Search

The purpose of this paper is to analyse and critically reflect on access to Assistive Technology (AT) for persons with disabilities (PWD) in Nepal, India and Bangladesh. This analysis aims to guide the development of a contextualised generic AT service delivery model suitable for these countries, based on the best practices identified. This paper is based on a comprehensive study conducted in Nepal, India and Bangladesh, observing mobility and hearing-related AT service delivery centres run by the government, as well as private and nongovernmental organisations, and interviews with key informants: policymakers (5), AT service providers (20) and AT service users (20) between December 2019 to February 2020. A descriptive, qualitative exploratory study design was followed. A quality assessment framework was used to structure the analysis and interpret the findings. AT service provisions are poorly developed in all three countries. On all quality indicators assessed, the systems show major weaknesses. AT users have very limited awareness about their rights to these services and the availability of AT services, the range of services available is very limited, and eligibility is dependent on medical criteria related to visible and severe disabilities. Lack of accessibility, eligibility, reachability and affordability are the main barriers to access AT services for PWD in Nepal, India and Bangladesh. Increased community level awareness, increased Government funding and a community based, medically informed flexible social model of AT services is a way forward to ensure access to AT services for PWD in these countries. Increased community awareness is necessary to increase access to Assistive Technology Services for Persons with Disabilities. Increased and flexible funding from the Government and philanthropists will improve rehabilitation. Establishment of community based Assistive Technology Services centres will increase access and improve rehabilitation. [ABSTRACT FROM AUTHOR]

This paper critically reviews and reflects on the processes for providing Assistive Technology (AT) services to Persons with Disabilities (PWD) in Bangladesh, India and Nepal. The aim is to investigate the AT service delivery systems in these countries and suggest improvements where weaknesses are identified. We carried out a descriptive qualitative exploratory study in Bangladesh, India and Nepal by conducting key informant interviews with policymakers (5), AT service providers (22) and mobility and hearing related AT service users (21). We used a directed content analysis approach guided by a seven-point AT service delivery process model to thematically analyse the existing processes for AT service delivery, from first contact through to follow-up and maintenance. AT service delivery processes are sub-optimal in all three countries, and improvements are needed. No common AT service delivery process was found, although there are common features. In general, it is easier for PWDs in India and Nepal to access AT than for those in Bangladesh, but all three countries are failing to live up to their commitments to uphold the human rights of PWDs. Although good elements of AT service delivery processes can be identified, the systems in all three countries are fragmented and generally weak. A more holistic approach of looking at the process of AT service delivery, from first contact right through to follow-up and device maintenance, with a single door service delivery system, free of cost at the point of service is recommended in these countries. Although we found significant weaknesses in AT delivery in all three countries, there are some good AT service delivery practices and opportunities for these countries to learn from one another. A systematic and stepwise approach to assessing current AT service delivery processes in the three countries – examining the delivery system as a whole, from initiation to repair and management – can help identify opportunities to improve the process for (prospective) AT users. A more coherent single door system of AT service delivery will increase the quality and efficiency of the fragmented AT service delivery practices in Bangladesh, India and Nepal. [ABSTRACT FROM AUTHOR]

Purpose:A power tilt wheelchair allows independence in changing body position to address a variety of needs throughout the day; however, literature and clinical practice suggest that actual use varies greatly. This grounded theory study examined how power tilt was used in daily life from the perspectives of adults who used power tilt and therapists who prescribed this technology. Methods:A constant comparative approach was used to collect and analyze interview data from five people who use power tilt and six therapists who prescribe this technology. Results:This paper presents the findings specific to understanding the reasons why power tilt was used, focusing on the relationships between tilt use and (1) the reasons for use, (2) the reasons for prescribing power tilt and (3) the associated amplitudes of tilt. Conclusions:This study advances knowledge related to how power tilt is used in daily life by elucidating that how the reasons for use are conceptualized is complex. The three relationships related to the reason for power tilt use identified in this paper have the potential to influence the quality of communication about power tilt use in clinical practice between therapist and client and in research between researcher and participant.Implications for Rehabilitation:Understanding the inconsistencies and variations in how power tilt is used in daily life is dependent on exploring the reasons beyond the words or terms expressed to describe use.Reasons for tilt use are context dependent, particularly the activity occurring at the time of tilt use, the associated amplitude of tilt and the influence of other reasons occurring at the same time. [ABSTRACT FROM PUBLISHER]

The present study seeks to survey information and training needs of informal caregivers related to the use of assistive technologies at home, so as to, in the near future, try to meet them. Therefore, the full aim of this study is to contribute to reducing technology abandonment and to enhancing its use in the family setting by children with cognitive and/or motor limitations. Content analysis of a set of ten interviews with informal caregivers of children and youngsters with cognitive and/or motor disabilities. Assistive technologies open a wide range of opportunities, mostly to students whose learning skills diverge from standard development. They promote communication, independence as well as inclusion of children with cognitive and/or motor disabilities. Despite the human and material resources available, the implementation of assistive technologies in many family settings is still a struggling task. The results reveal a perspective on (i) the interaction between those caregivers and their children, (ii) children's skills in using assistive technology, (iii) caregivers' digital literacy and (iv) their training needs. The present paper highlights the fact that carrying out interviews with informal caregivers leads to obtaining significant data for a diagnosis of the use of assistive technologies in the family setting and to assess the needs of informal caregivers. From this study, the need to provide caregivers with further training on assistive technologies emerges as preponderant, and to improve caregivers' skills in the search for and access to practical information. Cognitive and/or motor disabilities impact on communication, independence and also on the full inclusion of children, especially when efforts developed at school do not have any follow up at home. Endowing informal caregivers with the knowledge and skills to use assistive devices with their children is a step forward to their full development. Interviews conducted with informal caregivers are a means to gaining insights into understanding the reasons behind assistive technology abandonment at home. [ABSTRACT FROM AUTHOR]

Purpose: The telehealthcare sector has been expanding steadily in the UK. However, confusing, complex and unwieldy designs of telehealthcare devices are at best, less effective than they could be, at worst, they are potentially dangerous to the users. Method: This study investigated the factors within the new product development process that hindered satisfactory product design outcomes, through working collaboratively with a leading provider based in the UK. Results: This study identified that there are too many costly late-stage design changes; a critical and persistent problem area ripe for improvement. The findings from analyzing 30 recent devices, interviewing key stakeholders and observing on-going projects further revealed that one major cause of the issue was poor practice in defining and communicating the product design criteria and requirements. Conclusions: Addressing the characteristics of the telehealthcare industry, such as multiple design commissioners and frequent deployment of design subcontracts, this paper argues that undertaking a robust process of creating the product design brief is the key to improving the outcomes of telehealthcare device design, particularly for the small and medium-sized enterprises dominating the sector. Implications for rehabilitation: Product design criteria and requirements are frequently ill-defined and ineffectively communicated to the designers within the processes of developing new telehealthcare devices. The absence of a (robust) process of creating the design brief is the root cause of the identified issues in defining and communicating the design task. Deploying a formal process of creating the product design brief is particularly important for the telehealthcare sector. [ABSTRACT FROM AUTHOR]

We tested the feasibility, implementation strategy and mechanism of impact of FindMyApps. FindMyApps is a tablet intervention consisting of a selection tool to help people with dementia find usable apps for self-management and meaningful activities, including training to support informal carers in employing errorless learning principles to help people with dementia learn tablet and tool usage. We conducted an exploratory, pilot randomized controlled trial with a mixed-methods design. Twenty persons with mild dementia and carer dyads were randomly assigned to the FindMyApps group (n = 10), receiving either the FindMyApps training and selection tool, or a control condition (n = 10), receiving only a short tablet training. Pre- and post-test measurements at a three month follow-up, consisted of questionnaires and post-test semi-structured interviews. The FindMyApps tool was mostly perceived as useful and easy to use. Persons with dementia were generally able to learn how to use the tool, though they regularly needed support from informal carers. Persons with dementia found apps through the tool, which they used regularly. Persons with dementia and informal carers were positive about the training and support they received. No significant differences were found on outcome measures of persons with dementia, but based on effect sizes FindMyApps is a promising intervention. Qualitative results indicate that the FindMyApps intervention has the potential to positively influence the self-management abilities and engagement in meaningful activities of people with dementia. Remarks are made to improve the intervention and recommendations are given for future effectiveness studies. The person-centred tablet intervention FindMyApps has the potential to positively influence the self-management and engagement in meaningful activities in people with dementia. Based on the input of persons with dementia and informal carers, the FindMyApps intervention and study procedure will be further improved and evaluated in terms of effectiveness in an RCT. [ABSTRACT FROM AUTHOR]

People living in long-term care frequently have inadequate access to properly fitted wheelchairs. This can lead to potential problems with mobility, positioning, comfort, and skin integrity. A provincial programme to provide individually fitted lightweight wheelchairs to residents started in January 2016; however, no research has evaluated programme outcomes. To identify seating needs of residents before and after implementation of a provincial wheelchair programme at two long term care facilities in Vancouver and to explore stakeholders experiences with this programme. A pre/post study design was used which involved chart reviews to collect Seating Identification Tool (SIT), and interviews with stakeholders having experience with the provincial programme to gather information on their experiences. SIT data were analysed using a Wilcoxon Signed-Rank test and interviews were analysed thematically. SIT scores improved by 2 (median) which was statistically significant for the 22 residents with pre/post data available. Prevalence of seating needs decreased on average by 18%. Among the six stakeholders interviewed, themes identified included: wheelchairs/cushions provided addressed many residents' needs; and saved residents and their families money and stress; and there is still ongoing need for more specialised equipment for frail residents (not covered by this programme). This study provides some evidence regarding the benefits of the introduction of this programme in two care homes and identifies potential changes that might improve wheelchair seating among residents with more severe seating needs. Further research is required on how these equipment changes might affect their mobility or participation in activities. These findings appear to support the provision of lightweight individually fitted wheelchairs and moderate pressure redistribution cushions by occupational therapists in long-term care through this programme. Regular use of the SIT (i.e., on admission, condition change, annual care conference, and as needed) may be beneficial to ensure residents are properly screened for seating needs. Collaboration with the resident appears to be important to ensure equipment on provision and follow-up are meeting residents' needs. Recommend future research on the use of tilt in space wheelchairs for residents' in long-term care. [ABSTRACT FROM AUTHOR]

Purpose: The present research aims to contribute to the comprehension of the product development process (PDP) of Assistive Technology (AT) through methodological multi-case studies in Brazil. The following considerations presented in the study are part of a Master's degree thesis, conducted from 2013 to 2015. Methodology: The research adopted a multi-case study methodology by selecting four product developers from the Assistive technology field in Brazil, focusing on physical disability. Results: According to the findings, this research discusses the possible influences of Emotional Collaborative Design on the process of Assistive Technology, aiming at enhancing new perspectives about such tools on the product development process. As a result, it was possible to set a delimitation of PDP of AT stages in the four cases approached, in most of the methodological steps empirically developed. Conclusion: Final considerations of the study, collaborate with the comprehension of the assistive product development, stating there is still a little emphasis on the design concepts throughout these processes, also illustrates the necessity for further studies about the product development in the area. The visualization of a still scarce dialogue between the multiple areas that could contribute for AT development; The potential correlation between high dissatisfaction in several issues regarding use of ATs and the poor understanding of user needs; The predominance of a great functionality emphasis, and the negligence of the individual's emotional in AT development; The understanding that product design maybe is still poorly applied/understood in this field. [ABSTRACT FROM AUTHOR]