Assistive Technology Provision Research Articles

IPPA, a user-centred approach to assess effectiveness of Assistive Technology provision

IPPA (Individually Prioritised Problem Assessment) is a new instrument to assess the effectiveness of assistive technology provision. It assesses the impact that problems have on daily life as perceived by the end-user. In an international trial, 248 clients of service delivery centres were interviewed using the instrument, of whom 188 also participated in a follow-up interview. Respondents had problems in mobility, hearing, speech-related communication or self-care. In addition to IPPA, SIP68 and EuroQol were administered for validation purposes. The instrument fits well into the process of service delivery (and even facilitates the actual assessment). The direction of changes measured by IPPA is consistent with the direction of changes measured by SIP68 and EuroQol, supporting construct validity. Changes measured by IPPA are considerably larger, supporting our view that solving problems is a key outcome in provision of assistive devices. Results support the ideas behind the instrument and are promising enough to continue.

A model of cost-outcome analysis for assistive technology

During the CERTAIN study (research carried out in 1994–96 within the Technology Initiative for Disabled and Elderly (TIDE) programme of the European Union), a number of real life case studies of provision of assistive technology to disabled persons were investigated in order to assess the applicability of socio-economic principles, methods and techniques already available from Health Care Technology Assessment studies. A retrospective study on cost, effectiveness and utility resulting from the implementation of assistive technology was carried out over a sample of disabled persons who had adopted technical aids before the start of the project. The sample was selected in such a way to include different pathologies (steady or progressive), impairments, ages, technology and social environment. Each case was described by considering all clinical, technical and social aspects; a common structure for case reporting was developed and tested; attempts were carried out to apply and refine concept and tools derived from health technology assessment studies; on the grounds of such experience a decision support model was elaborated for the choice between different alternatives in order to maximize the client's quality of life while making efficient use of scarce resources. A computer implementation of such a model was also developed, along with a mathematical structure of cost analysis. Within a national research programme such findings were further exploited, leading to the development of a prototype cost-outcome instrument designed for use in clinical practice in the provision of assistive technology to individual cases.

A Home-Centered Approach to Assistive Technology Provision for Young Children with Disabilities

This article discusses a home-centered approach to the use of assistive technology. A home-centered approach essentially addresses two questions: (a) How can assistive technology interventions for children with disabilities be implemented successfully in the home environment? and (b) How can the family system be considered in the use of assistive technology in the home environment? This article helps answer these questions by reviewing the literature in two encompassing areas: children's home environments and self-determination, and family systems and assistive technology. The first area examines the home as the primary learning environment for children and how the home environment can contribute to the development of skills. The second area discusses how family culture, resources, interactions, and goals for the future must be considered if assistive technology is to be susccessful in the home environment. The article provides a discussion of suggestions for working with families in the process of identifying and providing assistive technologies for young children in the home environment.

Evaluation of accessibility needs in a home for the aged

Audiological rehabilitation has traditionally focused on the hard‐of‐hearing individual. In contrast, the needs of groups who perform specific activities in specific locations must be evaluated in planning facility‐based accessibility programs. Such evaluations are necessary when planners design programs where solutions may be achieved by a combination of strategies including modification of the environment, provision of personal or institutional assistive technology, or communication training. The present study demonstrates how accessibility needs were evaluated in a home for the aged. For a group of 30 residents, scope of participation in activities and quality of communication during activities were measured four times over two years, twice before and twice after program implementation. In a pilot study, groups of residents and staff identified situations at the home where they felt that hearing was important. The evaluation of communication function was keyed to these situations. The patterns of scope and quality of communication were used to formulate an accessibility plane. Baseline and outcome data regarding the extent to which the program accomplished accessibility will be presented. For example, the program rendered meetings and chapel services accessible to most residents whereas situations such as dining in the dining hall remained inaccessible. [Work supported by NHRDP.]

The Provision of Assistive Technology for the Elderly in Sweden

The Provision of Assistive Technology for the Elderly in Sweden

Clinical trials and quality control: checkpoints in the provision of assistive technology.

Clinical trials and quality control measures are characterized by evaluation of assistive technology by users, and feedback to providers for the purpose of improving devices or service delivery. These processes recognize that consumer satisfaction is an important measure of device and service delivery effectiveness. In this article, types of clinical trials are reviewed, and both prospective and retrospective methods of quality control are presented. The authors take the position that rehabilitation engineering centers providing customized devices and adapted technology should implement quality control measures in order to improve services to their clients.

Young Children with Respiratory Problems and Assistive Technology Needs: A Nursing Care Perspective

An examination was conducted of the technology needs of 33 children with respiratory problems ages 0-5 years as part of a larger survey of persons with disabilities. Unmet technology needs were reported for these children in all areas of life functioning. Children's needs for assistive technology exceeded their usage of equipment and devices in two thirds of the identified areas of functioning. Technology needs were critical particularly in the areas of taking care of the home; using a telephone; using a computer; talking with others; and use of specialized cars, vans, and buses. It was reported for most children that evaluations preceded the provision of assistive technology, and that families were satisfied with technology services received. More than three fourths of the families reported not having had the opportunity to purchase technology on a credit plan, with two thirds of the families showing that such an option would have been helpful to them. Also, more than one half of the children could not try their technology before it was purchased. A need for more information about assistive technology and services was reported for more than one half of these children. Lack of transportation services were reported for most children, with families of almost two thirds of the children indicating travel exceeding 50 miles to receive technology and services. Implications for nurses involved in comprehensive service delivery to these children are discussed.