Assistive technology evaluation in spinal cord diseases : facilitators and barriers
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Spinal cord diseases (SCDs) are a set of conditions affecting the spinal cord that can cause functional deficits, disrupting people's identities, purpose, and dignity. Assistive technology (AT) is a vital intervention that enables many people with SCDs to participate in daily activities. Evaluation is the most critical phase in AT provision because all other phases are based on it. A three-round Delphi technique surveyed 18 expert AT providers to identify facilitators for and barriers to AT evaluation. In round one, participants generated ideas about relevant barriers and facilitators. These data were analyzed using conceptual content analysis to identify barriers and facilitators that became the content of the subsequent surveys. In rounds two and three, the participants ranked agreement with each item on a 7- point Likert scale and provided rank orders for the top five barriers and the top five facilitators. Participants also had the opportunity to provide qualitative feedback on each item. Stability was measured using Wilcoxon matched-pairs signed-ranks tests, and consensus was measured using the interquartile range. The final analysis identified 14 facilitators and 10 barriers that achieved both stability and consensus. The top barriers to AT evaluation are largely related to system problems related to the US healthcare landscape. The top facilitators for AT evaluation are largely related to centering the user in the evaluation process.
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Ph. D.