Biomedical Engineering Reference
In-Depth Information
MODERATING FACTORS
Recipients' use of AT
Device type
Amount of use
Manner of use
Background and context
Social support
Environmental accessibility
Living arrangements
Quality of relationship
Duration of caregiving
STRESSORS
Primary
Secondary
CAREGIVERS' OUTCOMES
Areas if assistance
Forms of assistance
Number of tasks
Time required
Safety and security of tasks
Physical effort/work
Role overload
Elective use of time
Home modifications
Quality of life
Psychological health factors
Physical health
Participation
MEDIATING FACTORS
Personal resources
Coping strategies
Self-eŠcacy
FIgUre 5.2
A conceptual framework for understanding outcomes experienced by caregivers who assist assistive technol-
ogy users. (Reprinted with permission Demers, L. et al.,
American Journal of Physical Medicine & Rehabilitation
,
88
(8), 645- 655, 2009.)
5.3.3 Conceptual Framework 3
Given the inter-related outcomes of assistance users and their informal caregivers, it
seems logical that informal caregivers should be included as key players in the AT pre-
scription process. Rather than involve informal caregivers in an ad hoc manner, on the
basis of our work in the area, we recommend working with assistance users and their
informal caregivers using a five-step process (described in Table 5.1). Conceptual frame-
work 3 was developed as part of an experimental study to ensure the intervention was
safe, feasible, and relevant to the targeted individuals. To develop this model we used
an iterative process that involved delineating the intervention in consultation with clini-
cians, assistance users, and caregivers and preliminary testing of the intervention with
two dyads. This approach is congruent with the ATA process, but it explicitly acknowl-
edged the role of the informal caregiver in this process and is not necessarily based in a
center for technical aid. According to this model, the process begins with identification
and assessment of problematic activities that have been selected cooperatively by the
assistance user and his or her informal caregiver(s). After the identification of potential
strategies, the best potential strategy is identified for trial implementation by the user/
caregiver dyad. After AT provision and training, desired outcomes are reassessed. The
process will continue until an appropriate solution is found or all options have been
exhausted.
