Biomedical Engineering Reference
In-Depth Information
factors are changeable and which are not (Threats 2003, 2007; Howe 2008; Geyh et al. 2011).
Ethnicity, language, cultural background, gender, age, developmental level, sexual orienta-
tion, and sexual identity are all unchangeable personal factors that highly affect, in a given
context, the relation of the user/client with technology (Threats 2003, 2007; Howe 2008;
Geyh et al. 2011). This distinction plays a central role because the psychologist, according to
the humanistic and cross-cultural psychology principles (Olkin 1999), promotes the user/
client's awareness of the individual resources on which he or she can operate to obtain the
best person-technology matching and empowers user/client well-being. In other words,
the team of the center for technical aid operates not only to turn environmental barriers
into facilitators but also to motivate the user/client to do the same on his or her adjustable
individual resources. The psychologist encourages the user/client to explore his or her
individual features and to leverage on all of his or her personal factors that can disclose an
adaptive potential in a given context.
Another main distinction within personal factors concerns the difference between objec-
tive and subjective factors. As reported by Wade, “the focus of rehabilitation is the patient's
activities, their behavior” (2000, p. 115), but “the nature of a patient's beliefs and expecta-
tions can influence the extent and nature of disability, and indeed may on occasion be the
primary cause” (p. 117). The subjective dimension of functioning has been described by
Ueda and Okawa (2003) as a combination of negative and positive subjective experiences
situated at a “psychological-existential level” (Ueda and Okawa 2003, p. 599). The subjec-
tive dimension is strictly linked with the objective one, interrelated and interacting but also
strongly independent of each other. Ueda and Okawa (2003) make a distinction between
personal factors and the subjective dimension because they put almost all of the traits pro-
posed in literature as belonging to personal factors within the objective level. Aside from
whether or not any consideration of the subjective dimension of functioning is gathered by
the personal factors of the ICF and the extent to which they overlap, there is no doubt that
the “psychological-existential level” should be held in high consideration by the psycholo-
gist. In other words, objective and subjective dimensions are concerned with the different
point of view of individual functioning: On the side of the professional, most of the ICF's
dimensions can be viewed as objective dimensions, for a codifiable and measurable indi-
vidual functioning; on the side of the user/client, most of the ICF codes are relevant insofar
as these are elements of subjective individual functioning or disability experience. Because
the goal of the ATA process is user/client well-being, by providing the best match of user/
client and assistive solution, with human well-being as an outcome of a subtle equilibrium
between the subjective and objective dimension of health (Sen 2002; Federici and Olivetti
Belardinelli 2006; Chapter 2 of this text), the psychologist then should pay significant atten-
tion to balancing the subjective and objective factors by mediating between the user/
client's request and the multidisciplinary team's assistive solution provision.
The psychologist should give special attention to the difference between body functions
and personal factors. As reported by Threats (2007), there has been some confusion in the
literature between those two components and it is really important to make the right attri-
bution, especially during the assessment stage. In a center for technical aid this distinction
may become particularly relevant when the professional measures the predisposition of
the user/client to the use of technology. Technology use was found to be influenced not
only by factors associated with the user's environment and technology characteristics, but
also by nature, characteristics of the purpose of use, and by personal characteristics of the
user (Scherer 1998, 2002). Properly encoding the predisposition to the use of the technol-
ogy allows for the identification of the best-matching solution. For example, if a client with
palsy due to a car accident indicates that he was not confident with technology prior to the
