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| Wheelchair prescription in the western region of the Eastern Cape | |
| Duffield;Svenje | |
| 出版年 | 2013 |
| 学位授予单位 | Stellenbosch : Stellenbosch University |
| 英文摘要 | Thesis (MScPhysio)--Stellenbosch University, 2013. ENGLISH ABSTRACT: Background: Access to wheelchairs is considered a basic human right. Wheelchairs enhance function, improve independence, and enables persons with disabilities to successfully live in the community. An inappropriate wheelchair may however limit function rather than promote it. Achieving an ideal match between user and technology, however is challenging. A recent audit in the Eastern Cape revealed that standard folding frame type wheelchairs were predominantly being issued and waiting list for wheelchairs is long. The need for investigation into prescription practice, from the perspective of both prescribing therapists as well as wheelchair users, was identified. Aims: To describe wheelchair prescription practice in the public sector of the Eastern Cape; and to determine whether the wheelchairs being issued address the psychosocial needs of users. Study design: A descriptive mixed-method cross-sectional study design was used. Quantitative and qualitative data from questionnaires and functional wheelchair skills tests of wheelchair users (Phase 1) and from semi-structured interviews with prescribing therapists (Phase 2) was used to describe prescription practice and investigate the psychosocial needs of wheelchair users. Methods: A small sample of convenienve according to home address was obtained that included 30 users (15 from a rural; 15 from a semi-rural setting). The Psychosocial Impact of Assistive Devices Scale (PIADS) questionnaire, Functioning Everyday with a wheelchair (FEW/FMA) scale and a self-compiled wheelchair specifications checklist (WSC) were used to determine user functionality and level of satisfaction with the wheelchair. Purposive sampling was done to identify the therapists that had prescribed the wheelchairs for the participants in the first phase of the study. A semi- structured interview was used to determine prescription practice including perceived barriers of wheelchair prescription with ten prescribing therapists. Data analysis: Qualitative data was analysed deductively and frequency of responses tabulated. Quantitative data was summarised as means and standard deviations and subgroup analysis comparisons were done using the Chi-square test and relationships between variables investigated using Pearson/ Spearman correlation or ANOVA. A p < 0.05 was deemed significant. Results: Eighty three % of wheelchairs issued were urban wheelchairs. These are generally perceived by users as sufficient to address their psychosocial needs regarding mobility and transport, however, seem to fail users in terms of accessibility and independence within their rural/ semi- rural environment. According to the WSC scores, peri-urban wheelchairs were found to be more appropriate for the users than urban wheelchairs (p < 0.01). No significant relationships were found between wheelchair fit, use of a cushion, occurrence of pressure sores and self-perceived psychosocial needs in this sample. The users experienced most difficulty with outdoor mobility (57% needed full assistance) and transport (63% needed full assistance) within their current wheelchairs. Ten prescribing therapists participated in the study. Most valued appropriate seating, are knowledgeable regarding prescription practice, but reported several barriers to this practice including budget restraints (90%), time to delivery (100%) and lack of training (40%). The need for more appropriate wheelchair designs to suit multi- level manoeuvrability of persons in rural/ semi-rural environments was also reported (60%). Conclusion: The results of this study show that wheelchair prescription in the Western Region of the Eastern Cape (WRoEC) has various challenges. Although the wheelchair users were mostly satisfied with their wheelchairs, this study identified areas for improvement in the users’ functioning, postural support and biomechanics within their wheelchairs, especially as it relates to their h |
| 英文关键词 | Psychosocial impact Wheelchairs Dissertations -- Physiotherapy Theses -- Physiotherapy |
| URL | http://hdl.handle.net/10019.1/85769 |
| 来源机构 | Stellenbosch University |
| 资源类型 | 学位论文 |
| 条目标识符 | http://119.78.100.177/qdio/handle/2XILL650/247279 |
| 推荐引用方式 GB/T 7714 | Duffield;Svenje. Wheelchair prescription in the western region of the Eastern Cape[D]. Stellenbosch : Stellenbosch University,2013. |
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