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Orellano-Colón EM, Rivero-Méndez M, Ralat-Fonseca BN, Varas-Díaz N, Lizama-Troncoso M, Jiménez-Velázquez IZ, Jutai JW. Multilevel barriers to using assistive technology devices among older hispanics from poor and disadvantaged communities: the relevance of a gender analysis. Disabil Rehabil Assist Technol 2024; 19:682-698. [PMID: 36170426 PMCID: PMC10043044 DOI: 10.1080/17483107.2022.2117427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 06/28/2022] [Accepted: 08/19/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To get a rich description of the barriers to using assistive technology (AT) among men and women ≥65 years living in poor and disadvantaged communities in Puerto Rico, an issue not well described among older people. METHODS We conducted qualitative interviews assisted by videos of AT and guided by the Matching Person and Technology Model and the Gender Analysis Framework with a purposive sample of 23 men and women. Participants were asked questions regarding reasons for not using AT, willingness for using AT, their identified gender roles and gender-related activities, and bargaining positions. They were also asked about their access to resources to acquire AT, bargaining positions, the stigma associated with AT use, and the characteristics of AT. Directed content analysis with input from a Community Advisory Board was used for the interpretation of the results. RESULTS The predominant barrier (for both men and women) to using AT devices were: lack of information about AT s and access to money for their purchase, lack of availability and cost of such devices, and (self)-stigma. More women than men experienced limited access to AT services, limited access to and control of money, limited skills for using AT, and less bargaining power for making independent decisions. More men than women expressed a lack of functional need and personal preferences other than using AT devices for managing difficulties in activities. CONCLUSION There are gender differences concerning the multilevel barriers to using AT devices among older Hispanics residing in low-income communities.IMPLICATIONS FOR REHABILITATIONOlder Hispanic men and women in this study experienced different obstacles to using assistive technology (AT) they need for compensating their functional disabilities in daily living activities.Women in this study reported having less access to money and AT services, diminished skills for using AT devices, and less power to make independent decisions to access AT devices compared to men.To ensure the equitable provision of AT, cultural as well as gender-related factors concerning AT use need to be considered.Future research should focus on women's functional health, also should focus on the development of gender-sensitive and culturally competent AT interventions to improve older Hispanics from poor communities function and opportunities for ageing at their homes and in their communities.
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Affiliation(s)
- Elsa M Orellano-Colón
- Occupational Therapy Program, School of Health Professions, University of Puerto Rico, San Juan, PR, USA
| | | | | | - Nelson Varas-Díaz
- Global and Sociocultural Studies, Florida International University, Miami, FL, USA
| | | | | | - Jeffrey W Jutai
- Interdisciplinary School of Science, University of Ottawa, Ontario, Canada
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Gauthier-Beaupré A, Kuziemsky C, Battistini BJ, Jutai JW. Framework for policymaking on self-management of health by older adults using technologies. Health Res Policy Syst 2024; 22:32. [PMID: 38443938 PMCID: PMC10913262 DOI: 10.1186/s12961-024-01119-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/07/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, the use of information and communication technologies (ICTs) to support care management exponentially increased. Governments around the world adapted existing programs to meet the needs of patients. The reactivity of governments, however, led to changes that were inequitable, undermining groups such as older adults living with chronic diseases and disability. Policies that align with recent developments in ICTs can promote better health outcomes and innovation in care management. A framework for policymaking presents potential for overcoming barriers and gaps that exist in current policies. OBJECTIVE The goal of this study was to examine how well a provisional framework for policymaking represented the interactions between various components of government policymaking on older adults' self-management of chronic disease and disability using ICTs. METHODS Through an online survey, the study engaged policymakers from various ministries of the government of Ontario in the evaluation and revision of the framework. The data were analyzed using simple statistics and by interpreting written comments. RESULTS Nine participants from three ministries in the government of Ontario responded to the questionnaire. Overall, participants described the framework as useful and identified areas for improvement and further clarification. A revised version of the framework is presented. CONCLUSIONS Through the revision exercise, our study confirmed the relevance and usefulness for a policymaking framework on the self-management of disease and disability of older adults' using ICTs. Further inquiries should examine the application of the framework to jurisdictions other than Ontario considering the dissociated nature of Canadian provincial healthcare systems.
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Affiliation(s)
- Amélie Gauthier-Beaupré
- Faculty of Health Sciences and Life Research Institute, University of Ottawa, Ottawa, ON, Canada.
| | - Craig Kuziemsky
- School of Business, MacEwan University, Edmonton, AB, Canada
| | - Bruno J Battistini
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Jeffrey W Jutai
- Faculty of Health Sciences and Life Research Institute, University of Ottawa, Ottawa, ON, Canada
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3
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Jahan AM, Guitard P, Jutai JW. Psychosocial predictors of mobility assistive devices non-adherence among older adults. Disabil Rehabil Assist Technol 2024:1-9. [PMID: 38393746 DOI: 10.1080/17483107.2024.2320723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 02/13/2024] [Indexed: 02/25/2024]
Abstract
Background: Mobility assistive devices (MADs) provide support to older adults to improve their quality of life; however, research shows that as many as 75% of older adults are non-adherent to prescribed MADs. This study investigated the psychosocial factors that predict non-adherence to MADs among older adults.Methods: A sample of Canadian older adult MADs users who resided in a long-term care facility was included. The data was collected using the Psychosocial Impact of Assistive Devices Scale (PIADS), and the Medical Outcomes Study Social Support Survey (mMOS-SS). Data analysis was performed using SPSS 28. Descriptive statistics were used to describe the sample and the study variables. Pearson correlation coefficients were used to evaluate the association between the study variables. Variables that were associated with non-adherence in a univariate analysis were subsequently entered into a multiple regression analysis.Results: The sample comprised 48 residents (26 females and 22 males), with a mean age of 86.8. In the univariate analysis, scores from the three PIADS subscales, namely, Competence, Adaptability, and Self-esteem, and the Social Support scale were significantly correlated with non-adherence (p < 0.05). In the multiple regression analyses, only Self-esteem significantly predicted non-adherence (p < 0.05), and this model explained between 43.5 and 54.3% of the variance in non-adherence.Conclusion: This study revealed that the Self-esteem construct, which includes several concepts related to psychological well-being, was the only significant predictor of non-adherence among the studied sample of older adults. The clinical implications of the findings are subsequently discussed.
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Affiliation(s)
- Alhadi M Jahan
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Paulette Guitard
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Jeffrey W Jutai
- School of Interdisciplinary Health Sciences and Life Research Institute, University of Ottawa, Ottawa, Canada
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Hosseini M, Thomas R, Pilutti L, Fallavollita P, Jutai JW. Acceptance of physical activity virtual reality games by residents of long-term care facilities: a scoping review. Disabil Rehabil Assist Technol 2023:1-9. [PMID: 38146958 DOI: 10.1080/17483107.2023.2298839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 12/19/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE This scoping review aims to identify evidence on older adults' acceptance of PA VR games in LTC facilities, describe research designs used, define key acceptance concepts, and identify knowledge gaps for future research. MATERIALS AND METHODS Following Arksey and O'Malley's framework, data from published and unpublished articles (Jan 2000-May 2023) were collected. Twelve databases and additional sources were searched for studies on LTC residents (≥65 years), PA video games (including VR and console games), acceptance, and attitudes. Data extraction included article details, design, population, intervention, outcomes, and limitations. RESULTS Five studies met inclusion criteria from 1628 initial titles. They assessed acceptance of PA VR games among older adults in LTC facilities, showing varying levels of acceptance. Most studies used analytical designs, including RCTs. Key concepts of VR acceptance were poorly defined, with only one study using a validated TAM questionnaire. Knowledge gaps highlight the need for further research to understand PA VR acceptance among older adults in LTC facilities. CONCLUSION Validated acceptance questionnaires are needed in study of VR acceptance by older adults. Use of qualitative and quantitative methods can enhance understanding of technology acceptance, alongside exploration of individual, environmental, and age-related factors. Detailed reporting of VR interventions is recommended to comprehend acceptance factors.
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Affiliation(s)
- Marjan Hosseini
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Canada
| | - Roanne Thomas
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Canada
| | - Lara Pilutti
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, and Brain and Mind Research Institute, University of Ottawa, Canada
| | - Pascal Fallavollita
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, and School of Electrical Engineering and Computer Science, Faculty of Engineering, University of Ottawa, Canada
| | - Jeffrey W Jutai
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, and Life Research Institute, University of Ottawa, Canada
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Hosseini M, Thomas R, Pilutti L, Fallavollita P, Jutai JW. Assessing virtual reality acceptance in long-term care facilities: a quantitative study with older adults. Disabil Rehabil Assist Technol 2023:1-12. [PMID: 38146956 DOI: 10.1080/17483107.2023.2295946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/13/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE Our study aimed to investigate the factors associated with the acceptance of virtual reality (VR) games among older adults living in LTC, with a particular emphasis on identifying social and individual factors that have been overlooked in existing technology acceptance models. MATERIALS AND METHODS We conducted VR gaming sessions, followed by a composite questionnaire to explore the factors associated with the acceptance of VR games among residents of LTC with a focus on technology acceptance models (TAM) and social factors derived from Selective Optimization with Compensation (SOC) theory and Socioemotional Selectivity Theory (SST). RESULTS We studied 20 older adults aged 65 and older. Participants were moderately sedentary, with the majority of them having prior gaming experience. Participants with prior gaming experience had higher mean scores in most SOC theory and SST subscales, except for elective selection. Participants perceived the technology as useful and easy to use, with no heightened gaming-related anxiety. Significant correlations were found between perceived ease of use and selection strategies, and between attitudes towards gaming and elective selection strategies. No significant score differences were observed between male and female participants. CONCLUSIONS The positive correlation between VR acceptance and using SOC strategies suggests a positive response to straightforward experiences. Our study highlights VR exergaming's potential benefits for encouraging LTC residents' engagement in valued activities and pursuing goals. Moreover, social theories of aging can inform technology acceptance and guide the design and marketing of VR exergames to better suit older adults' needs and preferences in LTC.IMPLICATIONS FOR REHABILITATIONThe findings of this study have important implications for rehabilitation programs aimed at enhancing physical activity (PA) and engagement among older adults living in long-term care (LTC) facilities. The use of virtual reality (VR) games can be an important tool to promote PA and improve the overall well-being of LTC residents. Based on the results, the following implications can be drawn:Integrating VR exergaming in rehabilitation:The positive perception of VR technology's usefulness and ease of use among older adults in LTC suggests that VR exergaming can be effectively integrated into rehabilitation programs. Healthcare professionals and rehabilitation specialists in LTC facilities can consider incorporating VR-based exercise routines and gaming sessions to motivate and engage residents in physical activities. By doing so, they can create enjoyable and interactive rehabilitation experiences that may lead to improved adherence to exercise regimens.Addressing social factors for VR acceptance:Our study highlights the significance of social factors derived from theories of aging, such as Selective Optimization with Compensation (SOC) and Socioemotional Selectivity Theory (SST), in influencing VR acceptance among LTC residents. Rehabilitation programs should take into account these social aspects and create a supportive and encouraging environment for older adults to engage with VR exergames. Encouraging social interactions and providing opportunities for residents to share their experiences with VR gaming may enhance acceptance and overall engagement.Tailoring VR exergames for older adults:The correlation between VR acceptance and the use of SOC strategies indicates that customized experiences may be well-received by LTC residents. Game developers and rehabilitation specialists should consider designing VR exergames that align with the specific preferences and needs of older adults. This could involve providing choices and options for users to optimize their gaming experiences based on their individual abilities and interests.Recognizing gaming experience:Our study highlights that prior gaming experience positively influenced participants' attitudes towards VR gaming. Rehabilitation professionals should acknowledge and leverage this prior experience when introducing VR exergaming to older adults in LTC. By incorporating elements familiar to older adults or providing guidance for those new to gaming, rehabilitation programs can foster a more seamless and enjoyable transition to VR exergames.Promoting goal pursuit and valued activities:Our study suggests that VR exergaming has the potential to encourage LTC residents' engagement in valued activities and goal pursuit. Rehabilitation programs can utilize VR exergaming as a means to help residents achieve specific rehabilitation goals and engage in activities that are meaningful to them. This approach can contribute to a sense of purpose and satisfaction in the rehabilitation process.Overall, the integration of VR exergaming in rehabilitation for older adults in LTC facilities has promising implications for improving physical activity levels, enhancing engagement, and addressing the holistic well-being of residents. By considering the social factors influencing VR acceptance and tailoring experiences to individual preferences, rehabilitation professionals can optimize the potential benefits of VR technology in LTC settings.
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Affiliation(s)
- Marjan Hosseini
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Roanne Thomas
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Lara Pilutti
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - Pascal Fallavollita
- Faculty of Health Sciences, Faculty of Engineering, Interdisciplinary School of Health Sciences, School of Electrical Engineering and Computer Science, University of Ottawa, Ottawa, Canada
| | - Jeffrey W Jutai
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, Life Research Institute, University of Ottawa, Ottawa, Canada
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Gauthier-Beaupré A, Battistini BJ, Kuziemsky C, Jutai JW. Policymaker perspectives on self-management of disease and disabilities using information and communication technologies. Health Res Policy Syst 2023; 21:52. [PMID: 37316838 DOI: 10.1186/s12961-023-01004-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/18/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Policies that support health self-management are malleable and highly dependent on various factors that influence governments. Within a world that is shifting toward digitalization due to pressures such as the COVID-19 pandemic and labor shortages, policymaking on older adults' self-management of chronic diseases and disability using information and communication technologies (ICTs) needs to be better understood. Using the province of Ontario, in Canada, as a case study, the research question was What is the environment that policymakers must navigate through in development and implementation of policies related to older adults' self-management of disease and disability using information and communication technologies (ICTs)? METHODS This study used a qualitative approach where public servants from 4 ministries within the government of Ontario were invited to participate in a 1-h, one-on-one, semi-structured interview. The audio-recorded interviews were based on an adapted model of the policy triangle, where the researcher asked questions about the influences from the different sources identified in the model. The interviews were later transcribed and analyzed using a deductive-inductive coding approach. RESULTS Ten participants across 4 different Ministries participated in the interviews. Participants shared insights on various aspects of context, process and actors that help shape the current content of policies. The analysis revealed that policies, in the form of programs, services, legislation and regulations, are the result of collaborations and dialogue between different actors and get developed and implemented via a set of complex government processes. In addition, policy actions come from a plethora of sectors which all get influenced by several predictable and unpredictable external pressures. CONCLUSIONS The environment for policymaking in the government of Ontario regarding older adults' self-management of disease and disability using ICTs is one that is mostly reactive to external pressures, while organized within a set of complex processes and multi-sectoral collaborations. The present research helped us to understand the complexity of policymaking on the topic and highlights the need for increased foresight and proactive policymaking, regardless of which governments are in-place.
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Affiliation(s)
| | - Bruno J Battistini
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Craig Kuziemsky
- School of Business, MacEwan University, Edmonton, AB, Canada
| | - Jeffrey W Jutai
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
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Gauthier-Beaupré A, Kuziemsky C, Battistini BJ, Jutai JW. Evolution of public health policy on healthcare self-management: the case of Ontario, Canada. BMC Health Serv Res 2023; 23:248. [PMID: 36918904 PMCID: PMC10011770 DOI: 10.1186/s12913-023-09191-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 02/16/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND As people live longer, they are at increased risk for chronic diseases and disability. Self-management is a strategy to improve health outcomes and quality of life of those who engage in it. This study sought to gain a better understanding of the factors, including digital technology, that affect public health policy on self-management through an analysis of government policy in the most populous and multicultural province in Canada: Ontario. The overarching question guiding the study was: What factors have influenced the development of healthcare self-management policies over time? METHODS Archival research methods, combining document review and evaluation, were used to collect data from policy documents published in Ontario. The documents were analyzed using the READ approach, evaluated using a data extraction table, and synthesized into themes using the model for health policy analysis. RESULTS Between January 1, 1985, and May 5, 2022, 72 policy documents on self-management of health were retrieved from databases, archives, and grey literature. Their contents largely focussed on self-management of general chronic conditions, while 47% (n = 18/72) mention diabetes, and 3% (n = 2/72) focussed solely on older adults. Digital technologies were mentioned and were viewed as tools to support self-management in the context of healthcare delivery and enhancing healthcare infrastructure (i.e., telehealth or software in healthcare settings). The actors involved in the policy document creation included mostly Ontario government agencies and departments, and sometimes expert organizations, community groups and engaged stakeholders. The results suggest that several factors including pressures on the healthcare system, hybrid top-down and bottom-up policymaking, and political context have influenced the nature and implementation timing of self-management policy in Ontario. CONCLUSIONS The policy documents on self-management of health reveal a positive evolution of the content discussed over time. The changes were shaped by an evolving context, both from a health and political perspective, within a dynamic system of interactions between actors. This research helps understand the factors that have shaped changes and suggests that a critical evidence-based approach on public health policy is needed in understanding processes involved in the development of healthcare self-management policies from the perspective of a democratic governing system.
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Affiliation(s)
| | - Craig Kuziemsky
- Office of Research Services and School of Business, MacEwan University, Edmonton, Alberta, Canada
| | - Bruno J Battistini
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeffrey W Jutai
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Chan A, Cohen R, Robinson KM, Bhardwaj D, Gregson G, Jutai JW, Millar J, Ríos Rincón A, Roshan Fekr A. Evidence and User Considerations of Home Health Monitoring for Older Adults: Scoping Review. JMIR Aging 2022; 5:e40079. [PMID: 36441572 DOI: 10.2196/40079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Home health monitoring shows promise in improving health outcomes; however, navigating the literature remains challenging given the breadth of evidence. There is a need to summarize the effectiveness of monitoring across health domains and identify gaps in the literature. In addition, ethical and user-centered frameworks are important to maximize the acceptability of health monitoring technologies. OBJECTIVE This review aimed to summarize the clinical evidence on home-based health monitoring through a scoping review and outline ethical and user concerns and discuss the challenges of the current user-oriented conceptual frameworks. METHODS A total of 2 literature reviews were conducted. We conducted a scoping review of systematic reviews in Scopus, MEDLINE, Embase, and CINAHL in July 2021. We included reviews examining the effectiveness of home-based health monitoring in older adults. The exclusion criteria included reviews with no clinical outcomes and lack of monitoring interventions (mobile health, telephone, video interventions, virtual reality, and robots). We conducted a quality assessment using the Assessment of Multiple Systematic Reviews (AMSTAR-2). We organized the outcomes by disease and summarized the type of outcomes as positive, inconclusive, or negative. Second, we conducted a literature review including both systematic reviews and original articles to identify ethical concerns and user-centered frameworks for smart home technology. The search was halted after saturation of the basic themes presented. RESULTS The scoping review found 822 systematic reviews, of which 94 (11%) were included and of those, 23 (24%) were of medium or high quality. Of these 23 studies, monitoring for heart failure or chronic obstructive pulmonary disease reduced exacerbations (4/7, 57%) and hospitalizations (5/6, 83%); improved hemoglobin A1c (1/2, 50%); improved safety for older adults at home and detected changing cognitive status (2/3, 66%) reviews; and improved physical activity, motor control in stroke, and pain in arthritis in (3/3, 100%) rehabilitation studies. The second literature review on ethics and user-centered frameworks found 19 papers focused on ethical concerns, with privacy (12/19, 63%), autonomy (12/19, 63%), and control (10/19, 53%) being the most common. An additional 7 user-centered frameworks were studied. CONCLUSIONS Home health monitoring can improve health outcomes in heart failure, chronic obstructive pulmonary disease, and diabetes and increase physical activity, although review quality and consistency were limited. Long-term generalized monitoring has the least amount of evidence and requires further study. The concept of trade-offs between technology usefulness and acceptability is critical to consider, as older adults have a hierarchy of concerns. Implementing user-oriented frameworks can allow long-term and larger studies to be conducted to improve the evidence base for monitoring and increase the receptiveness of clinicians, policy makers, and end users.
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Affiliation(s)
- Andrew Chan
- Faculty of Rehabilitation Medicine, Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada.,Innovation and Technology Hub, Glenrose Rehabilitation Research, Edmonton, AB, Canada
| | - Rachel Cohen
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Katherine-Marie Robinson
- School of Engineering Design and Teaching Innovation, Faculty of Engineering, University of Ottawa, Ottawa, ON, Canada.,Department of Philosophy, Faculty of Arts, University of Ottawa, Ottawa, ON, Canada
| | - Devvrat Bhardwaj
- Department of Electrical Engineering and Computer Science, Faculty of Engineering, University of Ottawa, Ottawa, ON, Canada
| | - Geoffrey Gregson
- Faculty of Rehabilitation Medicine, Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada.,Innovation and Technology Hub, Glenrose Rehabilitation Research, Edmonton, AB, Canada
| | - Jeffrey W Jutai
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,LIFE Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Jason Millar
- School of Engineering Design and Teaching Innovation, Faculty of Engineering, University of Ottawa, Ottawa, ON, Canada.,Department of Philosophy, Faculty of Arts, University of Ottawa, Ottawa, ON, Canada
| | - Adriana Ríos Rincón
- Faculty of Rehabilitation Medicine, Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada.,Innovation and Technology Hub, Glenrose Rehabilitation Research, Edmonton, AB, Canada
| | - Atena Roshan Fekr
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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9
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Jutai JW, Tuazon JR. The role of assistive technology in addressing social isolation, loneliness and health inequities among older adults during the COVID-19 pandemic. Disabil Rehabil Assist Technol 2022; 17:248-259. [PMID: 34978947 DOI: 10.1080/17483107.2021.2021305] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE Assistive technology (AT) is an effective tool to promote social connectedness among older adults affected by the COVID-19 pandemic; however, its role in reducing loneliness and health inequities is not well understood. The goal of this scoping review was to construct a model for how technologies may be deployed to mitigate the impact of the COVID-19 pandemic on social isolation, loneliness and health inequities for older adults. METHODS PubMed, SCOPUS and PsychINFO were searched from 2010 to 2020 for the following keywords: "social isolation," "loneliness," "social support," "resilience," "technology," "pandemic" and "health inequit*." Articles selected for full analysis attempted to understand how technology alleviates social isolation and/or loneliness among older adults. RESULTS Eighteen articles met the criteria for selection and data extraction. Six were review-type studies, seven were observational, three were randomized control trials, one opinion piece and one case study. ATs have been shown to reduce loneliness and social isolation, strengthen social support, and promote resilience among older adults. AT reduces loneliness both directly and indirectly, by affecting social isolation. There is insufficient evidence to determine technology's relationship to health inequities experienced by older adults. CONCLUSIONS The model we have proposed should help advance research on the relationship between ATs and health inequities among older adults that may be aggravated by the COVID-19 pandemic. We hypothesize that AT interventions for social support and functional competence should be sequenced to reduce health disparities.Implications for rehabilitationThe social distancing and quarantine measures as a result of the COVID-19 pandemic can be linked to adverse health outcomes among older adult populations.Technology is an effective tool to promote social connectedness among older adults affected by the pandemic.Assistive technology (AT) interventions for social support and functional competence should be sequenced in order to have best effects on reducing health disparities.
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Affiliation(s)
- Jeffrey W Jutai
- Interdisciplinary School of Health Sciences and LIFE Research Institute, University of Ottawa, Ottawa, Canada
| | - Joshua R Tuazon
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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10
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Orellano-Colón EM, Goff-Molina ND, Ferré-Martínez AC, Acevedo-Santiago PA, Colón-Cartagena EJ, Lizama-Troncoso M, Jiménez-Velázquez IZ, Varas-Díaz N, Jutai JW, Rivero-Méndez M. Understanding the Multilevel Disability Self-Management Strategies of Puerto Rican Older Men. Physical & Occupational Therapy In Geriatrics 2021; 39:325-353. [DOI: 10.1080/02703181.2021.1880530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Elsa M. Orellano-Colón
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Nanichi D. Goff-Molina
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Andrea C. Ferré-Martínez
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Pedro A. Acevedo-Santiago
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Edgardo J. Colón-Cartagena
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | | | | | - Nelson Varas-Díaz
- Global and Sociocultural Studies, Florida International University, Miami, Florida, USA
| | - Jeffrey W. Jutai
- Interdisciplinary School of Science, University of Ottawa, Ottawa,Canada
| | - Marta Rivero-Méndez
- School of Nursing, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
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Orellano-Colón EM, Suárez-Pérez EL, Rivero-Méndez M, Boneu-Meléndez CX, Varas-Díaz N, Lizama-Troncoso M, Jiménez-Velázquez IZ, León-Astor A, Jutai JW. Sex disparities in the prevalence of physical function disabilities: a population-based study in a low-income community. BMC Geriatr 2021; 21:419. [PMID: 34246238 PMCID: PMC8271294 DOI: 10.1186/s12877-021-02362-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Functional disability continues to be a significant public health problem that increases older adults' vulnerability to experience a diminished quality of life, loss of independence, higher healthcare costs and health services utilization, and increased risks of mortality. Thus, we aimed to study the prevalence of functional disabilities by sex according to the types of daily living activities, controlling for specific sociodemographic variables among older Hispanics from low-income communities. METHODS We used a cross-sectional epidemiological research design, considering a complex sampling design of households to interview adults ≥65 years living in low-income communities in Puerto Rico. Functional disability was measured by the PROMIS® Physical Function Short Form-20 T-score. The selected community was reported to have 5980 adult residents ≥65 years, according to the USA Census. The prevalence of functional disability was estimated using the logistic regression model, weighting by the effect of the sampling. Our estimated prevalence was compared between sexes using the prevalence ratio (PR), which was estimated with logistic regression models, controlling for age, income, number of chronic conditions, high and low impact of chronic conditions in functional disabilities, marital status, and sampling design. RESULTS We recruited 211 older Hispanics from a randomly selected sample. Their mean age was 74.4 ± 7.1 years, with female predominance (57.3%). The overall estimated prevalence of physical function disability using T-score among females was 2.70 (95% CI: 1.4, 5.1) times the estimated prevalence of physical function disability among males. Women were more likely to report functional disabilities in instrumental activities of daily living, self-care activities, and functional mobility compared to males. However, sex differences were largely explained by the presence of musculoskeletal conditions of high impact in functional disability. CONCLUSIONS The females in our study bear the greater burden of physical function disability in their adult age. Health policies, as well as future studies, should be targeted at reducing the burden of physical function disabilities in different types of daily activities through gender-sensitive disability self-management programs.
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Affiliation(s)
- Elsa M Orellano-Colón
- Occupational Therapy Program, School of Health Professions, University of Puerto Rico, Medical Sciences Campus, PO Box 365067, San Juan, PR, 00936-5067, USA.
| | - Erick L Suárez-Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, USA
| | - Marta Rivero-Méndez
- School of Nursing, University of Puerto Rico Medical Sciences Campus, San Juan, USA
| | - Claudia X Boneu-Meléndez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, USA
| | - Nelson Varas-Díaz
- Global and Sociocultural Studies, Florida International University, Florida, USA
| | - Mauricio Lizama-Troncoso
- Puerto Rico Assistive Technology Program, University of Puerto Rico Central Administration, San Juan, USA
| | | | - Arelí León-Astor
- Office of Environmental Quality, Health, and Occupational Safety, University of Puerto Rico Medical Sciences Campus, San Juan, USA
| | - Jeffrey W Jutai
- Interdisciplinary School of Science, University of Ottawa, Ottawa, Ontario, Canada
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12
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Orellano-Colón EM, Abdalla-Mukhaimer N, Rodríguez-Ramos BA, Rodríguez-Robles R, Rivero-Méndez M, Lizama-Troncoso M, Jutai JW, Jiménez-Velázquez IZ, Varas-Díaz N, Hallman-Navarro D. Self-Management Strategies Used by Older Hispanic Women to Overcome Functional Disabilities. Physical & Occupational Therapy In Geriatrics 2021. [DOI: 10.1080/02703181.2020.1788691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Elsa M. Orellano-Colón
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Nelly Abdalla-Mukhaimer
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Bryan A. Rodríguez-Ramos
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Rebecca Rodríguez-Robles
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Marta Rivero-Méndez
- School of Nursing, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Mauricio Lizama-Troncoso
- Puerto Rico Assistive Technology Program, Central Administration, University of Puerto Rico, San Juan, Puerto Rico
| | - Jeffrey W. Jutai
- Interdisciplinary School of Science, University of Ottawa, Ottawa, Canada
| | | | - Nelson Varas-Díaz
- Global and Sociocultural Studies, Florida International University, Miami, Florida, USA
| | - Deanna Hallman-Navarro
- School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
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13
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Auger C, Mortenson WB, Jutai JW, Seguin-Tremblay N, Chenel V, Guay M. Older adults' use of an online decision support system: Usability and stability of assistive technology recommendations. Assist Technol 2020; 34:316-325. [PMID: 32865488 DOI: 10.1080/10400435.2020.1815251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Online decision support systems (DSS) may help older adults self-select assistive technology (AT) by offering recommendations. User interactions with DSSs may change the recommendations they receive. OBJECTIVE We evaluated recommendations stability and usability of an online DSS. METHODS Middle-aged and older adults (n = 43) were observed while using the DSS. The stability of DSS recommendations (ATs and advice) was compared between two time points, using a three-point scale: no, partial, or full agreement. Usability was coded, referencing ISO standards. RESULTS Half (51%) of participants received AT recommendations from the DSS in both sessions, with full (14%) or partial (12%) agreement. All but one participant received advice, and almost all of them had full (40%) or partial (56%) agreement between sessions. Many of the usability issues appear to be the result of the users inaccurately measuring their environment, challenges in understanding the questions being asked, and improperly making selections from the system. DISCUSSION Strict AT matching rules versus generic advice, and usability issues, likely reduced the matching rate and stability of AT recommendations. CONCLUSION It appears that some users may require assistance with the system, and we suggest changes to the DSS format and content to improve stability and usability.
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Affiliation(s)
- Claudine Auger
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Canada.,School of Rehabilitation, Université de Montréal, Montréal, Canada
| | - W Ben Mortenson
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Jeffrey W Jutai
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada.,LIFE Research Institute, Ottawa, Canada
| | | | - Vanessa Chenel
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Canada.,School of Rehabilitation, Université de Montréal, Montréal, Canada
| | - Manon Guay
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
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14
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Abstract
Hearing-specific and generic measures of hearing aid outcome were examined in order (a) to determine their relative sensitivity to hearing aid use and (b) to examine the relationship between pre–hearing aid use expectations and post-use outcomes. Ninety-two hearing-impaired individuals completed some combination of the Abbreviated Profile of Hearing Aid Benefit, Expected Consequences of Hearing Aid Ownership (ECHO), Satisfaction with Amplification in Daily Life (SADL), and Psychosocial Impact of Assistive Devices Scale, and provided reports of their daily and lifetime hearing aid use. In general, (a) the longer individuals wear hearing aids, the more positive the reported outcome, and (b) ECHO scores of non–hearing aid users are higher than SADL scores of new hearing aid users (six weeks to one year of use) but are similar to those obtained from experienced users (greater than one year of use). Between-questionnaire comparisons showed the generic measure to be as sensitive as the hearing aid specific measures. We suggest that generic measures have some advantages over hearing specific measures but that each has a place in the clinic.
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Affiliation(s)
- Gabrielle H Saunders
- National Center for Rehabilitative Auditory Research, 3710 SW US Veterans Hospital Road, Portland, OR 97207, USA.
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15
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Tuazon JR, Jutai JW. Towards improving the quality of assistive technology outcomes research. Disabil Rehabil Assist Technol 2020; 17:587-593. [PMID: 32758053 DOI: 10.1080/17483107.2020.1801865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The Assistive Technology Device Outcomes Research (ATDOR) checklist was developed as a reporting guideline for researchers to enhance the quality of research in this field. The checklist contains 13 items that cover outcome domains unique to assistive technology devices (ATDs). The ATDOR was intended to be an adjunct to existing publication guidelines for outcomes research. PURPOSE The aim of this investigation was to examine the ability of the ATDOR checklist to identify strengths and weaknesses in ATD outcomes research publications that may not be detected using another publication guideline designed for outcomes research. METHODS Twenty original ATD outcome studies were scored using the Template for Intervention Description and Replication (TIDieR) checklist, and the ATDOR in two evaluation rounds. In the first round, articles were scored using the TIDieR alone. In the second round, they were scored using the TIDieR and ATDOR together. The difference in percentage scores between the two evaluation rounds was examined using the Wilcoxon signed rank-sum test for paired data. RESULTS There was a statistically significant difference in the percentage scores between the two evaluation rounds (Wilcoxon statistic = 10, Z = -3.547, p<.000). CONCLUSION When used alongside the TIDieR, the ATDOR adds significant value to evaluations of reporting quality on assistive technology outcomes research. As this field continues to grow, researchers are invited to join in efforts to standardise reporting to promote healthier outcomes for ATD users.Implications for rehabilitationReporting guidelines that evaluate research studies enhance their reporting quality and promote healthier outcomes for ATD users.The Assistive Technology Device Outcomes Research (ATDOR) checklist was shown to be a useful tool for achieving a minimum standard of reporting in the field of assistive technology.As the field of assistive technology continues to explore different methodologies, ongoing efforts to develop and update reporting guidelines are necessary in order to capture the future needs of this research area.
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Affiliation(s)
- Joshua R Tuazon
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Jeffrey W Jutai
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada.,LIFE Research Institute, Ottawa, Canada
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16
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Abstract
PURPOSE The aim of this study was to develop and pilot-test reporting guidelines for manuscripts describing studies of assistive technology device outcomes, with the hopes of improving the overall quality of research in this field. METHODS The research is presented in two stages. In Stage 1, a literature review was completed to identify the essential components of a conceptual framework for reporting guidelines and to create a checklist. In Stage 2, two independent reviewers evaluated twenty articles using the checklist to identify any short-comings of the tool and produce an estimate of interrater reliability. Two items of the original checklist were revised after reconciling disagreements between the two raters. RESULTS The Cohen's Kappa value of the checklist was 0.887 (p < .000), reflecting excellent interrater agreement. The overall percent agreement was 94.6%. CONCLUSIONS Reporting guidelines for studies of assistive technology device outcomes appear to be reliable. Although the checklist may require periodic updating, it has potential for advancing outcomes research. Researchers are invited to share comments and criticisms to aid in the efforts of enhancing the quality of reporting in this field.Implications for rehabilitationReporting checklists and guidelines are effective tools for achieving a minimum standard of reporting quality in all areas of rehabilitation research.This study presents a preliminary reporting checklist for the field of assistive technology device outcomes that has potential for advancing outcomes research.Authors and journal editors are encouraged to adopt and adhere to reporting guidelines in order to enhance the clarity and completeness of prospective studies.
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Affiliation(s)
- Joshua R Tuazon
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Jeffrey W Jutai
- Interdisciplinary School of Health Sciences and LIFE Research Institute, University of Ottawa, Ottawa, Canada
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17
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Strong JG, Jutai JW, Russell-Minda E, Evans M. Driving and Low Vision: Validity of Assessments for Predicting Performance of Drivers. Journal of Visual Impairment & Blindness 2019. [DOI: 10.1177/0145482x0810200603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The authors conducted a systematic review to examine whether vision-related assessments can predict the driving performance of individuals who have low vision. The results indicate that measures of visual field, contrast sensitivity, cognitive and attention-based tests, and driver screening tools have variable utility for predicting real-world driving performance.
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Affiliation(s)
- J. Graham Strong
- Centre for Sight Enhancement and School of Optometry, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Jeffrey W. Jutai
- Aging, Rehabilitation and Geriatric Care Research Centre, Lawson Health Research Institute, 801 Commissioners Road East, Room B3002a, London, Ontario, Canada, N6C 5J1
| | - Elizabeth Russell-Minda
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, 801 Commissioners Road East, Room B-3016, London, Ontario, N6C 5J1, Canada
| | - Mal Evans
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, 801 Commissioners Road East, Room B-3016, London, Ontario, N6C 5J1, Canada
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18
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Huber JG, Jutai JW, Strong JG, Plotkin AD. The Psychosocial Impact of Closed-Circuit Televisions on Persons with Age-Related Macular Degeneration. Journal of Visual Impairment & Blindness 2019. [DOI: 10.1177/0145482x0810201104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Closed-circuit televisions (CCTVs) are used by many elderly people who have age-related macular degeneration (AMD). The functional vision of 68 participants, which was measured immediately after they adopted CCTVs, suggested successful outcomes, but the psychosocial impact of the use of CCTVs did not peak until a month later. The findings help identify circumstances in which CCTV-assisted rehabilitation may be enhanced for better long-term outcomes.
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Affiliation(s)
- Jessica G. Huber
- University of Western Ontario, 1201 Western Road, London, Ontario, N6G 1H1, Canada
| | - Jeffrey W. Jutai
- Faculty of Health Sciences, University of Ottawa, 43 Templeton Street, Ottawa, Ontario, K1N 6X1, Canada
| | - J. Graham Strong
- Centre for Sight Enhancement, and professor, School of Optometry, University of Waterloo
| | - Ann D. Plotkin
- Low Vision Clinic, Centre for Sight Enhancement and School of Optometry, University of Waterloo, Waterloo, 200 University Avenue West, Waterloo
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19
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Jutai JW, Strong JG, Russell-Minda E. Effectiveness of Assistive Technologies for Low Vision Rehabilitation: A Systematic Review. Journal of Visual Impairment & Blindness 2019. [DOI: 10.1177/0145482x0910300404] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A systematic review of all types of assistive devices indicated the need for more research related to performance measurements and the effectiveness of vision rehabilitation devices.
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Affiliation(s)
- Jeffrey W. Jutai
- Faculty of Health Sciences, University of Ottawa, 43 Temple-ton Street, Room 109, Ottawa, Ontario, K1N 6X1, Canada
| | - J. Graham Strong
- Center for Sight Enhancement, and professor, School of Optometry, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Elizabeth Russell-Minda
- Aging Rehabilitation and Geriatric Care Research Centre, Lawson Health Research Institute, University of Western Ontario, 801 Commissioners Road East, Room B-3002a, London, Ontario, N6C 5J1, Canada
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20
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Russell-Minda E, Jutai JW, Strong JG, Campbell KA, Gold D, Pretty L, Wilmot L. The Legibility of Typefaces for Readers with Low Vision: A Research Review. Journal of Visual Impairment & Blindness 2019. [DOI: 10.1177/0145482x0710100703] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article presents a systematic review of the research evidence on the effects of the characteristics of typefaces on the legibility of text for adult readers with low vision. The review revealed that research has not produced consistent findings and thus that there is a need to develop standards and guidelines that are informed by evidence.
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Affiliation(s)
- Elizabeth Russell-Minda
- Lawson Health Research Institute, Aging, Rehabilitation, and Geriatric Care Research Centre, Parkwood Hospital, 801 Commissioners Road East, Room B-3016, London, ON, Canada, N6C 5J1J
| | - Jeffrey W. Jutai
- Senior scientist, Lawson Health Research Institute, Aging, Rehabilitation, and Geriatric Care Research Centre
| | - J. Graham Strong
- Centre for Sight Enhancement, School of Optometry, University of Waterloo, Waterloo, ON, Canada N2L 3G1
| | - Kent A. Campbell
- Research Support Unit, Bloorview Research Institute, Bloorview Kids Rehab, 150 Kilgour Road, Toronto, ON, Canada M4G1R8, and assistant professor, Department of Occupational Therapy, University of Toronto, Toronto, Canada
| | - Deborah Gold
- Research Department, Canadian National Institute for the Blind (CNIB), 1929 Bayview Avenue, Toronto, ON Canada M4G 3E8
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21
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Affiliation(s)
- J. Graham Strong
- Centre for Sight Enhancement, and professor, School of Optometry, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Jeffrey W. Jutai
- Aging, Rehabilitation and Geriatric Care Research Centre, Lawson Health Research Institute, 801 Commissioners Road East, Room B3002a, London, Ontario, Canada, N6C 5J1
| | - Elizabeth Russell-Minda
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, 801 Commissioners Road East, Room B-3016, London, Ontario, N6C 5J1, Canada
| | - Mal Evans
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, 801 Commissioners Road East, Room B-3016, London, Ontario, N6C 5J1, Canada
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22
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Auger C, Rushton PW, Jutai JW, Miller WC. Reliability, convergent validity and applicability of the Assistive Technology Outcome Profile for Mobility for middle-aged and older power wheelchair users. Aust Occup Ther J 2018; 65:439-448. [DOI: 10.1111/1440-1630.12515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Claudine Auger
- School of Rehabilitation; Faculty of Medicine; Université de Montréal; Montréal Québec Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) - Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal (CSSMTL); Montréal Québec Canada
| | - Paula W. Rushton
- School of Rehabilitation; Faculty of Medicine; Université de Montréal; Montréal Québec Canada
- CHU Sainte-Justine Research Centre; Centre de réadaptation Marie Enfant; Montréal Québec Canada
| | - Jeffrey W. Jutai
- Interdisciplinary School of Health Sciences; University of Ottawa; Ottawa Ontario Canada
| | - William C. Miller
- Department of Occupational Science and Occupational Therapy; Faculty of Medicine; University of British Columbia; Vancouver British Columbia Canada
- GF Strong Rehabilitation Centre; Vancouver British Columbia Canada
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Abstract
Purpose: The aim of this study was to identify and examine how existing literature has conceptualized adherence to assistive devices (ADs) among older adults. Methods: English articles were searched in MEDLINE, PubMed, and CINAHL (January 1990 to October 2017) for the key words "acceptance", "adherence", "assistive devices", "compliance", "concept," and relevant synonyms. Bibliographies of selected articles were also examined. Articles were analyzed if the following conditions were met conjointly: (1) attempted to define or conceptualize adherence to some degree; (2) were concerned with any AD for older adults; (3) were concerned with adults aged 65 years or older. Results: Sixteen of the 484 articles were included. Adherence to ADs among older adults seemed to be conceptualized under three core themes: psychological, contextual, and functional factors; each with their own unique considerations related to adherence that are analyzed in this study. Conclusion: This review identified a large gap in knowledge about adherence to ADs. Adherence is multi-factorial and highly specific to the individual's circumstances and their relationship with their health care practitioner. Further empirical research should focus on how the three core themes of adherence interact with and influence each other. Implications for rehabilitation Health care professionals who assess for, and recommend ADs should foster a shared decision-making relationship with their clients This review identifies some of the key themes that practitioners should consider when developing and implementing AD regimens with older adults Conceptualizing AD adherence among older adults will help improve monitoring of and quality of care for AD users.
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Affiliation(s)
- Joshua R Tuazon
- a Interdisciplinary School of Health Sciences , University of Ottawa , Ottawa , Ontario , Canada
| | - Alhadi Jahan
- a Interdisciplinary School of Health Sciences , University of Ottawa , Ottawa , Ontario , Canada
| | - Jeffrey W Jutai
- a Interdisciplinary School of Health Sciences , University of Ottawa , Ottawa , Ontario , Canada.,b LIFE Research Institute , Ottawa , Ontario , Canada
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24
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Ben Mortenson W, Demers L, Fuhrer MJ, Jutai JW, Bilkey J, Plante M, DeRuyter F. Effects of a caregiver-inclusive assistive technology intervention: a randomized controlled trial. BMC Geriatr 2018; 18:97. [PMID: 29669536 PMCID: PMC5907288 DOI: 10.1186/s12877-018-0783-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 04/04/2018] [Indexed: 11/10/2022] Open
Abstract
Background The principal aim of this study was to investigate whether a caregiver-inclusive assistive technology intervention improved older care recipients’ functional autonomy and decreased the perceived burden of their family caregivers compared to customary care. Methods The study was a single-blind, mixed-methods, randomized controlled trial with baseline data collection and follow-ups at 6-, 22-, and 58-weeks after baseline evaluation, which was prospectively registered (ClinicalTrials.gov Identifier: NCT01640470. Registered 11/21/2011). Dyads comprising a care recipient and family caregiver were randomly assigned to either a caregiver-inclusive experimental group (N = 44) or a customary-care comparison group (N = 46). Eligible care recipients were aged ≥55 years and had one or more limitations with mobility or daily activities, and family caregivers provided at least four hours per week of assistance. Outcome measures were administered to both groups at baseline and at the three follow-up time points. The data collectors were blinded regarding participants’ intervention group. The primary outcome measures were the Functional Autonomy Measurement System to assess care recipients’ functional performance, and the Caregiver Assistive Technology Outcome Measure to assess caregivers’ burden. Qualitative interviews examined participants’ perceptions of the caregiver-inclusive and customary care interventions. Results The experimental intervention addressed significantly more dyad-identified problematic activities, but caregiver involvement was evident in both groups and outcomes were not significantly different over time. In both groups, care recipients’ functional autonomy declined significantly (P < .01), and caregivers’ activity-specific and overall burden decreased significantly (P < .01). Conclusions Given the unintended congruence between the caregiver-inclusive and customary care interventions, the overall findings lend support for the provision of assistive technology to reduce caregiver burden.
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Affiliation(s)
- W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada. .,GF Strong Rehabilitation Research Program, Vancouver, BC, Canada. .,International Collaboration on Repair Discoveries, Vancouver, BC, Canada.
| | - Louise Demers
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, PQ, Canada.,École de réadaptation, Université de Montréal, Montréal, PQ, Canada
| | - Marcus J Fuhrer
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Jeffrey W Jutai
- Interdisciplinary School of Health Sciences, University of Ottawa, and Bruyère Research Institute, Ottawa, ON, Canada
| | - Jessica Bilkey
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada.,GF Strong Rehabilitation Research Program, Vancouver, BC, Canada
| | - Michelle Plante
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, PQ, Canada
| | - Frank DeRuyter
- Department of Surgery/Speech Pathology and Audiology, Duke University, Durham, NC, USA
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25
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Abstract
Assistive technology devices for computer access can facilitate social reintegration and promote independence for people who have had a stroke. This work describes the exploration of the usefulness and acceptability of a new computer access device called the Nouse™ (Nose-as-mouse). The device uses standard webcam and video recognition algorithms to map the movement of the user's nose to a computer cursor, thereby allowing hands-free computer operation. Ten participants receiving in- or outpatient stroke rehabilitation completed a series of standardized and everyday computer tasks using the Nouse™ and then completed a device usability questionnaire. Task completion rates were high (90%) for computer activities only in the absence of time constraints. Most of the participants were satisfied with ease of use (70%) and liked using the Nouse™ (60%), indicating they could resume most of their usual computer activities apart from word-processing using the device. The findings suggest that hands-free computer access devices like the Nouse™ may be an option for people who experience upper motor impairment caused by stroke and are highly motivated to resume personal computing. More research is necessary to further evaluate the effectiveness of this technology, especially in relation to other computer access assistive technology devices.
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Affiliation(s)
- Jasmine Mah
- a Interdisciplinary School of Health Sciences , University of Ottawa , Ottawa , Canada
| | - Jeffrey W Jutai
- a Interdisciplinary School of Health Sciences , University of Ottawa , Ottawa , Canada
| | - Hillel Finestone
- b Bruyère Research Institute , Ottawa , Canada.,c Bruyère Continuing Care , Ottawa , Canada.,d Division of Physical Medicine and Rehabilitation, Faculty of Medicine , University of Ottawa , Ottawa , Canada
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Chalghoumi H, Cobigo V, Dignard C, Gauthier-Beaupré A, Jutai JW, Lachapelle Y, Lake J, Mcheimech R, Perrin M. Information Privacy for Technology Users With Intellectual and Developmental Disabilities: Why Does It Matter? Ethics & Behavior 2017. [DOI: 10.1080/10508422.2017.1393340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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27
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Southall K, Tuazon JR, Djokhdem AH, van den Heuvel EA, Wittich W, Jutai JW. Assessing the stigma content of urinary incontinence intervention outcome measures. J Rehabil Assist Technol Eng 2017; 4:2055668317738943. [PMID: 31186943 PMCID: PMC6453035 DOI: 10.1177/2055668317738943] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 10/05/2017] [Indexed: 11/15/2022] Open
Abstract
The goal of this narrative review is to evaluate the efficacy of available
questionnaires for assessing the outcomes of “continence difficulty”
interventions and to assess the selected questionnaires concerning aspects of
stigmatization. The literature was searched for research related to urinary
incontinence, as well as questionnaires and rating scale outcome measurement
tools. The following sources were searched: Cochrane Library, EMBASE, Medline,
and PubMed. The following keywords were used separately or in combination:
“Urinary incontinence,” “therapy,” ”treatment outcome,” “patient satisfaction,”
“quality of life,” “systematic reviews,” “aged 65+ years,” and “questionnaire.”
The search yielded 194 references, of which 11 questionnaires fit the inclusion
criteria; 6 of the 11 questionnaires did not have any stigma content and the
content regarding stigma that was identified in the other five was very limited.
A representative model of how stigma impacts continence difficulty interventions
was proposed. While the 11 incontinence specific measurement tools that were
assessed were well researched and designed specifically to measure the outcomes
of incontinence interventions, they have not been used consistently or
extensively and none of the measures thoroughly assess stigma. Further studies
are required to examine how the stigma associated with continence difficulty
impacts upon health care interventions.
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Affiliation(s)
- Kenneth Southall
- Centre de Recherché, Institute Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada.,School of Social Work, McGill University, Montreal, Quebec, Canada
| | - Joshua R Tuazon
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Abdul H Djokhdem
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | | | - Walter Wittich
- School of Optometry, Université de Montréal, Montréal, Québec, Canada.,MAB-Mackay Rehabilitation Centre, Montreal, QC, Canada
| | - Jeffrey W Jutai
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
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Mortenson WB, Pysklywec A, Fuhrer MJ, Jutai JW, Plante M, Demers L. Caregivers’ experiences with the selection and use of assistive technology. Disabil Rehabil Assist Technol 2017; 13:562-567. [DOI: 10.1080/17483107.2017.1353652] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- W. Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
- GF Strong Rehabilitation Research Program, Vancouver, Canada
- International Collaboration on Repair Discovery, Vancouver, Canada
| | - Alex Pysklywec
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
- GF Strong Rehabilitation Research Program, Vancouver, Canada
| | - Marcus J. Fuhrer
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Jeffrey W. Jutai
- Interdisciplinary School of Health Sciences, University of Ottawa, Bruyère Research Institute, Ottawa, Canada
| | - Michelle Plante
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, Montréal, Canada
| | - Louise Demers
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Île-de-Montréal, Montréal, Canada
- École de réadaptation, Université de Montréal, Montréal, Canada
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Orellano-Colón EM, Rivero-Méndez M, Lizama M, Jutai JW. Assistive technology unmet needs of independent living older Hispanics with functional limitations. Disabil Rehabil Assist Technol 2017; 13:194-200. [PMID: 28326905 DOI: 10.1080/17483107.2017.1300693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To identify: (1) the most frequently used assistive technology (AT) by a sample of community-living older Hispanics; (2) their AT needs; (3) the AT that would not be used by the simple; and (4) the factors associated with the willingness to use AT. MATERIALS AND METHODS We used a cross-sectional descriptive study design with a purposive sample of 60 individuals 70 years and older living in Puerto Rico. Data collection tools included a socio-demographic questionnaire and the Assistive Technology Card Assessment. We used descriptive statistics to identify the sample AT use and needs, χ2 to determine the frequency distribution of the socio-demographic variables and the Spearman's rank correlation coefficient (rho) to describe the strength of the association between these variables and the willingness to use AT devices. RESULTS The sample had unmet needs for AT devices for cooking, home tasks and home safety. A higher number of health conditions as well as having low educational levels were associated with willingness to use AT devices. CONCLUSIONS Policy implications are discussed supporting the role of rehabilitation professionals, state government and community-based programmes, including the Area Agencies on Aging, in providing culturally relevant AT education and accessibility to assistive devices. Implications for rehabilitations Hispanic older adults with functional limitations living independently in Puerto Rico have unmet needs for AT devices to compensate for physical limitations and increase safety performance, predominantly in instrumental activities of daily living. New policies need to be developed to advocate for increased healthcare coverage of low tech AT devices that could be highly beneficial to older people with functional limitations. Community-based programs administered by the state government, the Area Agencies of Aging, or operated through Medicare need to be developed to provide education, training, loans, purchasing, and delivery of low AT devices that can compensate for older people functional limitations.
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Affiliation(s)
- Elsa M Orellano-Colón
- a Occupational Therapy Program, School of Health Professions , Medical Sciences Campus, University of Puerto Rico , San Juan , Puerto Rico.,b Puerto Rico Assistive Technology Program, Research and Technology Vice-Presidency , San Juan , Puerto Rico
| | - Marta Rivero-Méndez
- c School of Nursing, Medical Sciences Campus, University of Puerto Rico , San Juan , Puerto Rico
| | - Mauricio Lizama
- b Puerto Rico Assistive Technology Program, Research and Technology Vice-Presidency , San Juan , Puerto Rico
| | - Jeffrey W Jutai
- d Faculty of Health Sciences , University of Ottawa , Ottawa , ON , Canada
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Demers L, Mortenson WB, Fuhrer MJ, Jutai JW, Plante M, Mah J, DeRuyter F. Effect of a tailored assistive technology intervention on older adults and their family caregiver: a pragmatic study protocol. BMC Geriatr 2016; 16:103. [PMID: 27177609 PMCID: PMC4866430 DOI: 10.1186/s12877-016-0269-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 04/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many older adults with mobility limitations use assistive technology to help them perform daily activities. However, little attention has been paid to the impact on their family caregivers. This neglect produces an incomplete portrayal of the outcomes of assistive technology provision. This paper describes the protocol for a study that examines the impact of a tailored assistive technology intervention that is inclusive of assistance users and their family caregivers. METHODS/DESIGN This research will use a combination of quantitative and qualitative methods. The quantitative portion will be an experimental, single-blinded study in which participants are randomly assigned to either an experimental assistive technology intervention or a standard care group. We will enroll 240 participants (120 dyads) into the study from three Canadian sites. Participants will include older adults (>55) and family caregivers who provide ≥4 h per week of assistance with daily activities and social participation. The primary outcome measure for the older adults will be the Functional Autonomy Measurement System, and the primary outcome measure for the caregivers will be the Caregiver Assistive Technology Outcomes Measure. Qualitative data will be collected through detailed records of the therapists' interventions, as well as through interviews with dyads and therapists following the interventions. Data collection will occur at baseline (T0) with follow-ups at 6 weeks (T1), 22 weeks (T2), and 58 weeks (T3) after baseline evaluation. DISCUSSION The findings from this study will help service providers and clinicians to move forward with assistive technology recommendations that are more attuned to the needs of both older adults with mobility limitations and their family caregivers. Additionally, the study's findings will enhance our conceptual understanding of the spectrum of assistive technology outcomes and set the stage for econometric studies assessing cost-effectiveness. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01640470 . Registered 11/21/2011.
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Affiliation(s)
- Louise Demers
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, PQ, Canada. .,École de réadaptation, Université de Montréal, Montréal, PQ, Canada.
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada.,GF Strong Rehabilitation Research Program, Vancouver, BC, Canada.,International Collaboration on Repair Discovery, Vancouver, BC, Canada
| | - Marcus J Fuhrer
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Jeffrey W Jutai
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Michelle Plante
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, PQ, Canada
| | - Jasmine Mah
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Frank DeRuyter
- Department of Surgery/Speech Pathology and Audiology, Duke University, Durham, NC, USA
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Auger C, Miller WC, Jutai JW, Tamblyn R. Development and feasibility of an automated call monitoring intervention for older wheelchair users: the MOvIT project. BMC Health Serv Res 2015; 15:386. [PMID: 26376853 PMCID: PMC4572692 DOI: 10.1186/s12913-015-1048-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 09/07/2015] [Indexed: 11/15/2022] Open
Abstract
Background Recent advances in wheeled mobility technology are multiplying opportunities for community integration and improved quality of life. The mobility needs of older wheelchair users are particularly complex due to a constellation of chronic conditions and comorbidities that may compromise optimal use of the device. The purpose of the Mobility Outcomes via Information Technologies (MOvIT) project is to examine the feasibility of automated calls for the systematic monitoring for adverse outcomes associated with wheelchair use. Methods A two-phase mixed methods approach was used. Phase I involved user-centered development and face validation of a monitoring questionnaire with end-users (seven wheelchair users and five healthcare providers). Phase II tested the feasibility of monitoring outcomes using automated calls to administer the MOvIT questionnaire 1 and 3 months after wheelchair delivery with a prospective cohort of older adults (50–84 years of age). When problems were identified, the computer monitoring system notified a clinical coordinator who followed up with respondents requiring interventions. Feasibility data were extracted from the web database and from individual interviews covering perceived ease of use, usefulness and intention to use the MOvIT questionnaire in the future. Results The MOvIT monitoring questionnaire developed in phase I tracks nine potential wheelchair-related adverse outcomes considered important for end-users: 1) non-use of wheelchair, 2) pain, 3) skin condition, 4) positioning, 5) wheelchair incidents, 6) psychosocial issues, 7) restricted wheelchair participation, 8) limited wheelchair skills and knowledge, and 9) technical problems. In phase II, 92 individuals who received a wheelchair were eligible, 71 out of 92 accepted (77 %) and 65 out of 71 (92 %) completed the 3-month follow-up. In the sample of 65 participants, a wheelchair-related adverse outcome was confirmed by a rehabilitation professional for 58.5 %, and at least one recommendation was given to 66.2 % during the 3-month monitoring period. A majority of participants found the intervention useful (82.8 %) and said they intended to use the MOvIT monitoring questionnaire in the future (81.5 %). Participants made suggestions to make the calls more adaptive to various ability profiles. Conclusions Automated calls tailored for individuals with mobility limitations and associated comorbidities are a promising approach to reach clients who need post-rehabilitation support.
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Affiliation(s)
- Claudine Auger
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal and School of Rehabilitation, Université de Montréal, C.P. 6128, succursale Centre-ville, Montreal, QC, H3C 3J7, Canada.
| | - William C Miller
- GF Strong Rehabilitation Center and Graduate Program in Rehabilitation Sciences, Department of Occupational Science & Occupational Therapy, University of British Columbia, T325-2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
| | - Jeffrey W Jutai
- Bruyère Research Institute and Interdisciplinary School of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON, K1N 6N5, Canada.
| | - Robyn Tamblyn
- Clinical and Health Informatics Research Group, Department of Medicine, and Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, 1140 Pine Avenue West, Montreal, QC, H3A 1A3, Canada.
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32
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Smith CAM, Toupin-April K, Jutai JW, Duffy CM, Rahman P, Cavallo S, Brosseau L. A Systematic Critical Appraisal of Clinical Practice Guidelines in Juvenile Idiopathic Arthritis Using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) Instrument. PLoS One 2015; 10:e0137180. [PMID: 26356098 PMCID: PMC4565560 DOI: 10.1371/journal.pone.0137180] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 08/14/2015] [Indexed: 11/19/2022] Open
Abstract
Objectives The objectives of this review are to: 1) appraise the methodological quality of clinical practice guidelines (CPGs) in juvenile idiopathic arthritis (JIA) providing pharmacological and/or non-pharmacological intervention recommendations, and 2) summarize the recommendations provided by the included CPGs and compare them where possible. Methods A systematic search was performed. Three trained appraisers independently evaluated the methodological quality of the CPGs using a validated and reliable instrument, the Appraisal of Guidelines in Research and Evaluation II. Six domains were considered: 1) score and purpose; 2) stakeholder involvement; 3) rigor of development; 4) clarity of presentation; 5) applicability; and 6) editorial independence. The domains consist of a total of 23 items each scored on a 7-point scale. High quality CPGs were identified if they had a domain score above 60% in rigor of development, and two other domains. Results Of the three included CPGs, the Royal Australian College of General Practitioners (RACGP) and American College of Rheumatology (ACR) CPGs were considered to be of high quality, but the German Society for Pediatric Rheumatology was of lower quality. Domains one to four had high domain scores across the guidelines (mean (standard deviation)): 72.76 (13.80); 66.67 (9.81); 64.67 (7.77); and 87.00 (9.64), respectively. Lower scores were obtained for applicability (14.00 (5.57)) and editorial independence (43.44 (7.02)). Recommendations varied across CPGs due to differences in context, target audience (general practitioners, rheumatologists, and other multidisciplinary healthcare professionals) and patients’ disease presentations. Despite this variability, progression of pharmacological treatment did not conflict between CPGs. Recommendations for non-pharmacological interventions were vague and the interventions considered varied between CPGs. Conclusions Overall, recommendations were based on a paucity of evidence and weak study designs. Further research is needed on interventions in JIA, as well as higher quality CPGs to facilitate implementation of the best evidence-based recommendations in clinical practice.
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Affiliation(s)
- Christine A. M. Smith
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Karine Toupin-April
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeffrey W. Jutai
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Ciarán M. Duffy
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Prinon Rahman
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sabrina Cavallo
- École de Santé Publique, Université de Montréal, Montréal, Québec, Canada
| | - Lucie Brosseau
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- * E-mail:
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Abstract
Visual perceptual disorders are a common clinical consequence of stroke. They include unilateral neglect, which has a major impact on rehabilitation outcome. The nature of the behavioral deficits associated with neglect has suggested that behavioral modification strategies may improve performance. This article presents a critical review and synthesis of published research evidence for the effectiveness of treatments for visual perceptual disorders after stroke. The strongest evidence for rehabilitation effectiveness was for the following: (a) specific treatment for perceptual disorders; and (b) specific training for neglect (including visual scanning). Findings also suggest that more research is needed into how the assessment of specific features of visual perceptual disorders might lead to improved methods for rehabilitation, including the use of assistive devices for mobility and activities of daily living.
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Affiliation(s)
- Jeffrey W Jutai
- Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, Ontario, Canada
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Orellano EM, Jutai JW. Cross-cultural adaptation of the psychosocial impact of assistive device scale (PIADS) for Puerto Rican assistive technology users. Assist Technol 2014; 25:194-203. [PMID: 24620702 DOI: 10.1080/10400435.2012.761292] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Assistive technology (AT) is important for individuals with disabilities' independence and participation in daily life, and there is a lack of valid AT outcome tools for the Puerto Rican population. This pilot study examined the content validity of a new adaptation of the Psychosocial Impact of Assistive Device Scale (PIADS): the Puerto Rican-Spanish PIADS (PR-PIADS). Following standard procedures, the cultural adaptation methodology included a bilingual multidisciplinary committee review of the original (English language) and Spanish versions of the PIADS and pilot testing of the preliminary version of the PR-PIADS with 20 AT users. The committee recommended a total of 58 semantic and conceptual modifications of the Spanish PIADS. Pilot data analysis resulted in 4 additional semantic and conceptual modifications of items that did not reach the minimum content validity ratio of 0.42 for a panel composed by 20 members: competence (0), efficiency (-0.6), performance (-0.95), and eagerness to take chances (-0.6). This pilot study demonstrated evidence of initial content validity of the PR-PIADS. Future research is required before using this tool with greater confidence to address the construct validity and reliability that are also critical to a successful cultural adaptation.
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Abstract
SUMMARY This pilot study describes the effect of wheelchair use on the quality of life of persons with multiple sclerosis (MS), and examines the clinical utility of the Psychosocial Impact of Assistive Devices Scale (PIADS) as an outcome measure for use by occupational therapists. Sixteen hospitalized adults with MS were interviewed using the PIADS. Descriptive comparisons of PIADS subscale scores (competence, adaptability, self-esteem) were conducted for participants using different types of wheelchairs, daily versus non-daily wheelchair users, and participants who required different levels of assistance to propel their wheelchairs. Results suggest that using a wheelchair has a positive impact on the quality of life of persons with MS. The PIADS was found to be clinically useful for exploring person-environment interactions and appears to be well suited to the goals and values of occupational therapy. Recommendations for future research and for incorporating the PIADS into occupational therapy practice are discussed.
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Affiliation(s)
- Rachel Devitt
- Bridgepoint Health, 14 St. Mathews Road, Toronto, ON, M4M 2B5, Canada
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36
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Mortenson WB, Demers L, Fuhrer MJ, Jutai JW, Lenker J, DeRuyter F. How assistive technology use by individuals with disabilities impacts their caregivers: a systematic review of the research evidence. Am J Phys Med Rehabil 2012; 91:984-98. [PMID: 22955027 PMCID: PMC5668128 DOI: 10.1097/phm.0b013e318269eceb] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Informal caregivers are a critical yet frequently unacknowledged part of the healthcare system. It is commonly presumed that providing assistive technology will decrease the burden of their care provision; however, no review has evaluated the evidence behind this assumption. Therefore, a systematic review was undertaken to evaluate evidence of the impact of assistive technology use by care recipients on their informal caregivers. Data sources included EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Web of Science, PsychINFO, PubMed, and active researchers in this area. Twenty-two studies met the specified inclusion criteria. Collectively, the findings suggest that assistive technology use helps caregivers by diminishing some of the physical and emotional effort entailed in supporting individuals with disability. However, confidence in this causal connection is limited because of the study designs that were used. This undermines the understanding of the impacts of assistive technology use on the users' informal caregivers.
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Affiliation(s)
- W Ben Mortenson
- Centre de recherche de l'institut universitaire de gériatrie de Montréal, Montreal, Canada
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37
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Meyers EM, Jutai JW. The Disability Experience: Living with a Birth Defect Resulting from Thalidomide Exposure. Interdiscip Sci 2012. [DOI: 10.18192/riss-ijhs.v2i2.1518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The drug, Thalidomide, is a classic example of how medicine has the potential to cause us harm. The market flooding of this drug in the 1950’s resulted in the birth of 8 to 10 thousand children with birth defects. Today in Canada this tragedy still affects the lives of approximately 125 individuals. How do these individuals live their lives and what has been the overall impact of their impairment? This article explores the lived experience of a woman born with upper limb phocomelia as a result of Thalidomide exposure. A one-hour unstructured face-to-face interview was conducted. Permission was received from the interviewee to make a voice recording of the interview allowing for a more concrete data review. The interview uncovered 6 primary themes indicating that a physical impairment resulting from thalidomide can have a minimal impact on an individual’s overall quality of life, as long as sufficient support and a positive self identity is present. The interviewee’s accounts suggest that living with disability is a unique experience that can lead to positive outcomes. The ultimate conclusion of this paper is that more extensive research is needed to further represent the voices of the disability community.
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Salter KL, Foley NC, Zhu L, Jutai JW, Teasell RW. Prevention of poststroke depression: does prophylactic pharmacotherapy work? J Stroke Cerebrovasc Dis 2012; 22:1243-51. [PMID: 22554569 DOI: 10.1016/j.jstrokecerebrovasdis.2012.03.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 03/20/2012] [Accepted: 03/25/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Given the negative influence of poststroke depression (PSD) on functional recovery, cognition, social participation, quality of life, and risk for mortality, the early initiation of antidepressant therapy to prevent its development has been investigated; however, individual studies have offered conflicting evidence. The present systematic review and meta-analysis examined available evidence from published randomized controlled trials (RCTs) evaluating the effectiveness of pharmacotherapy for the prevention of PSD to provide updated pooled analyses. METHODS Literature searches of 6 databases were performed for the years 1990 to 2011. RCTs meeting study inclusion criteria were evaluated for methodologic quality. Data extracted included the antidepressant therapy used, treatment timing and duration, method(s) of assessment, and study results pertaining to the onset of PSD. Pooled analyses were conducted. RESULTS Eight RCTs were identified for inclusion. Pooled analyses demonstrated reduced odds for the development of PSD associated with pharmacologic treatment (odds ratio [OR] 0.34; 95% confidence interval [CI] 0.22-0.53; P<.001), a treatment duration of 1 year (OR 0.31; 95% CI 0.18-0.56; P<.001), and the use of a selective serotonin reuptake inhibitor (OR 0.37; 95% CI 0.22-0.61; P<.001). CONCLUSIONS The early initiation of antidepressant therapy, in nondepressed stroke patients, may reduce the odds for development of PSD. Optimum timing and duration for treatment and the identification of the most appropriate recipients for a program of indicated prevention require additional examination.
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Affiliation(s)
- Katherine L Salter
- Aging, Rehabilitation & Geriatric Care Program, Lawson Health Research Institute, Parkwood Hospital, London, Ontario, Canada.
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Lenker JA, Shoemaker LL, Fuhrer MJ, Jutai JW, Demers L, Tan CH, DeRuyter F. Classification of assistive technology services: Implications for outcomes research. ACTA ACUST UNITED AC 2012. [DOI: 10.3233/tad-2012-0334] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- James A. Lenker
- Department of Rehabilitation Science, School of Public Health & Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Laura L. Shoemaker
- Regina Qu'Appelle Health Region, Wascana Rehabilitation Centre, Adult Program, Regina, Saskatchewan, Canada
| | - Marcus J. Fuhrer
- The Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Columbia, MD, USA
| | - Jeffrey W. Jutai
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Louise Demers
- Research Center, Montreal Geriatric University Institute, Montreal, Quebec, Canada
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Chuan Hoh Tan
- Department of Rehabilitation Science, School of Public Health & Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Frank DeRuyter
- Department of Surgery, Duke University Medical Center, Division of Speech Pathology & Audiology, Durham, NC, USA
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Affiliation(s)
- Daniel Fok
- Health and Rehabilitation Sciences Program (Occupational Science), Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Janice Miller Polgar
- School of Occupational Therapy, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Lynn Shaw
- School of Occupational Therapy, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
| | - Jeffrey W. Jutai
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Canada
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Fok D, Polgar JM, Shaw L, Jutai JW. Low vision assistive technology device usage and importance in daily occupations. Work 2011; 39:37-48. [PMID: 21815311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
UNLABELLED When selected, accepted and used appropriately, low vision assistive technology devices (ATDs) have the potential to facilitate the performance of occupations that lead to positive outcomes. OBJECTIVE This paper identifies some low vision ATDs currently used and explores their relative importance for the performance of daily occupation from participants' perspectives. PARTICIPANTS 17 adults (M=56 years old, SD=15.8) with low vision we0re recruited through a purposeful sampling strategy. METHODS Through one-on-one semi-structured telephone interviews, ATD usage data, ranking of perceived importance of ATDs and verbal data were collected from the participants. RESULTS A total of 124 devices were identified by the participants of which 104 (83.9%) were used and 20 (16.1%), mostly adaptive computer technologies, were not. 22 (21%) mainstream aids to daily living were identified (large monitor, large screen TV, DVD player) and they ranked high in terms of perceived importance by the participants for daily activities. Verbal feedback from participants supplemented this finding. CONCLUSION Concepts related to usage and ranking of importance of ATDs for daily occupations are multi-faceted and complex(e.g. combination of devices used, multiple equal rankings, etc.). The authors suggested future research opportunities to examine these concepts through qualitative means.
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Affiliation(s)
- Daniel Fok
- Health and Rehabilitation Sciences Program (Occupational Science), Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada.
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Lenker JA, Fuhrer MJ, Jutai JW, Demers L, Scherer MJ, DeRuyter F. Treatment theory, intervention specification, and treatment fidelity in assistive technology outcomes research. Assist Technol 2010; 22:129-38; quiz 139-40. [PMID: 20939422 DOI: 10.1080/10400430903519910] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Recent reports in the rehabilitation literature have suggested that treatment theory, intervention specification, and treatment fidelity have important implications for the design, results, and interpretation of outcomes research. At the same time, there has been relatively little discussion of how these concepts bear on the quality of assistive technology (AT) outcomes research. This article describes treatment theory, intervention specification, and treatment fidelity as interconnected facets of AT outcome studies that fundamentally affect the interpretation of their findings. The discussion of each is elucidated using case examples drawn from the AT outcomes research literature. Recommendations are offered for strengthening these components of AT outcomes research.
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Affiliation(s)
- James A Lenker
- Department of Rehabilitation Science, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York 14214-3079, USA.
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Auger C, Demers L, Gélinas I, Miller WC, Jutai JW, Noreau L. Life-Space Mobility of Middle-Aged and Older Adults at Various Stages of Usage of Power Mobility Devices. Arch Phys Med Rehabil 2010; 91:765-73. [DOI: 10.1016/j.apmr.2010.01.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 01/18/2010] [Accepted: 01/24/2010] [Indexed: 11/25/2022]
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Salter KL, Jutai JW, Foley NC, Teasell RW. Clinical Outcome Variables Scale: A retrospective validation study in patients after stroke. J Rehabil Med 2010; 42:609-13. [DOI: 10.2340/16501977-0567] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
PURPOSE A key step in planning assistive technology outcomes research is formulation of a conceptual model, specific to a particular type of device, that provides a rationale for the expected outcomes. This paper reflects the conviction that the development of device-specific causal models will be facilitated by having available an overarching framework that is potentially applicable to multifarious types of devices and their outcomes. METHOD A literature review identified the critical, unmet needs for a conceptual framework. The assumptions underlying the framework were specified preparatory to describing it and discussing its implications. RESULTS The outcomes of assistive technology devices are depicted as resulting from the interaction among characteristics of a specific device-type, its users, and their environment. Initial junctures include procurement of a type of device and a period of introductory use that, interacting with various moderating co-factors, result in a variety of shorter-term outcomes, possible longer-term use, and its outcomes. CONCLUSIONS The framework has the potential of facilitating the development of device-specific causal models. It also may contribute to developing a research agenda for assistive technology outcomes research by highlighting measures that need to be developed and by identifying testable hypotheses concerned, for example, with the manner and duration of devices' usage.
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Affiliation(s)
- M J Fuhrer
- National Institute of Child Health and Human Development, National Institutes of Health, Damascus, MD 20872, USA.
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Abstract
PURPOSE To evaluate the psychometric and administrative properties of outcome measures assigned to the ICF Body Functions category, and commonly used in stroke rehabilitation research. METHOD Critical review and synthesis of measurement properties for five commonly reported instruments in the stroke rehabilitation literature. Each instrument was rated using the eight evaluation criteria proposed by the UK Health Technology Assessment (HTA) programme. The instruments were also assessed for the rigour with which their reliability, validity and responsiveness were reported in the published literature. RESULTS The reporting of specific measurement qualities for outcome instruments was relatively consistent across measures located within the same general ICF category. Far less information was available on the responsiveness of measures, compared with reliability and validity. The best available instruments were associated with the following body functions: cognitive impairment, depression and motor recovery. CONCLUSIONS The reader is encouraged to examine carefully the nature and scope of outcome measurement used in reporting the strength of evidence for improved body functions in stroke rehabilitation since there is significant diversity. However there appears to be good consensus about what are the most important indicators of successful rehabilitation outcome in each domain of body function.
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Affiliation(s)
- K Salter
- Department of Physical Medicine and Rehabilitation, St. Joseph's Health Care, London N6C 5JI, Canada.
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Abstract
PURPOSE To evaluate the psychometric and administrative properties of outcome measures in the WHO International Classification of Functioning, Disability and Health (ICF) Activity category used in stroke rehabilitation research and reported in the published literature. METHOD Critical review and synthesis of measurement properties for nine commonly reported instruments in the stroke rehabilitation literature. Each instrument was rated using the eight evaluation criteria proposed by the UK Health Technology Assessment (HTA) programme. The instruments were also assessed for the rigour with which their reliability, validity and responsiveness were reported in the published literature. RESULTS The reporting of specific measurement qualities for outcome instruments was relatively consistent across measures located within the same general ICF category. There was evidence to suggest that the measures were responsive to change as well as being valid and reliable tools. The best available instruments were associated with the assessment of activities of daily living, balance (static and dynamic), functional independence, and functional mobility. CONCLUSIONS Given the diversity that exists among available measures, the reader is encouraged to examine carefully the nature and scope of outcome measurement used in reporting the strength of evidence for improved functional activity in stroke rehabilitation. However, there appears to be good consensus regarding the most important indicators of successful rehabilitation outcome, especially in the case of functional mobility.
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Affiliation(s)
- K Salter
- Department of Physical Medicine and Rehabilitation, St. Joseph's Health Care London, Ontario, Canada.
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Wright FV, Jutai JW. Evaluation of the longer-term use of the David Hart Walker Orthosis by children with cerebral palsy: a 3-year prospective evaluation. Disabil Rehabil Assist Technol 2009; 1:155-66. [PMID: 19260183 DOI: 10.1080/17483100600627382] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate a walking device, the David Hart Walker Orthosis (HW), that was designed to allow children with severe cerebral palsy to ambulate with hands-free support. METHOD A pre-/post-test prospective one-group study evaluated outcomes three years after receiving the HW. Physical therapy assessment, parent interview and satisfaction questionnaire provided details on outcomes. RESULTS The HW remained the sole walking device for 13 of 20 children at 3 years. Six of seven children who discontinued use were over 12-years-old and had outgrown its maximum size. Twelve of 13 children who still used the HW were assessed. GMFM Stand and Walk Dimension mean score increases of about 3% points for the 1- 3-year follow-up were not significant (P > 0.16). Timed walk scores were unchanged. Steering ability gains were demonstrated on a directional mobility assessment (from 12.0 to 27.9% [P= 0.02]). Despite its eventual height limitations, parents considered HW use to be worthwhile (mean satisfaction = 8.2/10). CONCLUSIONS Sixty-five percent of the children continued to use the HW as their sole walking device, and demonstrated improved ability overall to manoeuvre it during functional ambulation. The primary reason for discontinuation was inability to accommodate taller children.
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Chudyk AM, Jutai JW, Petrella RJ, Speechley M. Systematic review of hip fracture rehabilitation practices in the elderly. Arch Phys Med Rehabil 2009; 90:246-62. [PMID: 19236978 DOI: 10.1016/j.apmr.2008.06.036] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Revised: 06/02/2008] [Accepted: 06/05/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To address the need for a research synthesis on the effectiveness of the full range of hip fracture rehabilitation interventions for older adults and make evidence based conclusions. DATA SOURCES Medline, PubMed, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials were searched from 1980 to 2007 for studies published in English. The terms rehabilitation and hip fracture were exploded in order to obtain related search terms and categories. STUDY SELECTION In the initial search of the databases, a combined total of 1031 articles was identified. Studies that did not focus on hip fracture rehabilitation, did not include persons over the age of 50 years, and/or did not include measures of physical outcome were excluded. DATA EXTRACTION Only studies with an Oxford Center for Evidence-Based Medicine Levels of Evidence level of I (randomized controlled trial, RCT) or II (cohort) were reviewed. The methodologic quality of both types of studies was assessed using a modified version of the Downs and Black checklist. DATA SYNTHESIS There were 55 studies that met our selection criteria: 30 RCTs and 25 nonrandomized trials. They were distributed across 6 categories for rehabilitation intervention (care pathways, early rehabilitation, interdisciplinary care, occupational and physical therapy, exercise, intervention not specified) and 3 settings (acute care hospital, postacute care/rehabilitation, postrehabilitation). CONCLUSIONS When looking across all of the intervention types, the most frequently reported positive outcomes were associated with measures of ambulatory ability. Eleven intervention categories across 3 settings were associated with improved ambulatory outcomes. Seven intervention approaches were related to improved functional recovery, while 6 intervention approaches were related to improved strength and balance recovery. Decreased length of stay and increased falls self-efficacy were associated with 2 interventions, while 1 intervention had a positive effect on lower-extremity power generation.
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Affiliation(s)
- Anna M Chudyk
- Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada.
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Abstract
The objective of this follow-up study was to describe changes in the mobility-related assistive technology devices (ATDs) that are used from shortly after discharge from a hospital setting until 5-6 months later. One hundred and thirty-nine participants who had one or more mobility ATDs (canes, crutches, walkers, and wheelchairs) that had been recommended during hospitalization were interviewed an average of 5.5 weeks after discharge and an average of 23.2 weeks later. Information about mobility ATD usage was obtained by questionnaire during face-to-face interviews. The SF-36 was used to assess perceived health status, both physical and mental, as an additional outcome. Results show that at follow-up, only 23.3% of participants were using the ATD provided at baseline as their primary aid. Seven distinct groups of participants were noted based on individual experience with ATD use from the time of discharge to follow-up. Those groups varied according to continued versus discontinued use of an ATD, single versus multiple ATD use across time, and primary versus secondary importance attributed to the ATD. The groups also differed in terms of their differential association with rehabilitation diagnosis, age, as well as physical and mental perceived health status. The findings have implications for designing ATD outcome studies and for interpreting the relationship of ATD outcomes to other variables. The information about changes in mobility-related ATDs can also help rehabilitation specialists at the point of device referral target their patients for interventions that will either increase their adherence to device prescriptions or support nondevice strategies for managing disabilities.
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Affiliation(s)
- Louise Demers
- School of Rehabilitation, University of Montreal, Box 6128, succursale Centre-Ville, Montreal, Quebec, Canada
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