Psychosocial Impact Of Assistive Devices Scale Research Articles

Translation and validation of the Persian version of “The Psychosocial Impact of Assistive Devices Scale” in patients with neurological disorders

ABSTRACT Neurological disorders are a heterogeneous group of central or peripheral nervous disorders of which the main symptoms include impaired walking and balance. One of the main interventions for neurological disorders is the use of assistive devices, and it is necessary to consider the psychosocial effects of these devices on users. The psychometric properties of the Persian version of the Psychosocial Impact of Assistive Devices Scale (PIADS) were evaluated in patients with neurological disorders. After translating the scale into Persian based on IQULA, face and content validity were determined. The divergent validity of the scale was examined through its relationship with the Orthotics and Prosthetics Users’ Survey (OPUS). Reliability of the tool was evaluated using an internal consistency and test-retest method over two weeks with 50 patients with neurological disorders and a history of using assistive devices for at least six months. The face and content validity of the PIADS was confirmed. The ICC for all subscales was higher than 0.78, which indicates a good correlation. However, the divergent validity of the scale with the OPUS scale was not confirmed. The Persian version of PIADS is a valid and reliable measure for patients with neurological disorders in Iran.

The psychosocial impact of eye-gaze assistive technology on everyday life of children and adults

Purpose This study investigates the psychosocial impact of eye-gaze assistive technology (EGAT) in both children and adults with long-term experience using eye-gaze assistive technology in everyday life, as well as the psychosocial impact as related to duration of use. Methods In this descriptive comparative study, 34 adult and 27 child EGAT users participated in a structured individual interview using the Psychosocial Impact of Assistive Devices Scale (PIADS). Results The participants’ age ranged from 5–74 years, 50% were female and 52% had been diagnosed with cerebral palsy. The EGAT had a positive psychosocial impact on competence, adaptability, and self-esteem among adult and child users. Competence was the only subscale with a higher value for adults (p = 0.038), compared to children. The items with the highest impact for the psychosocial aspects were quality of life, ability to participate, and self-esteem. The adults had longer duration of use than children, but for high-, medium-, and low-duration users, the device showed a positive psychosocial impact. Conclusions Participants considered EGAT to have high positive impacts for participation and quality of life. The study adds new knowledge in that high positive psychosocial impact may be found even among low-duration users of EGAT, which is important to consider for service providers.

Psychosocial predictors of mobility assistive devices non-adherence among older adults

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.

The Impact of Frame Running on Quality of Life in Young Athletes With Mobility Limitations.

PurposeThe para-athletic sport Frame Running is developed for persons with neurological impairments causing severe limitations of walking ability. Participating in sports can contribute to a better quality of life (QoL). It is unknown if participation in Frame Running contributes to QoL in children with mobility limitations. This study aims to explore the changes in QoL in children and youth who started Frame Running.Materials and MethodsWe conducted a cross-sectional study amongst young Frame Running athletes with mobility limitations due to various underlying causes, aged 6–19 years, who are members of one of the Frame Running groups in the Netherlands. For 62 athletes, parents completed the Psychosocial Impact of Assistive Devices Scale (PIADS) questionnaire (subscales: competence, adaptability, and self-esteem). For six athletes, parents were interviewed to obtain more in-depth insight in the perceived changes in the QoL of their children.ResultsParents (of 58% boys, mean age 12 years 4 months; SD 3 years 3 months; 52% supported walkers) reported a significant positive change on all three subscales of the PIADS questionnaire since their children started Frame Running. Most change was experienced in the items performance, the ability to participate, happiness and self-confidence. Quotes of the parents who were interviewed elucidated these changes.ConclusionFrame Running increased QoL in young athletes with a mobility limitation. Frame Running may therefore be advised for these children and youth to improve QoL.

Acceptability and Preliminary Results of Technology-Assisted Balance Training in Parkinson's Disease.

(1) Background: Parkinson’s Disease (PD) is one of the most common causes of disability among older individuals. The advanced stages of PD are usually characterized by postural instability and, as a consequence, falls. Those are among the main factors that determine the quality of life, as well as the morbidity and mortality of a person with PD. In the field of PD rehabilitation, robotics is also rapidly gaining ground. As a primary aim, we evaluate the acceptability of the technology integrated intervention, using the Psychosocial Impact of Assistive Devices Scale (PIADS), in order to analyze the attitude of the participants towards the Tymo® system. As a secondary outcome, we assess the result of the rehabilitation treatment integrated with the Tymo® system on several patient’s features. (2) Methods: We studied a population of 16 patients with Parkinson’s Disease. Each recruited subject completed 10 treatment sessions, organized as two training sessions per week, for 5 weeks. The intervention included 30 min of traditional therapy and 20 min of technological treatment with a robotic system. PIADS is composed of three subscales (Competence subscale, Adaptability subscale, Self-esteem subscale) ranging from −3 to +3, reflecting, respectively, a negative or positive feeling towards the device. (3) Results: The Competence subscale, measuring feelings of competence and usefulness, obtained a score of 1.24 (SD = 0.78). The score of Adaptability subscale, indicating a willingness to try out new things and to take risks, was 1.83 (SD = 0.65). Finally, the Self-esteem subscale, indicating feelings of emotional health and happiness, reached a score of 1.31 (SD = 0.72). Moreover, statistical analysis reveals a significant effect on balance performance after intervention. (4) Conclusions: This feasibility study represents a starting point in the use of technology in the rehabilitation pathway of patients affected by Parkinson’s Disease. In fact, our results suggest that a standard therapy combined with an innovative treatment using Tymo® may be accepted by PD patients, which may benefit especially from preserving balance.

Flow. A Socially Responsible 3D Printed One-Handed Recorder.

The recorder is one of the most common instruments used during primary school in the formal education system in the EU. However, there are a percentage of students with only one functional hand. The existing one-handed recorders available for them to be able to play and perform in the same way as their peers are expensive and difficult to use. This study’s purpose is to document the development of Flow—a low cost one-handed recorder as well as the user’s assessment of the psychosocial benefits of the recorder. The methods used for fabrication were 3D modelling and additive manufacturing (AM) technology or 3D printing using the technique of stereolithography, and for the assessment of the product, the Psychosocial Impact of Assistive Devices Scale (PIADS) questionnaire was distributed to 20 primary school users. The results show that the use of resins and Stereolithography is appropriate for wind instruments providing quality and strength at a fair price. Flow also proved to have a positive impact on the users and their inclusion in school. The main conclusions of this study underscore the adequacy of using AM for adaptations required for people with disabilities and the positive psychosocial benefits generated by the use of Flow in children.

Psychometric Properties of the Spanish Version of Psychosocial Impact of Assistive Devices Scale in a Large Sample of People With Neuromuscular, Neurological, or Hearing Disabilities.

Assistive technology (AT) is any device, software, or equipment designed for and used by individuals with disabilities to engage in everyday activities and achieve independence. However, the usefulness of those technology-based or supported treatments is a complex issue that has led to the development of various conceptual models for assistive technology outcomes research and practice as well as different assessment tools that help to explore the effect of technology on people's lives. One of those instruments is the Psychosocial Impact of Assistive Device Scale (PIADS), a 26-item questionnaire that measures the psychosocial impact of interventions, using assistive devices in three quality-of-life domains: competence, adaptability, and self-esteem. PIADS scale has been translated and adapted to several languages, and it has been successfully used to measure AT outcomes in different disability profiles to predict abandonment or even as a relevant determinant of future adoption of eHealth. Quinteiro (2010) adapted PIADS to Spanish for the first time, although no studies have yet been published to systematically study its psychometric properties. Therefore, the purpose of this study was to evaluate measurement properties of the Spanish version of PIADS scale by means of a dataset obtained from its application to a large sample (n = 417) of people with neuromuscular, neurological, or hearing disabilities that used different assistive devices. The results will provide valuable indicators about the measurement quality of the Spanish PIADS scale and will help to promote the use of reliable and valid AT outcome assessment tools for research and clinical purposes.

Trekking Poles to Aid Multiple Sclerosis Walking Impairment: An Exploratory Comparison of the Effects of Assistive Devices on Psychosocial Impact and Walking.

Walking dysfunction is reported by two-thirds of persons with multiple sclerosis (MS). Assistive devices are frequently recommended to improve walking; however, it is uncommon to consider their psychosocial impact, although many users abandon their assistive devices. The psychosocial impact, walking, balance, and fatigue associated with three assistive devices were compared to guide clinical decision making. Twenty-five persons with MS (median Expanded Disability Status Scale score, 4.0; range, 2.5-6.0) who reported walking difficulty were trained in the use of three assistive devices-a single-point cane (SPC), a four-point cane (FPC), and a trekking pole (TP)-at 1- to 2-week intervals, then used the assistive device for their usual activities. Outcome measures included the Psychosocial Impact of Assistive Devices Scale (PIADS), the 6-Minute Walk Test (6MWT), walking speed, cadence, stride length, stride time, the 12-item Multiple Sclerosis Walking Scale (MSWS-12), the Activities-specific Balance Confidence (ABC) scale, the 5-item Modified Fatigue Impact Scale (MFIS-5), and a visual analogue scale of fatigue (VAS-F). The SPC and TP were more positive in the PIADS adaptability, competence, and self-esteem subscales. The SPC and TP resulted in higher 6MWT, walking speed, cadence, stride length, stride time, and MSWS-12 scores compared with the FPC. No differences were found in ABC scale, MFIS-5, or VAS-F scores. Participants reported more positive psychosocial impact, and walked faster and with higher quality, with the SPC and TP than with the FPC. Clinicians should consider suggesting an SPC or TP to patients who may benefit from assistive device use and for whom psychosocial impact is an important consideration.

How Loan Bank of Assistive Technology Impacts on Life of Persons with Amyotrophic Lateral Sclerosis and Neuromuscular Diseases: A Collaborative Initiative.

(1) Background: The study is focused on the implementation of outcome measurement tools to assess the impact of an assistive device from a loan bank in the lives of people with Amyotrophic Lateral Sclerosis and Neuromuscular Diseases. The secondary purpose is to analyse the correct matching between the person and technology, derived from the counselling of an occupational therapist. (2) Methods: Cross-sectional study. The sample was formed by 28 people with rare neurodegenerative disorders. A specific questionnaire, the Psychosocial Impact of Assistive Device Scale (PIADS), and the Matching Person and Technology (MPT) tool were applied to collect the data. (3) Results: The dimension of the PIADS with the best score was competence, and the variations according to gender were not remarkable. The three dimensions of the PIADS (competence, adaptability, and self-esteem) were correlated positively between them and with the mean score of the MPT tool (p < 0.01). The type of assistive technology (AT), diagnosis, and correct match between person–technology are the main factors that condition a positive impact. (4) Conclusions: The results noted the importance of assessing the needs, demands, and contexts of people with rare neurodegenerative diseases to prescribe the best AT. Loan banks of AT have to be considered a valid service that complements their lack in public health services.

Impacto funcional y psicosocial del uso de prótesis de bajo costo en impresión 3D en amputado unilateral de antebrazo: estudio de un caso

Introducción: Los pacientes que presentan una amputación a nivel trans-radial cuentan con oferta reducida de dispositivos protésicos (gancho y mano cosmética). Postulamos que disponer de nuevos sistemas protésicos 3D de bajo&#x0D; &#x0D; &#x0D; &#x0D; 16&#x0D; &#x0D; IMPACTO FUNCIONAl y PSICOSOCIAl DEl USO DE PRóTESIS DE BAJO COSTO EN IMPRESIóN 3D&#x0D; &#x0D; &#x0D; costo y la experiencia de su uso, permitirá aumentar las opciones para mejorar funcionalidad, actividad y participación. Objetivo: Evaluar el impacto fun-cional y psicosocial del uso de mano protésica manufacturada con impresión 3D. Método: Se seleccionó un paciente Teletón con amputación transradial de antebrazo izquierdo nivel tercio medio, 15 años de edad, con consentimiento informado. Se tomó molde en yeso y confeccionó prótesis 3D fabricada en acrilonitrilo butadieno estireno (ABS) y ácido poli-láctico (PLA); el pulgar tiene dos articulaciones y los demás dedos tres articulaciones. La prótesis la constituyen también el antebrazo y muñeca. El usuario recibió cuatro sesiones de entrenamiento con la prótesis en el lapso de un mes. Las evaluaciones con pauta de funcionalidad de mano Bilan 400 points modificada, índice funcio-nal de las extremidades superiores (UEFI) y escala del impacto psicosocial de la asistencia tecnológica (PIADS), se aplicaron previo al ingreso, a tres y once meses de seguimiento. Resultados: La funcionalidad de mano mostró un incremento de alrededor de 30% con ambos instrumentos. En medición PIADS, competencia, autoestima y adaptabilidad, variaron de ningún efecto de la asistencia tecnológica, hasta el máximo de 3 puntos para adaptabilidad en el seguimiento a 11 meses. Conclusión: Este estudio de caso destaca poten-ciales beneficios del uso de prótesis de extremidad superior en el desempeño funcional y calidad de vida.

The development of an augmented reality device for the autonomous management of the electric bed and the electric wheelchair for patients with amyotrophic lateral sclerosis: a pilot study

Purpose The main aim of this Human Centred Design project was to develop the Environment COntrol in Amyotrophic Lateral Sclerosis (ECO-ALS) System, a new device which could improve ALS patient’s autonomy in controlling the environment. Moreover, we verified the feasibility and usability of this technology in ALS patients in advanced stages of the disease. Material and methods Twelve ALS patients in advanced disease stage were recruited, two patients for the development phase and ten patients and their caregivers for the two weeks’ trial phase. We evaluated the impact of the ECOALS system by administering the Psychosocial Impact of Assistive Devices Scale (PIADS), the Individual Prioritised Problem Assessment (IPPA), the McGill Quality of Life Questionnaire (MQOL) and the Caregiver Burden Inventory (CBI). Results In the trial phase, patients were very satisfied for having recovered their autonomy in the management of the EAB, that enabled patients to reduce calls to their caregivers to change their bed position. The IPPA questionnaire showed a significant improvement in patients’ participation and management of the system. Moreover, the PIADS questionnaire showed that patients perceived a progress in competence, adaptability and areas of self-esteem, confirming a positive psychosocial impact of the patients’ assistance device. Conclusion The project has collected some useful information for technological system development to face the need for autonomy ALS patients. Patients were satisfied with the tested aids and were interested in the future developments. Further studies are needed to improve the system and overcome some technical problems that occurred during the project. IMPLICATIONS FOR REHABILIATION The ECO-ALS system seems to improve the patients' perceived autonomy. The ECO-ALS system seems to improve the patients' perceived progress in competence, adaptability and areas of self-esteem, confirming a positive psychosocial impact of the assistance device. The ECO-ALS system seems to improve the patients' perceived quality of life. Patients were satisfied with the tested aids and were interested in the future developments.

Psychosocial impact of mobility assistive technology on people with neurological conditions

Introduction A wide range of products are available to assist mobility, and it is, therefore, of great importance to obtain empirical information regarding the expected impact of the use of these products based on outcome measures. People affected by neurological disorders often use products to assist mobility such as wheelchairs (both manual self-propelled wheelchairs and externally propelled chairs such as electric wheelchairs), walkers, walking sticks, etc. It is important to conduct an assessment of the psychosocial impact of these products on the lives of affected people. Methods We performed this assessment using the Psychosocial Impact of Assistive Devices Scale (PIADS) and a socio-demographic questionnaire. Results The results showed greater psychosocial benefits relating to the use of electric wheelchairs in comparison with walking sticks or manual, non-self-propelled chairs. Moreover, significant differences are present in the three subscales of the PIADS in relation to variables such as age, training in the use of assistive technology (AT) and funding. Conclusion Therefore, we conclude that the use of AT should be promoted among this group as a way to improve their adaptability, competency and self-esteem, and to reduce limits on participation deriving from the physical and contextual barriers faced by this collective. Implications for rehabilitation Among the assessment of different mobility AT displaying a higher score in the three subscales of the PIADS amongst people using electric wheelchairs than among those using non-self-propelled manual wheelchairs. On the other hand, we found that the walker has a significant score only in the competence subscale. Canes, for example the stick 4-p is significant in the three subscales, or the walking cane in terms of competence. Despite the fact that crutches and walking sticks obtained the lowest score in this study. Not only the assessment is necessary, but also the adjustment of AT to the person who is going to use it, as well as some training on how to use it. Only 23.8% of the participants received training in the use of their main assistive device in this study. The results seem to indicate that for elder users, the score on adaptability with the AT is lower. That may result in future lines of research in usability and improving in terms of the needs of end-users and these AT since a high percentage of people with neurological conditions are elder people. The application of specific scales such as PIADS that helps to measure the use and capacity of the AT prescribed to patients with neurological disease provides more informed clinical reasoning.

Linking the Psychosocial Impact of Assistive Devices Scale (PIADS) to the International Classification of Functioning, Disability, and Health.

Assistive technologies are widely implemented in clinical and research settings. Despite their dissemination, the psychosocial impact of their adoption still deserves further consideration. The aim of the present study is to determine the degree of compatibility between the Psychosocial Impact of Assistive Devices Scale (PIADS) and the International Classification of Functioning, Disability, and Health (ICF). Six health professionals (two neurologists, one neuro-rehabilitation technician, two psychologists, one university professor of rehabilitation) created a technical board to discuss upon the PIADS-ICF linking. The standardized linking methodology was applied, and a Delphi technique was used to examine consensus. Five Delphi sessions were required to reach 100% of consensus and to finalize the procedure. Of the 26 PIADS' items, 23 were linked to an ICF category: 9 items were endorsed at the 3rd ICF level, and 14 items at the 2nd ICF level. Two items were classified as "not defined" and 1 item as "not covered". The study highlighted the conceptual connection between the PIADS and the ICF framework and set a bio-psychosocial standpoint by which accounting the role of assistive devices in rehabilitation settings.

Psychosocial Impact of powered wheelchairs on participation profile of their users

Disability is a worldwide health issue and demands for support with assistive technologies, like powered wheelchairs (PW). The purpose of this study is to assess the psychosocial impact of PW on social participation and quality of life of its users. From May to October 2017, 30 PW users were interviewed using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST), the Psychosocial Impact of Assistive Devices Scale (PIADS) and the Activities and Participation Profile related to Mobility (APPM), in addition to some demographic, clinical and powered wheelchair related questions. Descriptive and correlational statistics were performed. From the 30 participants sample, 18 were men (60%) and 12 women (40%). The mean age was 40.63, ranging from 23 to 65 years old. Cerebral palsy was the most prevalent diagnosis (37%). All the participant's current PW was being used for at least 1 year. According to the data obtained from APPM, there was an average moderate limitation in social participation, with a mean score of 1.72 (SD = 0.69). The APPM score was negatively correlated with all QUEST scores, meaning the most satisfied users were the ones with a better performance on social participation (with less limitations and, therefore, a lower APPM score). A worst participation profile was noted among the users who use wheelchairs for a longer period. There was no relation between the psychosocial impact of the PW and participation. According to our findings, the user's social participation doesn’t seem to be related with the psychosocial impact of the PW. Although, there was an overall positive psychosocial impact of the powered wheelchairs, and, therefore, an increase in the quality of life of the users. Also, higher levels of satisfaction with the PW characteristics and assistance resulted in better participation outcomes.

Pain, fatigue, function and participation among long-term manual wheelchair users partnered with a mobility service dog

Purpose: To assess the effects of a mobility service dog (MSD) on pain, fatigue, wheelchair-related functional tasks, participation and satisfaction among manual wheelchair users over a nine-month period.Method: A longitudinal study with repeated assessment times before and three, six and nine months after intervention was achieved. Intervention consisted in partnering each participant with a MSD. The setting is a well-established provincial service dog training school and participants homes. A convenience sample of 24 long-term manual wheelchair users with a spinal cord injury was involved. Outcome measures were: Wheelchair User’s Shoulder Pain Index (WUSPI), Rate of Perceived Exertion (RPE), vitality scale from the SF-36, grip strength, Wheelchair Skills Test (WST), Canadian Occupational Performance Measure (COPM), Reintegration to Normal Living Index (RNLI), Life Space Assessment, Psychosocial Impact of Assistive Devices Scale (PIADS) and Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0).Results: Shoulder and wrist pain as well as fatigue decreased significantly over time with the use of a MSD as evidenced by scores from WUSPI, RPE and SF-36 (feeling less worn out). Manual wheelchair propulsion skills (steep slopes, soft surfaces and thresholds) improved significantly over time as confirmed by the WST. Participation increased significantly over time as revealed by the COPM (for five occupations) and the RNLI (for five items). Satisfaction with the MSD was high over time (QUEST: nine items) and with a high positive psychosocial impact (PIADS: 10 items).Conclusion: MSD represents a valuable mobility assistive technology option for manual wheelchair users.IMPLICATIONS FOR REHABILITATION For manual wheelchair users partenered with mobility service dog • Shoulder pain and fatigue significantly decreased and continued to decrease between the third and sixth month and the ninth month. • Performance with propelling the wheelchair up steep slopes increased from 41 to 88% and on soft surfaces increased from 53 to 100% after 3 months, respectively. • Occupational performance satisfaction was significantly increased for mobility in relation with the transfers, navigating in a natural environment and picking up objects. • High satisfaction towards psychosocial competency, psychosocial adequacy and self-esteem were reported at months three, six and nine.

Can technology-assisted toilets improve hygiene and independence in geriatric rehabilitation? A cohort study

Purpose: To investigate whether technology-assisted toilets (TATs) could be used to improve toileting hygiene and independence for geriatric rehabilitation patients. TATs are commercially available toilet seats that use a stream of warm water to clean the user, have a fan for drying and are operated by a remote control.Materials and methods: Twenty-five geriatric rehabilitation in-patients were recruited, six completed the study, and seven partially completed the study. Each participant had two trial bowel movements. One trial involved cleaning themselves with toilet paper; the other involved cleaning themselves with the TAT functions. After each trial, participants received a visual inspection for cleanliness and answered the Psychosocial Impact of Assistive Devices Scale (PIADS), a validated scale, to assess their sense of competence, adaptability and self-esteem in the bathroom. A toileting cleanliness scale, designed for this study, was completed by a nurse after TAT usage. Participants received a score from 1 (completely clean) to 4 (completely soiled) based on a visual inspection after cleaning.Results: TAT and toileting cleanliness scores were similar. PIADS scores showed a trend towards higher scores when using the TAT, but results were not statistically significant.Conclusions: TATs cleaned as well as standard toileting in geriatric rehabilitation inpatients. Participants indicated that TATs improved their sense of competence, adaptability and self-esteem. Geriatricians and rehabilitation professionals should consider prescribing TATs in their practice as an assistive device in order to promote patient independence and dignity and reduce the burden of care for patients requiring toileting assistance.Implications for rehabilitationTechnology-assisted toilets (TATs) are commercially-available toilet seats that could be used to allow rehabilitation patients to clean themselves more independently in the bathroom.Improved toileting independence can reduce burden of care of geriatric rehabilitation and reduce the impact of toileting assistance on patient dignity and self-esteem.Physiatrists should consider recommending TATs to their patients but should take into account whether a patient’s particular set of disabilities will allow them to use a TAT effectively.

Technology-assisted toilets: Improving independence and hygiene in stroke rehabilitation.

Background and PurposeDependence on assistance for toileting is a widespread problem for persons receiving healthcare. Technology-assisted toilets, which hygienically wash and dry the perineal region, are devices that could improve toileting independence in a variety of patients. The objective was to investigate whether technology-assisted toilets improve toileting independence, quality of life, and whether technology-assisted toilets can provide sufficient toileting hygiene in stroke rehabilitation.MethodsThis pilot study was carried out in a stroke rehabilitation unit. Thirty participants were recruited. Participants had a bowel movement and cleaned themselves using the technology-assisted toilet on one to three occasions. Participants rated their toileting before using the technology-assisted toilet and after each technology-assisted toilet use with the Psychosocial Impact of Assistive Devices Scale (PIADS). After each session, participants were rated for cleanliness.ResultsPIADS scores were analyzed from eight individual participants, five of whom completed the full protocol. PIADS scores were significantly higher with the technology-assisted toilet than with the participants’ regular toileting routine (p < 0.05). Technology-assisted toilets cleaned effectively in 73% of cases (16/22, p < 0.05).ConclusionTechnology-assisted toilets improved stroke patients’ psychosocial outcomes compared to standard toileting and completely cleaned participants in the majority of cases. A larger study should confirm technology-assisted toilet’s benefit in stroke rehabilitation through improved independence and hygiene.

Ready for eHealth. Older Swedes’ Perceptions of eHealth Services: Using the PIADS Scale as a Predictor for Readiness

Introduction: Relevant determinants of adoption of eHealth are needed in order to understand future usage. Aim: To investigate the anticipated psychosocial impact of present and future eHealth services and discuss how psychosocial factors can impact the readiness for eHealth services among older Swedes and reflect upon instruments for measuring eHealth acceptance. Method: The Psychosocial Impact of Assistive Device Scale (PIADS) measured the psychosocial impact of eHealth services as illustrated in pictures of a set of events of eHealth services that may reasonably occur in the present and the future. The PIADS scale and the scenarios were administered via a randomly selected sample from the Swedish population aged 55–105. Results and Discussion: Older Swedes have, from a psychosocial perspective, positive expectations regarding eHealth services. The PIADS scale could be a useful supplement to acceptance measurements in the context of eHealth. Using animated illustrations to depict eHealth services, together with the PIADS scale, can generate findings that are generalizable across technologies. The dimensions adaptability, competence and self-esteem could be relevant determinants of adoption of eHealth.

Home tele-rehabilitation for rheumatic patients: impact and satisfaction of care analysis

Introduction In this paper, we evaluated patients’ perspectives on the use of a system for home tele-rehabilitation, designed for subjects with low computer literacy suffering hand impairment due to rheumatic diseases. Methods After a clinical trial assessing device effectiveness, the Psychosocial Impact of Assistive Devices Scale (PIADS), Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) and Individually Prioritised Problem Assessment (IPPA) questionnaires were administered to evaluate the system’s impact on each patient’s life, and the results were correlated with clinical indices. Patients were asked to continue self-administered rehabilitation with common objects. One year later, a semi-structured telephone interview gathered data on their experience. Results The system received a positive QUEST score (4.5 ± 0.3) and a modest PIADS score (0.84 ± 0.8) due to the small impact on adaptability and self-esteem. The IPPA (3.7 ± 3.4) revealed improvement in the ability to perform tasks considered important, which was significantly correlated (r = 0.60; p < 0.02) with the clinical Health Assessment Questionnaire (HAQ) index improvement. The interviews revealed a positive engagement effect, enhanced by the need to develop skills to be able to use the device (technological challenge) and by the perception of more attention by the medical staff. This may explain the significant dropout rate (80%) from the post-trial rehabilitation of the patients who used the device. Discussion The system was largely accepted by the patients. The results suggest that the need for information on their rehabilitation progress and the technological challenge deserves further study to make patients more autonomous in cases of continuous rehabilitation.

Measuring the psychosocial impact of mobility assistive products with elderly people: Findings from Italian surveys

Purpose. In 2014 and 2015 the authors surveyed two samples of 79 and 65 users who had obtained mobility assistive devices from the National Health Service in Italy. The first sample was composed of powered wheelchair users, 71% of them being over 65 years old [1]. The second sample included users of seven different mobility assistive devices: powered wheelchairs, tilting manual wheelchairs, manual wheelchairs with seating system, tracked and wheeled stair-climbing devices, trans-femoral and trans-tibial lower limb prostheses); 42% of them were over 65 years old. Follow-up interviews were conducted in order to collect information about usage, effectiveness, usefulness and economic impact of their assistive device. Method. The instruments used in the interviews, which were conducted at the users’ homes, included an introductory questionnaire and other widely known assessment instruments, one of them being the PIADS (Psychosocial Impact of Assistive Devices Scale) [2], [3]. Results & Discussion. In both samples elderly people (those aged 65 or more) answered the PIADS items in greater numbers than those under 65. Some difficulties in answering the PIADS questions were noticed, which seem to be related to the kind of assistive device rather than to the age of the interviewed person. In the 2015 survey the number of subjects who did not answer the whole PIADS questionnaire was greater among users of assistive devices maneuvered by caregivers (tilting wheelchairs, manual wheelchairs with seating system, tracked and wheeled stair-climbing devices) than among users of devices providing full independence (powered wheelchairs, trans-femoral and trans-tibial lower limb prostheses). Another noteworthy finding is that, although all average scores obtained in the PIADS subscales were positive (about +1 in both samples), for elderly people the scores were a bit lower than those obtained from younger users. This does not occur for electronic wheelchairs users, whose scores don't differ in relation to the age of the interviewed subjects. Building on experience gained during these and previous studies, in the next two years a battery of outcome measurement instruments will be prepared to be used in clinical practice. References. 1. Salatino C, Andrich R, Converti RM, Saruggia M. An observational study of powered wheelchair pro-vision in Italy. Assistive technology 28(1) (2015) 41-52. 2. Andrich R, Pedroni F, Vanni G. Psychosocial Impact of Assistive Devices: Italian localization of the PIADS instrument. In: Craddock G et al (eds), Assistive technology: Shaping the future (AAATE 2003). Amsterdam: IOS Press (2003) 917–921. 3. Jutai J, Day H. Psychosocial Impact of Assistive Devices Scale (PIADS). Technology and Disability 14(3) (2002) 107–111.