Citation

Salatino C, Andrich R, Converti RM, Saruggia M. Assist. Technol. 2015; 28(1): 41-52.

Affiliation

Servizio DAT (Domotica, ausili, Terapia Occupazionale) , IRCCS Fondazione Don Carlo Gnocchi , Via Capecelatro 66, 20148 Milano.

Copyright

(Copyright © 2015, Rehabilitation Engineering and Assistive Technology Society of North America, Publisher Informa - Taylor and Francis Group)

DOI

10.1080/10400435.2015.1074631

PMID

26479206

Abstract

Powered wheelchairs are complex assistive devices that must be selected and configured on the basis of individual user needs, lifestyle, motivation, driving ability and environment. They are also expensive, which often means that providing agencies require evidence that their financial investment will lead to a successful outcome. Good practice suggests that users should be carefully assessed before provision in order to make sure that the most appropriate and cost-effective product is chosen for each; in addition, follow-up investigations should be carried out in order to check the achieved outcomes and activate corrective interventions in case of problems. Unfortunately, this does not happen everywhere and follow-up is not routine practice in many countries, including Italy. We surveyed a sample of 79 users who had obtained powered wheelchairs from a Regional Health Service in Italy in the period 2008-2013. The wheelchair prescriptions were made on the basis of an assessment protocol agreed with the local health authority, and follow-up interviews were conducted at the users' homes in order to collect information about wheelchair use, and its effectiveness, usefulness and economic impact. The instruments used in the interviews included an introductory questionnaire (describing wheelchair use), QUEST (to measure user satisfaction), PIADS (to measure psychosocial impact), FABS/M (to detect environmental facilitators and barriers), and SCAI (to estimate economic impact). The results indicated positive outcomes, especially in relation to user satisfaction (average "quite satisfied" to "very satisfied") and psychosocial impact (average the wheelchair "increased a little" the users' ability, adaptability and self-esteem). A number of barriers were identified in various settings (at home, in public places and public transportation) that sometimes restrict user mobility, and suggest corrective actions. Environmental factors acting as facilitators were also identified. In economic terms, the provision of a powered wheelchair generated considerable savings in social costs for most users: an average of about $ 38,000 per person over a projected 5-year period was estimated by comparing the social cost of the intervention (the cost of all of the material and human resources involved in the provision and use of the wheelchair) with that of non-intervention (the presumed social costs that would have been incurred in the case no powered wheelchair had been provided and the user had had to continue using no device or only their previous device). The study also provided an opportunity to develop and test a follow-up protocol that proved to be applicable to routine service delivery.

Language: en