Biomedical Engineering Reference
In-Depth Information
• The AT/aid assignment's processes were implemented by the Italian Public Health
Service, in which there are two legal systems, a national and a regional (which
decides itself how many local services must be established). The regional system
decides the operating guidelines within which each local health service can define
its own work processes. Over time, this system has led to a heterogeneity of pro-
cesses, with similarities mainly deriving from the regional guidelines and from
the national legal obligations (e.g., Federici and Borsci 2011): the initial request, the
fitting (for some aids and prostheses and for some local services only), the supply,
and heck on follow-up of use (for some aids and for some local services only).
• The assessment process, Matching Person and Technology (Scherer 1998; Scherer
and Craddock 2002), containing the unique validated Assistive Technology Device
Predisposition Assessment mentioned in the literature for matching the AT to the
consumer, which allows one to assess the features of a person, environment, and
technologies that interact when the AT assignment is considered.
The new model is the result of a decennial collaboration among the Sapienza University
of Rome and the University of Perugia (Italy), the Institute for Matching Person and
Technology of Webster (NY, United States), and the Leonarda Vaccari Institute in Rome
(Italy). In that period various processes have been integrated within the biopsychosocial
model of the ICF. The theoretical model created by these processes was shared with all
of the authors of the guide (professionals and researchers studying AT/aids from many
nationalities) that have been able to verify it and integrate it through the analysis of the
processes existing in real life. The proposed model that is presented here is therefore the
result of cross-cultural studies, both clinical and experimental, collected during this long-
standing cooperation. This model, far from seeking to prefigure a “gold standard,” instead
sought to create a structure that allows one to build or to change the existing processes so
that they can consider more variables, such as the nature of disability, personal motivation
and enthusiasm of the person with a disability and family members, and social and
political context and availability of human and financial resources within user-driven
processes and in the context of the biopsychosocial model of the ICF.
The ATA Process Under the Lens of the ICF Biopsychosocial Model
The ICF (WHO 2001) and ICF-CY (WHO 2007) provide a unified standard framework
for an ATA process in centers for technical aid, allowing them to seek the best match
of user/client-assistive solution by means of a comprehensive set of clinical measures,
functional analysis (see Chapter 3 and 4), and psycho-socio-environmental evaluations
(see Chapter 5). The best assistive solution can be achieved only by taking into account
the specific context of use, with the AT as a mediator of quality of life: In this way, the ATA
process, whether
from the perspective of the user/client or
from the perspective of the
center for technical aid, must be read under the ICF biopsychosocial model (Figure I.1).
Both the user's perspective and the actions of the centre for technical aid are illustrated
as follows:
A. User
a. The user (request) seeks a solution for one or more ICF components: body func-
tions and structures (health conditions), activities and participation, both with
a context of personal and environmental factors.
b. The user request triggers the user-driven process.
