Abstract
BackgroundProviding wheelchairs without comprehensive support services might be detrimental to user satisfaction and function.ObjectivesThis paper compares wheelchair user satisfaction and function before and after implementation of comprehensive wheelchair services, based on the World Health Organization guidelines on wheelchair service provision in less resourced settings, in Zimbabwe.MethodA pre- and post-test study with a qualitative component was done. Quantitative data were collected with the Quebec User Evaluation of Satisfaction with Assistive Technology for adults and children and the ‘Functioning Every day with a Wheelchair Questionnaire’. Data were collected from 55 consecutively sampled wheelchair users, who received a new wheelchair in the study period. Qualitative data were collected through two audio recorded focus groups and two case studies and are presented through narrative examples.ResultsThe proportion of adult users who were satisfied significantly increased for all wheelchair and service delivery aspects (p = 0.001 - 0.008), except follow-up (p = 0.128). The same was true for children’s post-test ratings on all variables assessed (p = 0.001 - 0.04), except training in the use of the device (p = 0.052). The biggest improvement in satisfaction figures were for comfort needs (44.3%), indoor mobility (43.2%), outdoor mobility (37.2%), safe and efficient, independent operation (33.5%) and transport (31.4%). The qualitative data illustrated user satisfaction with wheelchair features and services.ConclusionThe wheelchair service programme resulted in significant positive changes in user satisfaction with the wheelchair, wheelchair services and function. It is recommended that the Zimbabwean government and partner organisations continue to support and develop wheelchair services along these guidelines.
Highlights
Wheelchairs are often essential assistive devices for persons with mobility limitations
The post-test QUEST and Functioning Everyday with a Wheelchair Questionnaire (FEW) ratings following the implementation of the Comprehensive Mobility Support Project (CMSP) demonstrate statistically significant improvement in satisfaction with all except two http://www.ajod.org categories of wheelchair features, service delivery and function
The study findings illustrate that wheelchair users in low-resource settings can experience similar satisfaction levels with wheelchairs, services and function as wheelchair users from resourced settings, despite fewer resources and using more basic technology
Summary
Wheelchairs are often essential assistive devices for persons with mobility limitations. Wheelchairs, like shoes, are available in different designs and sizes in order to meet different functional, posture support and environmental needs (Borg, Lindstrom & Larsson 2011; Pearlman et al 2008; WHO 2008). An ill-fitting or inappropriate wheelchair which fails to meet the user’s posture support, functional and/or environmental needs leads to dissatisfaction, which may result in sub-optimal use or abandonment of these expensive devices (Mukherjee & Samanta 2005; Toro et al 2012). In the past, many donor organisations have provided wheelchairs with no or little accompanying services. Often, these donated wheelchairs were inappropriate for the user’s needs (Øderud 2014; Visagie et al 2015). Providing wheelchairs without comprehensive support services might be detrimental to user satisfaction and function
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