Abstract
Date Presented 04/21/2023
The wheelchair procurement process is challenging for brain injury survivors. Structured interviews at two time points identified gaps and priorities. Priority areas identified were comfort and effectiveness. Gap areas included fit and follow-up care.
Primary Author and Speaker: Catherine Cooper Hay
Additional Authors and Speakers: Caroline Jacob, Jade Furl
Contributing Authors: Dawn Phillips
To examine the gaps and priorities of individuals with acquired brain injury (ABI) as they receive their first wheelchair (W/C). Longitudinal single group observational study. Subjects were recruited from an inpatient rehabilitation facility. Inclusion criteria: Diagnosis of ABI, prescribed a wheelchair, planned discharge to home, able to speak and read in English. Exclusion criteria: discharge to a facility or another country, used wheelchair prior to this ABI. Data was collected from medical records, structured interviews, & questionnaires at two time points: discharge, and 4 months post discharge. Subjects answered questions about their W/C,plan for discharge, and completed the multidimensional scale of social support, the general self-efficacy scale, and the Neuro-QOL. At 4 months they were asked about their transition home and their wheelchair. Average importance and performance scores were calculated for each wheelchair category. Important performance analysis (IPA) was performed to visualize focus areas. The average age of the participants (n=11) was 48.2 years (range 18-86 years). Most of the participants were female (63.6) and non-Hispanic white (63.6%). Features of wheelchair with the highest average importance rating at discharge were fit, comfort, and effectiveness. At 4 month follow up features with highest average importance rating were safety, ease of use, comfort, and effectiveness. IPA indicated the areas that needed attention were fit of the wheelchair and availability of follow up services. Common themes identified in the follow up interviews included challenges and successes related to their wheelchair as well as adjustment challenges relating to being home, their new diagnosis and receiving follow up therapy. The preliminary data from this study provides further support for the importance of follow up care after rehabilitation discharge and demonstrates how IPA can be used in rehabilitation to visualize priority areas of treatment.
References
Babinec, M., Cole, E., Crane, B., Dahling, S., Freney, D., & Jungbluth-Jermyn, B. (2015). The rehabilitation engineering and assistive technology society of North America (RESNA) position on the application of wheelchairs, seating systems, and secondary supports for positioning versus restraint. Assist Technol, 27(4), 263-271. https://doi.org/10.1080/10400435.2015.1113802
Jutai, J., Coulson, S., Teasell, R. et al. (2007). Mobility assistive device utilization in a prospective study of patients with first-ever stroke. Arch Phys Med Rehabill, 88(10), 1268-1275. https://doi.org/S0003-9993(07)01280-4
Magasi, S., Wong, A., Miskovic, A., Tulsky, D., & Heinemann, A.W. (2018). Mobility device quality affects participation outcomes for people with disabilities: A structural equation modeling analysis. Arch Phys Med Rehabil., 99(1),1-8. https://doi.org/S0003-9993(17)30526-9
Samuelsson, K., & Wressle, E. (2008). User satisfaction with mobility assistive devices: An important element in the rehabilitation process. Disabil Rehabilitation, 30(7), 551-558. https://doi.org/779535075
