfunction in the process of accepting assistive device services, focusing on the real-life experiences of people with functional impairment, and proposing targeted suggestions for improving and optimizing the user experience can provide reference and basis for future intervention studies and related policy formulation.
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Affiliation(s)
- Jun Luo
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhujizhaba Gama
- Department of Rehabilitation Medicine, Tibet Autonomous Region People’s Hospital, Tibet, China
| | - Deji Gesang
- Department of Rehabilitation Medicine, Tibet Autonomous Region People’s Hospital, Tibet, China
| | - Qing Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Zhu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lining Yang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dingqun Bai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China,Corresponding author.
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Felipe SGB, Parreira Batista P, da Silva CCR, de Melo RC, de Assumpção D, Perracini MR. Impact of COVID-19 pandemic on mobility of older adults: A scoping review. Int J Older People Nurs 2022; 18:e12496. [PMID: 35941278 PMCID: PMC9538411 DOI: 10.1111/opn.12496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 05/12/2022] [Accepted: 07/03/2022] [Indexed: 01/13/2023]
Abstract
AIMS AND OBJECTIVES To identify the most frequent determinants of contact limitation on older adults' mobility addressed by the recommendations to mitigate mobility limitation during the COVID-19 pandemic and identify the recommendations characteristics and means of dissemination that might guide coping actions. BACKGROUND Measures for physical contact restriction were implemented to prevent COVID-19 spread. These measures directly impacted older people, reducing their mobility, especially outside home environment. Health systems worldwide need to be prepared to implement strategies to mitigate negative effects of reduced mobility in this population. DESIGN Scoping review using Arksey and O'Malley's methodological framework. METHOD Therefore, a scoping review was conducted in LILACS, CINAHL, MEDLINE, WEB OF SCIENCE and SCOPUS databases. Documents and reports with recommendations from government agencies were also consulted. Results were presented in a narrative synthesis based on a conceptual model of mobility proposed by Webber (The Gerontologist, 2010, 50, 443) regarding the most frequently addressed determinants, characteristics of the proposed interventions, and means of dissemination for the older person population. FINDINGS Twenty-eight studies were selected for the final sample. According to Webber's model, most articles (n = 14) presented the impacts on mobility from the perspective of physical determinants, relating this aspect to biological losses in the musculoskeletal system, and a minority assessed mobility in vital spaces, encompassing environmental (n = 3) and financial (n = 1) determinants. Also, the most frequent recommendation was that physical activity promotes maintenance of mobility and prevents the occurrence of adverse results, such as falls, fractures and functional decline. As to dissemination, digital technologies were recognised as a strategy to motivate, instruct and monitor exercise practice to increase mobility in older adults. CONCLUSION The main conditions related to the decline in mobility of older adults during COVID-19 pandemic were physical inactivity and sedentary lifestyle. The practice of physical activity is widespread and needs to be adapted according to individual needs. Finally, digital technologies are essential tools in this period, but other alternatives should also be considered for low-income seniors. IMPLICATIONS FOR PRACTICE It is hoped that the gaps identified through this scoping review can help enhance the discussion on the broader assessment of mobility in older adults and the design of interventions when contact restriction is a reality.
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Affiliation(s)
| | | | | | | | | | - Monica Rodrigues Perracini
- Universidade Estadual de Campinas (UNICAMP)CampinasSão PauloBrazil,Universidade Cidade de São Paulo (UNICID)São PauloSão PauloBrazil
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Rulik I, Sunny MSH, Sanjuan De Caro JD, Zarif MII, Brahmi B, Ahamed SI, Schultz K, Wang I, Leheng T, Longxiang JP, Rahman MH. Control of a Wheelchair-Mounted 6DOF Assistive Robot With Chin and Finger Joysticks. Front Robot AI 2022; 9:885610. [PMID: 35937617 PMCID: PMC9354078 DOI: 10.3389/frobt.2022.885610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Throughout the last decade, many assistive robots for people with disabilities have been developed; however, researchers have not fully utilized these robotic technologies to entirely create independent living conditions for people with disabilities, particularly in relation to activities of daily living (ADLs). An assistive system can help satisfy the demands of regular ADLs for people with disabilities. With an increasing shortage of caregivers and a growing number of individuals with impairments and the elderly, assistive robots can help meet future healthcare demands. One of the critical aspects of designing these assistive devices is to improve functional independence while providing an excellent human–machine interface. People with limited upper limb function due to stroke, spinal cord injury, cerebral palsy, amyotrophic lateral sclerosis, and other conditions find the controls of assistive devices such as power wheelchairs difficult to use. Thus, the objective of this research was to design a multimodal control method for robotic self-assistance that could assist individuals with disabilities in performing self-care tasks on a daily basis. In this research, a control framework for two interchangeable operating modes with a finger joystick and a chin joystick is developed where joysticks seamlessly control a wheelchair and a wheelchair-mounted robotic arm. Custom circuitry was developed to complete the control architecture. A user study was conducted to test the robotic system. Ten healthy individuals agreed to perform three tasks using both (chin and finger) joysticks for a total of six tasks with 10 repetitions each. The control method has been tested rigorously, maneuvering the robot at different velocities and under varying payload (1–3.5 lb) conditions. The absolute position accuracy was experimentally found to be approximately 5 mm. The round-trip delay we observed between the commands while controlling the xArm was 4 ms. Tests performed showed that the proposed control system allowed individuals to perform some ADLs such as picking up and placing items with a completion time of less than 1 min for each task and 100% success.
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Affiliation(s)
- Ivan Rulik
- Department of Computer Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
- *Correspondence: Ivan Rulik,
| | - Md Samiul Haque Sunny
- Department of Computer Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | | | | | - Brahim Brahmi
- Electrical Engineering Department, Collège Ahuntsic, Montreal, QC, Canada
| | | | - Katie Schultz
- Assistive Technology Program, Clement J. Zablocki VA Medical Center, Milwaukee, WI, United States
| | - Inga Wang
- Department of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Tony Leheng
- UFACTORY Technology Co., Ltd., Shenzhen, China
| | | | - Mohammad H. Rahman
- Department of Mechanical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
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Thawisuk C, Inoue K, Kaunnil A, Suyama N, Kim M, Ito Y. Occupational therapists’ perspectives on assistive technology services provision for older adult’s clients: A literature review. WORLD FEDERATION OF OCCUPATIONAL THERAPISTS BULLETIN 2022. [DOI: 10.1080/14473828.2022.2069359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Chirathip Thawisuk
- Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo, Japan
| | - Kaoru Inoue
- Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo, Japan
| | - Anuchart Kaunnil
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Natsuka Suyama
- Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo, Japan
| | - Minjoon Kim
- Department of Rehabilitation, Tokyo General Hospital, Tokyo, Japan
| | - Yuko Ito
- Department of Occupational Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo, Japan
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Fotteler ML, Mühlbauer V, Brefka S, Mayer S, Kohn B, Holl F, Swoboda W, Gaugisch P, Risch B, Denkinger M, Dallmeier D. The Effectiveness of Assistive Technologies for Older Adults and the Influence of Frailty: Systematic Literature Review of Randomized Controlled Trials. JMIR Aging 2022; 5:e31916. [PMID: 35377322 PMCID: PMC9016506 DOI: 10.2196/31916] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/09/2021] [Accepted: 12/13/2021] [Indexed: 12/05/2022] Open
Abstract
Background The use of assistive technologies (ATs) to support older people has been fueled by the demographic change and technological progress in many countries. These devices are designed to assist seniors, enable independent living at home or in residential facilities, and improve quality of life by addressing age-related difficulties. Objective We aimed to evaluate the effectiveness of ATs on relevant outcomes with a focus on frail older adults. Methods A systematic literature review of randomized controlled trials evaluating ATs was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Ovid Medline, PsycINFO, SocIndex, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CENTRAL (Cochrane Central Register of Controlled Trials), and IEEEXplore databases were searched from January 1, 2009, to March 15, 2019. ATs were included when aiming to support the domains autonomy, communication, or safety of older people with a mean age ≥65 years. Trials performed within a laboratory setting were excluded. Studies were retrospectively categorized according to the physical frailty status of participants. Results A total of 19 trials with a high level of heterogeneity were included in the analysis. Six device categories were identified: mobility, personal disease management, medication, mental support, hearing, and vision. Eight trials showed significant effectiveness in all or some of the primary outcome measures. Personal disease management devices seem to be the most effective, with four out of five studies showing significant improvement of disease-related outcomes. Frailty could only be assessed for seven trials. Studies including participants with significant or severe impairment showed no effectiveness. Conclusions Different ATs show some promising results in well-functioning but not in frail older adults, suggesting that the evaluated ATs might not (yet) be suitable for this subgroup. The uncertainty of the effectiveness of ATs and the lack of high-quality research for many promising supportive devices were confirmed in this systematic review. Large studies, also including frail older adults, and clear standards are needed in the future to guide professionals, older users, and their relatives. Trial Registration PROSPERO CRD42019130249; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130249
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Affiliation(s)
- Marina Liselotte Fotteler
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany.,Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Ulm, Germany.,Institute for Geriatric Research, Ulm University, Ulm, Germany.,Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - Viktoria Mühlbauer
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Simone Brefka
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Ulm, Germany.,Institute for Geriatric Research, Ulm University, Ulm, Germany.,Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - Sarah Mayer
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Ulm, Germany.,Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - Brigitte Kohn
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Ulm, Germany.,Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - Felix Holl
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany.,Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany.,Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States
| | - Walter Swoboda
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Petra Gaugisch
- Fraunhofer-Institute for Industrial Engineering, Stuttgart, Germany
| | - Beate Risch
- Fraunhofer-Institute for Industrial Engineering, Stuttgart, Germany
| | - Michael Denkinger
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Ulm, Germany.,Institute for Geriatric Research, Ulm University, Ulm, Germany.,Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - Dhayana Dallmeier
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Ulm, Germany.,Geriatric Center Ulm/Alb-Donau, Ulm, Germany.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
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20
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Sunny MSH, Zarif MII, Rulik I, Sanjuan J, Rahman MH, Ahamed SI, Wang I, Schultz K, Brahmi B. Eye-gaze control of a wheelchair mounted 6DOF assistive robot for activities of daily living. J Neuroeng Rehabil 2021; 18:173. [PMID: 34922590 PMCID: PMC8684692 DOI: 10.1186/s12984-021-00969-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/29/2021] [Indexed: 11/15/2022] Open
Abstract
Background Building control architecture that balances the assistive manipulation systems with the benefits of direct human control is a crucial challenge of human–robot collaboration. It promises to help people with disabilities more efficiently control wheelchair and wheelchair-mounted robot arms to accomplish activities of daily living. Methods In this study, our research objective is to design an eye-tracking assistive robot control system capable of providing targeted engagement and motivating individuals with a disability to use the developed method for self-assistance activities of daily living. The graphical user interface is designed and integrated with the developed control architecture to achieve the goal. Results We evaluated the system by conducting a user study. Ten healthy participants performed five trials of three manipulation tasks using the graphical user interface and the developed control framework. The 100% success rate on task performance demonstrates the effectiveness of our system for individuals with motor impairments to control wheelchair and wheelchair-mounted assistive robotic manipulators. Conclusions We demonstrated the usability of using this eye-gaze system to control a robotic arm mounted on a wheelchair in activities of daily living for people with disabilities. We found high levels of acceptance with higher ratings in the evaluation of the system with healthy participants.
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Affiliation(s)
- Md Samiul Haque Sunny
- Department of Computer Science, University of Wisconsin-Milwaukee, Milwaukee, WI, 53211, USA.
| | | | - Ivan Rulik
- Department of Computer Science, University of Wisconsin-Milwaukee, Milwaukee, WI, 53211, USA
| | - Javier Sanjuan
- Mechanical Engineering Department, University of Wisconsin-Milwaukee, Milwaukee, WI, 53211, USA
| | - Mohammad Habibur Rahman
- Mechanical Engineering Department, University of Wisconsin-Milwaukee, Milwaukee, WI, 53211, USA
| | - Sheikh Iqbal Ahamed
- Department of Computer Science, Marquette University, Milwaukee, WI, 53233, USA
| | - Inga Wang
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, 53211, USA
| | - Katie Schultz
- Clement J. Zablocki VA Medical Center, Milwaukee, WI, 53295, USA
| | - Brahim Brahmi
- Department of Electrical and Computer Engineering, Miami University, Oxford, OH, 45056, USA
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Jiménez-Arberas E, Díez E. Psychosocial Impact of Assistive Devices and Other Technologies on Deaf and Hard of Hearing People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147259. [PMID: 34299710 PMCID: PMC8303859 DOI: 10.3390/ijerph18147259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 11/16/2022]
Abstract
Deaf and hard of hearing people use a variety of assistive devices and technologies as a strategy to mitigate, counter or compensate for life difficulties resulting from hearing loss. Although outcome measures are commonly used with hearing aids, few studies have explored the perceived psychosocial impact of other assistive devices and technologies or the factors leading to their abandonment or lack of use. Therefore, the main aim of this study was to assess the psychosocial impact of different assistive devices on deaf and hard of hearing people using the Psychosocial Impact of Assistive Devices Scale. The sample was made up of 291 individuals, 176 women and 115 men, with an average age of 56.12 years (standard deviation (SD) = 25.11), who were all users of different assistive devices. Overall, the results of the study showed that the use of assistive devices had a positive psychosocial impact, although this impact varied slightly depending on the specific type of device. Moreover, a relationship was identified between the psychosocial impact and the probability of future abandonment of a hearing aid or a cochlear implant. The results point to the importance of considering the psychosocial impact derived from the use of a device as a relevant variable in the adoption process of assistive technologies for deaf and hard of hearing people.
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Affiliation(s)
- Estíbaliz Jiménez-Arberas
- Faculty Padre Ossó (Asociated Center of the University of Oviedo), Degree in Occupational Therapy, University of Oviedo, 33008 Oviedo, Spain;
| | - Emiliano Díez
- Institute for Community Inclusion (INICO), University of Salamanca, 37005 Salamanca, Spain
- Correspondence:
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22
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Munyoro J, Machimbidza T, Mutula S. Examining key strategies for building assistive technology (AT) competence of academic library personnel at university libraries in Midlands and Harare provinces in Zimbabwe. JOURNAL OF ACADEMIC LIBRARIANSHIP 2021. [DOI: 10.1016/j.acalib.2021.102364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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23
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Díez E, Jiménez-Arberas E, Pousada T. Psychometric Properties of the Spanish Version of Psychosocial Impact of Assistive Devices Scale in a Large Sample of People With Neuromuscular, Neurological, or Hearing Disabilities. Front Psychol 2021; 12:659562. [PMID: 34177710 PMCID: PMC8225245 DOI: 10.3389/fpsyg.2021.659562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/11/2021] [Indexed: 12/16/2022] Open
Abstract
Assistive technology (AT) is any device, software, or equipment designed for and used by individuals with disabilities to engage in everyday activities and achieve independence. However, the usefulness of those technology-based or supported treatments is a complex issue that has led to the development of various conceptual models for assistive technology outcomes research and practice as well as different assessment tools that help to explore the effect of technology on people's lives. One of those instruments is the Psychosocial Impact of Assistive Device Scale (PIADS), a 26-item questionnaire that measures the psychosocial impact of interventions, using assistive devices in three quality-of-life domains: competence, adaptability, and self-esteem. PIADS scale has been translated and adapted to several languages, and it has been successfully used to measure AT outcomes in different disability profiles to predict abandonment or even as a relevant determinant of future adoption of eHealth. Quinteiro (2010) adapted PIADS to Spanish for the first time, although no studies have yet been published to systematically study its psychometric properties. Therefore, the purpose of this study was to evaluate measurement properties of the Spanish version of PIADS scale by means of a dataset obtained from its application to a large sample (n = 417) of people with neuromuscular, neurological, or hearing disabilities that used different assistive devices. The results will provide valuable indicators about the measurement quality of the Spanish PIADS scale and will help to promote the use of reliable and valid AT outcome assessment tools for research and clinical purposes.
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Affiliation(s)
- Emiliano Díez
- INICO (Institute on Community Integration), University of Salamanca, Salamanca, Spain
| | - Estíbaliz Jiménez-Arberas
- Occupational Therapy, Faculty Padre Ossó (Center Attached to the University of Oviedo), University of Oviedo, Oviedo, Spain
| | - Thais Pousada
- CITIC (Centre for Information and Communications Technology Research), TALIONIS (Technology Applied on Occupation, Equality and Health), University of A Coruña, A Coruña, Spain
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Abraham CH, Boadi-Kusi B, Morny EKA, Agyekum P. Smartphone usage among people living with severe visual impairment and blindness. Assist Technol 2021; 34:611-618. [PMID: 33760680 DOI: 10.1080/10400435.2021.1907485] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Low vision care and rehabilitation is often limited by access to assistive devices, especially in low-resourced countries, due to their high cost and unavailability. Smartphones have the potential to serve as an alternative assistive device for people living with severe visual impairment and blindness (SVIB). This study aims to investigate the use of smartphones among people living with SVIB. The study was a cross-sectional study of 166 people living with SVIB in a low resourced setting. The participants were recruited from two tertiary institutions and four eye care facilities. A questionnaire was administered to all respondents and for those who could not read prints they were read out to them and their responses recorded. The majority of respondents (n = 88, 53.1%) either had no phone or used a basic phone. The prevalence of smartphone usage among people living with SVIB was found to be 46.90% (n = 78). Most respondents use their smartphones to interact on social media [n = 75 (96%)] and web browsing [n = 69,92%]. The most frequently demanded [n = 22 (44%)] smartphone functionality by the respondents was the image and color description feature. Most participants were unaware that 90% of their functionality demands already existed and were compatible with current smartphones. A significant number of people living with SVIB in this study used smartphones; however, most users are unaware of its full functionality and assistive capabilities.
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Affiliation(s)
- Carl Halladay Abraham
- Department of Optometry and Vision Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Bert Boadi-Kusi
- Department of Optometry and Vision Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Prince Agyekum
- Department of Optometry and Vision Sciences, University of Cape Coast, Cape Coast, Ghana
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Kamalakannan S, Rushton PW, Giesbrecht E, Rusaw DF, Bouziane SA, Nadeau M, McKee J, Gowran RJ, Kirby RL, Pedersen JP, Tasiemski T, Burrola-Mendez Y, Tofanin M, Goldberg M, Pearlman J. Wheelchair service provision education for healthcare professional students, healthcare personnel and educators across low- to high-resourced settings: a scoping review protocol. Disabil Rehabil Assist Technol 2020; 18:343-349. [PMID: 33301358 DOI: 10.1080/17483107.2020.1852325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Appropriate wheelchair provision is necessary for addressing participation barriers experienced by individuals with mobility impairments. Health care professionals involved in the wheelchair service provision process require a specific set of skills and knowledge to enable wheelchair use that meets individual posture, mobility and daily living requirements. However, inconsistencies exist in academic programmes globally about providing comprehensive education and training programmes. The planned scoping review aims to review and synthesize the global literature on wheelchair service provision education for healthcare professional students, healthcare personnel and educators offered by universities, organizations and industries. METHODS This scoping review will be guided by the Joanna Briggs Institute (JBI) methodological framework. Comprehensive literature searches will be conducted on various global electronic databases on health to seek out how wheelchair service provision education is organized, integrated, implemented and evaluated. Two independent reviewers will perform eligibility decisions and key data extractions. Data from selected studies will be extracted and analysed using conventional content analysis. Information related to wheelchair service provision education including curriculum development, content, teaching methods, evaluation and models of integration will be synthesized. IMPLICATIONS AND DISSEMINATION The planned scoping review will be the first to examine all aspects of wheelchair service provision education across professionals, settings and countries. We anticipate that results will inform the content of a Wheelchair Educators' Package, and if appropriate, a follow-up systematic review. An article reporting the results of the scoping review will be submitted for publication to a scientific journal.Implications for RehabilitationA comprehensive examination of wheelchair service provision education could help develop strategies to address the unmet need for wheelchair services globally.Findings for this review will facilitate the planning and development of an evidence-based education package that could bridge the existing knowledge gaps related to safe and effective wheelchair service provision among health professionals involved.This review will also inform the potential barriers and enablers for effective integration and implementation of wheelchair service provision education worldwide.
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Affiliation(s)
- Sureshkumar Kamalakannan
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.,Public Health Foundation of India, Indian Institute of Public Health, Hyderabad, India
| | - Paula W Rushton
- School of Rehabilitation, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada
| | - Ed Giesbrecht
- Department of Occupational Therapy, University of Manitoba, Winnipeg, Canada
| | - David F Rusaw
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | | | - Melodie Nadeau
- Department of Biology, University of Concordia, Montréal, Canada
| | - Jennifer McKee
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Rosemary J Gowran
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Health Implementation Science and Technology, University of Limerick, Limerick, Ireland
| | - R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada
| | - Jessica P Pedersen
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Tomasz Tasiemski
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| | - Yohali Burrola-Mendez
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.,Consejo Nacional de Ciencia y Tecnología (CONACyT), Ciudad de México, México
| | - Marco Tofanin
- Department of Neurosciences and Neurorehabilitation, Neurorehabilitation Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - Mary Goldberg
- International Society of Wheelchair Professionals, University of Pittsburgh, Pittsburgh, PA, USA.,Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jon Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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Chiu CJ, Hu JC, Lo YH, Chang EY. Health Promotion and Disease Prevention Interventions for the Elderly: A Scoping Review from 2015-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155335. [PMID: 32722162 PMCID: PMC7432678 DOI: 10.3390/ijerph17155335] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/07/2020] [Accepted: 07/22/2020] [Indexed: 11/21/2022]
Abstract
In this study, a scoping review method is used to review the distribution and trends in health promotion research and explore the use and contribution of eHealth technologies in health promotion in the elderly. The study includes six search databases: PubMed, CINAHL, the CochraneLibrary, EMBASE, PubPsych, and ERIC (EBSCOhost), and studies published from January 2015 to October 2019, written in English, were included and analyzed. The findings of the study reveal that the amount of literature on promoting health for the elderly has increased, and some specific types of interventions are still favored in current health promotion efforts for older adults. The most commonly used methods were found to be health promotion (n = 322), followed by screening (n = 264), primary prevention (n = 114), and finally social support (n = 72). Beyond the above interventions, eHealth technology is also used in health promotion activities to prevent the elderly from falling and to improve home safety, etc. However, although the application of eHealth technology has been applied in areas such as fall prevention, mental health promotion, and home security monitoring, it is still immature, and thus more rigorous research is needed in different areas, especially in older populations, various professions, women, and people with dementia.
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Affiliation(s)
- Ching-Ju Chiu
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
- Correspondence: ; Tel.: +886-6235-3535 (ext. 5739)
| | - Jia-Chian Hu
- School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
| | - Yi-Hsuan Lo
- Department of Statistics, College of Management, National Cheng Kung University, Tainan 70101, Taiwan;
| | - En-Yu Chang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan;
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Nuri RP, Ghahari S, Aldersey HM, Huque AS. Exploring access to government-led support for children with disabilities in Bangladesh. PLoS One 2020; 15:e0235439. [PMID: 32614867 PMCID: PMC7332059 DOI: 10.1371/journal.pone.0235439] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/15/2020] [Indexed: 12/20/2022] Open
Abstract
While access to support for individuals with disabilities has attracted international attention, children with disabilities and their families continue to face a range of barriers that limit their timely access to the needed support, including health service. This is even worse for children with disabilities living in resource poor settings like Bangladesh. The objective of this study was to determine the extent to which families of children with disabilities have knowledge about and access to government support for their children with disabilities in Bangladesh. We employed a cross-sectional study among 393 families of children with disabilities who sought services from the Centre for the Rehabilitation of the Paralysed for their children with disabilities in Bangladesh. We used chi-square test to measure the association between categorical variables and, Mann-Whitney U-test to compare mean across different sub-groups. Overall, family members of children with disabilities have limited knowledge about and access to government support. We found a significant association between knowledge and access to government support (p<0.001). Family members with children with disabilities aged younger than six years had less access to government support (p<0.001). We thus concluded with an urgent call on government agencies and service providers to provide relevant and timely information to families of children with disabilities to enable them to access the needed support.
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Affiliation(s)
- Reshma Parvin Nuri
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
- * E-mail:
| | - Setareh Ghahari
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
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Dorjbal D, Prodinger B, Zanini C, Avirmed B, Stucki G, Rubinelli S. Living with spinal cord injury in Mongolia: A qualitative study on perceived environmental barriers. J Spinal Cord Med 2020; 43:518-531. [PMID: 30633693 PMCID: PMC7480610 DOI: 10.1080/10790268.2019.1565707] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Context: Environmental factors play a key role in the lives of individuals with a spinal cord injury (SCI). This study identifies environmental barriers and their impacts on daily lives as perceived by individuals living with SCI in Mongolia. Design: A qualitative study with semi-structured interviews was conducted. A topic guide for the interviews was structured around the components of the International Classification of Functioning, Disability, and Health. Setting: Urban and rural areas of Mongolia. Participants: A purposive sample of 16 persons with traumatic SCI. Interventions: Not applicable. Outcome Measures: Not applicable. Results: Seven categories of environmental barriers were mentioned, such as poor access to the physical environment, absence of wheelchair-friendly transportation, negative societal attitudes, inadequate health and rehabilitation services, lack of access to assistive devices and medicines, limited financial resources for healthcare, and inaccurate categorization of disabilities in laws. These barriers were claimed to have an impact on physical and psychological health, limit activities, and restrict participation in almost all areas of life. Conclusion: This study contributes to the identification of targets for interventions aimed at improving the lived experience of persons with SCI in a low-resource context. The findings reveal that while the Mongolian government already has laws and policies in place to improve access to the physical environment, transportation, assistive devices and employment, much more has to be done in terms of enforcement. Specialized SCI care and rehabilitation services are highly demanded in Mongolia.
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Affiliation(s)
- Delgerjargal Dorjbal
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of LucerneLucerne, Switzerland
| | - Birgit Prodinger
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of LucerneLucerne, Switzerland
- Faculty of Applied Health and Social Sciences, University of Applied Sciences Rosenheim, Rosenheim, Germany
| | - Claudia Zanini
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of LucerneLucerne, Switzerland
| | - Baljinnyam Avirmed
- Department of Rehabilitation Medicine, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Gerold Stucki
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of LucerneLucerne, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of LucerneLucerne, Switzerland
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Nomura S, Siesjö V, Tomson G, Mohr W, Fukuchi E, Shibuya K, Tangcharoensathien V, Miyata H. Contributions of information and communications technology to future health systems and Universal Health Coverage: application of Japan's experiences. Health Res Policy Syst 2020; 18:73. [PMID: 32586326 PMCID: PMC7318469 DOI: 10.1186/s12961-020-00585-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 06/07/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Demographic changes in the pattern of disease burden, escalating health expenditures and inequitable access to healthcare are global challenges. Irrespective of their level of development, all countries need to reform their health systems to prepare for the future emerging health needs, in order to meet their commitments of health systems strengthening, universal health coverage (UHC) and explicit targets in the Sustainable Development Goals (SDGs). We propose three core principles for the future health system as described herein. A health system is not simply a 'cure delivery machine' but part of a 'social security system' that engages all stakeholders through a shared vision and value of health and well-being, not merely an absence of diseases. The future health system shall provide people-centred, affordable care, tailored to the individual's needs, accessible at any time and any place, and reflect the notion of leaving no one behind through a life course approach - underpinned by the SDGs. Information and communications technology (ICT) offers the potential to facilitate the realisation of these principles by improving the information flow between different parts of the health system through electronic means. We introduce Japan's new data platform - Person-centred Open PLatform for wellbeing (PeOPLe) - planned to be introduced in 2020 as one example of an ICT-based intervention to realise the three proposed principles. PeOPLe integrates data collected throughout the life course to enable all people to receive affordable, personalised health and social care at any time and any place throughout their lifetime. Furthermore, we discuss the applicability of these principles and PeOPLe to the health systems context of Thailand and the Philippines, including elaborations on ICT transformation challenges. CONCLUSION Current rising momentum and scale for ICTs in the UHC era offers a great opportunity to make a difference for countries. The PeOPLe concept is not only relevant to resource-rich countries; its applicability to other Asian countries could be feasible though it will need to be adapted to the various country contexts. We hope that this paper contributes to wider discussion around policy choices of ICT application for future health systems strengthening and UHC in order to achieve the SDGs.
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Affiliation(s)
- Shuhei Nomura
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.
- Institute of Global Health Policy Research (iGHP), National Center for Global Health and Medicine, Tokyo, Japan.
| | - Vera Siesjö
- Swedish Institute for Global Health Transformation (SIGHT), Royal Swedish Academy of Sciences, Stockholm, Sweden
- ACCESS Health International, Manila, Philippines
| | - Göran Tomson
- Swedish Institute for Global Health Transformation (SIGHT), Royal Swedish Academy of Sciences, Stockholm, Sweden
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Wiebke Mohr
- Swedish Institute for Global Health Transformation (SIGHT), Royal Swedish Academy of Sciences, Stockholm, Sweden
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Eriko Fukuchi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Shibuya
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute of Global Health Policy Research (iGHP), National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Hiroaki Miyata
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
- Institute of Global Health Policy Research (iGHP), National Center for Global Health and Medicine, Tokyo, Japan
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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30
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Bell D, Foiret J. A rapid review of the effect of assistive technology on the educational performance of students with impaired hearing. Disabil Rehabil Assist Technol 2020; 15:838-843. [PMID: 32525723 DOI: 10.1080/17483107.2020.1775317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To review the knowledge base regarding assistive technology (AT) and the education of people with a hearing impairment. Also, evaluating to what extent has the use and/or impact of AT for individuals with a hearing impairment been determined through evidence-based research in post-school education.Materials and method: Literature pertaining to the effect of AT on the educational performance of students with impaired hearing in the post-school sector was examined for the period from 1998 to 2018 (20 years). A total of 477 articles that contained evidence-based research and reports on the effect of AT in practice were located and reviewed.Results: It was found that, of the 20 studies that met all the inclusion criteria, only seven provided promising, evidence-based reports on the impact of assistive hearing technology on educational performance.Conclusion: This review concluded that the limited research speaks to the positive impact of AT on educational outcomes. Additionally, for students with a hearing impairment to be able to receive high-quality AT that will enhance their educational success, more evidence-based research on the efficacy of hearing AT needs to be conducted, especially as newer technologies emerge in this technological era.Implications for rehabilitationThe use of appropriate hearing assistive technology (AT) is a key facilitator within the educational environment and has a positive impact on the educational outcomes for students studying at college or university.This rapid review revealed the need to develop a body of scientifically based research that examines the relationship between academic achievement of participation by deaf learners and the use of AT - this is needed to develop a more comprehensive understanding of the benefits and limitations of educational technologies, especially as newer technologies emerge in this technological era.This study further highlights the need for more concrete research on the effectiveness of hearing-related AT so that the case can be made for students with hearing impairment to receive high quality, appropriate AT that will enhance their educational success.Ultimately, it is hoped that this article elicits the need for much more investigation into this topic to work towards finding solutions that lead to increased participation of deaf learners in the higher education arena, as well as providing evidence-based results to inform future policy and practice.
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Affiliation(s)
- Diane Bell
- Faculty of Business and Management Sciences, Strategic Initiatives and Projects, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Jaudon Foiret
- Faculty of Medicine and Health Sciences, Centre for Health Professions Education, University of Stellenbosch, Stellenbosch, South Africa
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31
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Gerłowska J, Furtak-Niczyporuk M, Rejdak K. Robotic assistance for people with dementia: a viable option for the future? Expert Rev Med Devices 2020; 17:507-518. [PMID: 32511027 DOI: 10.1080/17434440.2020.1770592] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Demographic changes in society and fewer personnel working in healthcare services have resulted in an increase in the speed of development of safe, reliable robotic assistance technologies for patients with neurological diseases. This paper aims to advocate for the frailty of patients in light of the economic need for robotic assistance, discuss potential hazards, and outline related factors that influence positive outcomes. AREAS COVERED This article reviews the state of the art and perspectives regarding the use of robotics in older adults with dementia. We focus on current trends in the development of robotic technologies for these patients and discuss the potential hazards associated with the implementation of such cutting-edge technology in daily practice. EXPERT OPINION We envisage a gradual increase in the usage of robot-based devices for the management and support of patients with cognitive deficits. In particular, the introduction of artificial intelligence will enhance the functionality of these technologies, but also increase potential hazards resulting from human-robot interactions. The development of such technology must consider whether neurological syndromes are static or progressive. Progressive syndromes pose the biggest challenge since the functionality of robotic devices must adapt to patients changing cognitive and motor performance profiles.
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Affiliation(s)
| | | | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin , Lublin, Poland
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Aenishänslin J, Amara A, Magnusson L. Experiences accessing and using rehabilitation services for people with physical disabilities in Sierra Leone. Disabil Rehabil 2020; 44:34-43. [PMID: 32352325 DOI: 10.1080/09638288.2020.1755375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To explore the experiences of persons with physical disabilities accessing and using rehabilitation services in Sierra Leone.Materials and methods: Interviews of 38 individuals with differing physical disabilities in three locations across Sierra Leone. An inductive approach was applied, and qualitative content analysis used.Results: Participants faced several barriers to accessing and using rehabilitation services. Six themes emerged: The initial and ongoing need for rehabilitation throughout life; challenges with the cost of rehabilitation and transportation to reach rehabilitation services; varied experiences with rehabilitation staff; coming to terms with disability and encountering stigma; the struggles without and opportunities with rehabilitation services; and limited knowledge and availability of rehabilitation services.Conclusions: There is a continued need to address the barriers associated with the affordability of rehabilitation through the financing of rehabilitation and transportation and exploring low-cost care delivery models. Rehabilitation services, assistive devices, and materials need to be available in existing rehabilitation centres. A national priority list is recommended to improve the availability and coordination of rehabilitation services. Improved knowledge about disability and rehabilitation services in the wider community is needed. Addressing discriminatory health beliefs and the stigma affecting people with disabilities through community interventions and health promotion is recommended.Implications for RehabilitationFinancing for rehabilitation, transportation to services and low-cost delivery models of care areneeded to reduce financial barriers and increase affordability of access and use.Community interventions and health promotion can provide information about the utility and availability of rehabilitation services, while addressing health beliefs and stigma towards persons with disabilities.The availability of both rehabilitation services and information, that is relevant and accessible is required to facilitate improved access and use of rehabilitation services.
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Affiliation(s)
- Justine Aenishänslin
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Abu Amara
- Department of Physiotherapy and Rehabilitation, Connaught Hospital, Freetown, Sierra Leone
| | - Lina Magnusson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Toro-Hernández ML, Alvarez L, Vargas-Chaparro MC, Goldberg M. Final Year Students' Knowledge on Basic Manual Wheelchair Provision: The State of Occupational Therapy Programs in Colombia. Occup Ther Int 2020; 2020:3025456. [PMID: 32410924 PMCID: PMC7206879 DOI: 10.1155/2020/3025456] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 04/15/2020] [Indexed: 12/18/2022] Open
Abstract
Access to personal mobility is a human right and as such, it implies the provision of wheelchair services for those with mobility impairments that need one. Lack of appropriately trained personnel is a major contributor to the gap in access to wheelchairs. Assistive technology provision is one of the core competencies of occupational therapists. The goal of this study was to assess the current wheelchair provision knowledge of final year occupational therapy students in Colombia as measured by the International Society of Wheelchair Professionals Basic Wheelchair Service Knowledge Test. A total of 83 students from 7 universities took the test. None of the students met the 70% passing threshold. The highest scores were in the assessment domain while the lowest in the fitting and user training domains. These results suggest that the current wheelchair provision education received in these programs do not meet the World Health Organization guidelines on appropriate wheelchair provision. The implementation of strategies to improve current wheelchair provision education in Colombian occupational therapy programs is granted.
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Affiliation(s)
| | - Liliana Alvarez
- School of Occupational Therapy, Western University, London, Canada
| | | | - Mary Goldberg
- International Society of Wheelchair Professionals, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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The Policies of Provision of Assistive and Welfare Technology—A Literature Review. SOCIETIES 2020. [DOI: 10.3390/soc10010022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Due to the increasing ageing population worldwide, humanity is facing global demographic challenges. For many people, their later years are often lived with changed functioning and the need for support in daily living activities. Assistive technology and welfare technology (AT/WT) constitute a partial solution to the demographic challenges. Objectives: The purpose of this literature review is to identify the policy features, such as decision models and guidance for the provision of AT/WT as reported in the current scientific literature. Methods: A literature review with a deductive approach using the structure of the Global Cooperation on Assistive Technology (GATE) model was conducted. The data were searched from the databases: PubMed, Cinahl Plus, and the Web of Science, resulting in nine included articles. Results: The findings are presented according to the structure of the eight domains from the GATE model— policy, assessment, procurement, technology, environment, usability, sustainability and rights— which are further grouped into categories exploring the variations in every domain. Conclusion: The review reveals a nascent and growing interest in the area; however, evidence-based decision models and other guidance on AT/WT are lacking. Recent scholarships and policy reforms can form the basis of stronger guidance to organise complex AT/WT systems, but further and future research is needed.
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Toro-Hernández ML, Kankipati P, Goldberg M, Contepomi S, Tsukimoto DR, Bray N. Appropriate Assistive Technology for Developing Countries. Phys Med Rehabil Clin N Am 2019; 30:847-865. [PMID: 31563175 DOI: 10.1016/j.pmr.2019.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Access to appropriate and affordable assistive technology is a human right, and a public health and development priority. This article elaborates on these aspects and illustrates the various opportunities and barriers to achieving equitable access to assistive technology through 4 specific country snapshots. In Brazil, mobility aids are provided through universal health coverage in rehabilitation reference centers in urban areas. A community-based rehabilitation pilot project in Argentina demonstrates how to reach an excluded indigenous community. A rapidly developing national legal framework in Colombia with imminent implementation challenges is showcased, as is a technology transfer model in India.
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Affiliation(s)
| | - Padmaja Kankipati
- Specialized Mobility Operations & Innovation, 804, Brigade Rubix, No. 20, HMT Main Road, Yeshwanthpura, Bangalore 560022, India
| | - Mary Goldberg
- International Society of Wheelchair Professionals, Department of Rehabilitation Science and Technology, Human Engineering Research Laboratories, University of Pittsburgh, 6425 Penn Avenue Suite 400, Pittsburgh, PA 15206, USA
| | - Silvana Contepomi
- Asociación Argentina de Tecnología Asistiva (AATA), Francia 3166, San Isidro 1642, Argentina
| | - Denise Rodrigues Tsukimoto
- Physical Medicine and Rehabilitation Institute (IMREA), Hospital das Clinicas, University of Sao Paulo, IMREA Rua Diderot, 43, Sao Paulo, Sao Paulo CEP: 04116030, Brazil
| | - Nathan Bray
- School of Health Sciences, Bangor University, Bangor, Gwynedd LL57 2EF, UK
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Tangcharoensathien V, Patcharanarumol W, Kulthanmanusorn A, Saengruang N, Kosiyaporn H. The Political Economy of UHC Reform in Thailand: Lessons for Low- and Middle-Income Countries. Health Syst Reform 2019; 5:195-208. [PMID: 31407962 DOI: 10.1080/23288604.2019.1630595] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Thailand achieved full population coverage of financial protection for health care in 2002 with successful implementation of the Universal Coverage Scheme (UCS). The three public health insurance schemes covered 98.5% of the population by 2015. Current evidence shows a high level of service coverage and financial risk protection and low level of unmet healthcare need, but the path toward UHC was not straightforward. Applying the Political Economy of UHC Reform Framework and the concept of path dependency, this study reviews how these factors influenced the evolution of the UHC reform in Thailand. We highlight how path dependency both set the groundwork for future insurance expansion and contributed to the persistence of a fragmented insurance pool even as the reform team was able to overcome certain path inefficient institutions and adopt more evidence-based payment schemes in the UCS. We then highlight two critical political economy challenges that can hamper reform, if not managed well, regarding the budgeting processes, which minimized the discretionary power previously exerted by Bureau of Budget, and the purchaser-provider split that created long-term tensions between the Ministry of Public Health and the National Health Security Office. Though resisted, these two changes were key to generating adequate resources to, and good governance of, the UCS. We conclude that although path dependence played a significant role in exerting pressure to resist change, the reform team's capacity to generate and effectively utilize evidence to guide policy decision-making process enabled the reform to be placed on a "good path" that overcame opposition.
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Affiliation(s)
| | | | - Anond Kulthanmanusorn
- International Health Policy Program (IHPP), Ministry of Public Health , Nonthaburi , Thailand
| | - Nithiwat Saengruang
- International Health Policy Program (IHPP), Ministry of Public Health , Nonthaburi , Thailand
| | - Hathairat Kosiyaporn
- International Health Policy Program (IHPP), Ministry of Public Health , Nonthaburi , Thailand
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