Ingvor Pettersson

The value of an outdoor powered wheelchair with regard to the quality of life of persons with stroke: a follow-up study.

Evaluating the use of a powered wheelchair is of importance because of the increasing number of people with disabilities who are provided with one. The aim of this study is to describe characteristics of persons with stroke using an outdoor powered wheelchair and to evaluate the impact of the wheelchair on quality of life. A further aim is to compare the impact on quality of life in respect to age, gender, different disability characteristics, and living conditions. The 32 participants with stroke were recruited consecutively from three county council areas in Sweden. A follow-up design was applied including the EuroQol-5D questionnaires at baseline before the persons were prescribed an outdoor powered wheelchair, and after the participants had used the wheelchair for 3 to 5 months, data were collected by means of the EuroQol-5D and the Psychosocial Impact of Assistive Devices Scale (PIADS). The results indicated an improved quality of life with respect to the items competence, independence, capability, quality of life, well-being, happiness, and self-esteem on the PIADS. The usual activity dimension on the EuroQol-5D showed a significant improvement after wheelchair use. The group who drove the powered wheelchair at least once a day in the summer showed a more positive score on the total PIADS and its Competence subscale than persons who drove less. Furthermore, the group with higher rankings of the importance of the powered wheelchair scored higher on psychosocial impact than did the group with lower rankings. The conclusion is that the powered wheelchair mostly has a positive impact on the quality of life of users with stroke. Service providers should be alert, however, to the possible negative impact of a powered wheelchair on quality of life and support the user.

Lifeworld perspectives utilizing assistive devices: individuals, lived experience following a stroke.

Background. In lifeworld research, the individuals experience of meaning is of primary importance. Purpose. This paper explores how individuals post stroke who have a disability, described their personal meaning and lived experiences associated with the use of assistive devices. Methods. A hermeneutic-phenomenological research approach was used. A conversational interview was conducted with 22 post-stroke individuals regarding their daily experiences utilizing assistive devices. Results. The results showed a dual experience regarding the use of assistive devices, which is often complex and contradictory. The devices were viewed as a prerequisite for well-being and independence but at the same time, the devices gave rise to negative feelings because of the restrictions implied by their use. These dual experiences were explored in relation to the lived body, space, relations to others, and time. Practice Implications. The results of this study will facilitate occupational therapists understanding of an individuals experiences utilizing assistive devices and their need for support with this process.

Lifeworld perspectives on assistive devices: lived experiences of spouses of persons with stroke.

The purpose of this study was to explore how spouses of persons with a disability following stroke describe their lived experiences regarding assistive devices in everyday life. A phenomenological lifeworld approach was used and conversational interviews were conducted with 12 spouses. Their lived experiences of assistive devices were explored in relation to four lifeworld existentials intertwined in everyday life. The results showed that lived body concerns aspects of feelings, habits, and incorporation of the devices with ones own body. The devices are, from the spouses’ perspective, a prerequisite for their partner with stroke living at home. Successively the devices are incorporated into the couples’ homes, and they provide a new view of the environment, aspects related to lived space. The devices bring about a changed relation to lived time, related to past, present, and future. Further, lived human relation concerns changed relationships to husbands/wives with stroke, including a great responsibility due to the devices and their usage. The results also included stigmatizing aspects and a twofold relationship to health professionals regarding participation in decisions about prescribing assistive devices. Understanding the unique meaning of assistive devices from the spouses’ perspective is vital for occupational therapists prescribing such devices.

ICF from an occupational therapy perspective in adult care: an integrative literature review

Abstract Since its launch there has been increasing interest in the International Classification of Functioning, Disability and Health (ICF) within occupational therapy (OT). The aim of this study was to perform an integrative literature review, in order to present an overview of knowledge, where the ICF constitutes a significant part in relation to OT. A systematic literature search, covering the period 2001–2008, was performed in the databases MEDLINE, AMED, and CINAHL. A total of 112 articles were included and the majority had exploratory and descriptive designs. The results showed that ICF was valuable for research, clinical practice, and education. ICF was used to link existing instruments and to construct new outcome measures. Occupational therapists have been members of expert groups involved in the development of Core Sets for certain health conditions. Several positive aspects were described, e.g. an effective medium for communication at different levels. Many limitations were mentioned, such as unclear concepts and lack of subjective experiences. Suggestions for improvements were described. The conclusion was that the ICF has been used for a broad spectrum of purposes. The results indicated that further research is needed concerning application of the ICF in clinical practice and education.

Perception of the influence of environmental factors in the use of electronic planning devices in adults with cognitive disabilities

Abstract Background: Adults with cognitive disabilities often have difficulties in dealing with the complexity of everyday life. With cognitive assistive technology (e.g. electronic planning devices [EPDs] and individual support), they can bring order to their often chaotic life. Assumptions are that environmental factors influence with non-use of EPDs. Objective: To explore how adults with cognitive disabilities perceive the influence of environmental factors in the use of EPDs. Methods: A reference group with experience of use of EPDs assisted the researchers. Twelve adults with cognitive disabilities and experience of using EPDs participated. An interview guide was implemented covering environmental factors according to the International Classification of Functioning, Disability and Health. Qualitative content analysis was applied in the analyses. Results: Five categories and two themes emerged, which were integrated into a model of facilitating factors influencing the use of EPDs. Measures to prevent or eliminate negative influences of the device use are important to be taken. Conclusions: Professionals need more knowledge about EPDs, while users need individual adaption of the EPDs. EPDs need to be user-friendly, manageable and work in any seasons. Implications for Rehabilitation The users should have access to specially trained prescribers. There is a need for development of user-friendly and manageable products to function in any climate. Knowledge is lacking on how to implement the users in all stages of the prescribing process. Prescribers should increase knowledge in the use of EPDs to influence the attitudes of the social environment.

The influence of environment: Experiences of users of myoelectric arm prosthesis—a qualitative study

Background: Prostheses are used to varying degrees; however, little is known about how environmental aspects influence this use. Objectives: To describe users’ experiences of how environmental factors influence their use of a myoelectric arm prosthesis. Study design: Qualitative and descriptive. Methods: A total of 13 patients previously provided with a myoelectric prosthetic hand participated. Their age, sex, deficiency level, etiology, current prosthesis use, and experience varied. Semi-structured interviews were audiotaped, transcribed, and analyzed through inductive content analysis. Results: Four categories were created from the data: “Prosthesis function,” “Other people’s attitudes,” “Support from family and healthcare,” and “Individual’s attitude and strategies.” The overarching theme, “Various degrees of embodiment lead to different experiences of environmental barriers and facilitators,” emerged from differences in individual responses depending on whether the individual was a daily or a non-daily prosthesis user. Environmental facilitators such as support from family and healthcare and good function and fit of the prosthesis seemed to help the embodiment of the prosthesis, leading to daily use. This embodiment seemed to reduce the influence of environmental barriers, for example, climate, attitudes, and technical shortcomings. Conclusion: Embodiment of prostheses seems to reduce the impact of environmental barriers. Support and training may facilitate the embodiment of myoelectric prosthesis use. Clinical relevance For successful prosthetic rehabilitation, environmental factors such as support and information to the patient and their social network about the benefits of prosthesis use are important. Local access to training in myoelectric control gives more people the opportunity to adapt to prosthesis use and experience less environmental barriers.