Biomedical Engineering Reference
In-Depth Information
Most of the research on AT use and abandonment took into consideration several factors
such as cost of equipment, physical abilities needed for use, demography, product safety,
and reliability. Specifically, there are three areas of study: (1) the personal characteristics
of users and acceptance of technology, (2) the product features preferred by consumers,
and (3) the inquiries about the AT use. Zola (1982) found that consumers prefer devices
that promote independence associated with psychological and social freedoms, not only
physical functioning. In addition, a number of personal factors have been identified that
may affect the AT use and its acceptance, such as motivation, awareness of disability, goals
of life, and effort-reward ratio. Devices that allow users to complete important tasks are
more likely to be used. In most studies, acquisition cost, durability, reliability, ease of use,
security features, aesthetics, ease of repair, handling/portability, and good instructions
were the most important features for a good AT.
Usually the factors associated with the person are combined with the technology and
environmental features. Philips and Zhao (1993) reported an abandonment of 29.3% for AT,
identifying four factors that are significantly related to AT nonuse and abandonment by
users regardless of type of disability:
1. Change in user needs,
2. AT was easy to obtain,
3. Low performance of the AT, and
4. Lack of consideration of the user's opinion when selecting the AT.
The highest abandonment rate occurred with mobility aids and mainly in the first year
of operation, or after five years, implying an impact both at the individual level in terms of
frustration and depression and at the entire health system level in terms of loss of funds
and funding (Verza et al. 2006).
Zimmer and Chappell (1999) examined the receptivity of 1400 elderly people in the
Canadian province of Manitoba to specific technologies to develop an appropriate model
of understanding. The authors found that receptivity is influenced by the following fac-
tors: predisposition, need, social support, and the individual's level of concern for prob-
lems that could be mitigated through the use of technology. However, on closer analysis
the results showed that the primary concern is home security. Older people often have to
cope with chronic functional problems that limit their activities and their independence.
Therefore, the technology acting on the practical difficulties of the elderly can be an oppor-
tunity to improve their quality of life and a means of coping with disability.
Few studies have investigated the use of AT by children (the pediatric population).
However, in most children with disabilities, use and abandonment of assistive devices are
often influenced by other people close to them, such as parents, teachers, and therapists
(Caudrey and Seeger 1983).
Although there are many models in the AT literature, none of these has been proved
capable of predicting AT use. Lenker and Paquet (2004) have proposed a holistic concep-
tual model that is user-centered, predicts AT use in terms of its perceived benefits, and
considers it a decision-making process that occurs and is shaped over time and not in a
moment. The use of AT has an impact on the user, the environment, and use of the technol-
ogy, but at the same time, the AT impact predicts its future use.
Similar results were obtained from Verza et al. (2006), who demonstrated how a multidis-
ciplinary approach to the evaluation of patients with multiple sclerosis who require AT can
reduce AT abandonment. These authors identified four factors of abandonment: deterioration
of physical state, non-acceptance of aid, failure/lack of information and training, and AT
