Biomedical Engineering Reference
In-Depth Information
inadequacy. Most of the equipment that was abandoned was done so immediately or within
the first year of use.
The predisposition to the use of technology is multifaceted and includes the needs,
abilities, preferences, previous experiences with technology, personality factors, expecta-
tions, and many other variables. A cross-cultural analysis (Federici et al. 2003) confirmed
the hypothesis of a relationship between self-representation of disability (assessed with
the WHODAS II), coping strategies [measured by the Coping Inventory for Stressful
Situation—CISS (Endler and Parker 1999)], and the individual predisposition to the use of
AT [assessed with the Survey of Technology Use (SOTU)].
In all studies, we highlight the central role of the user during the whole process of AT
selection (aid assignment), by informed choice, trial use, then the use of technology to
produce a noticeable advantage in terms of efficiency, satisfaction, acquisition of greater
autonomy, and improving the quality and way of life (Lenker and Paquet 2004). The com-
plexity of matching user and technology requires a person-centered approach and, thus,
a more complete assessment of the user before the AT selection/assignment. In addition, a
better training of professionals and service providers and an appropriate training of users
on the ATs will facilitate decisions regarding the AT assignment, thus reducing the likeli-
hood of AT abandonment.
Indeed, the need to assign an AT that enhances the individual skills and quality of life
often clashes with the nonuse or abandonment of AT or with the non-optimal use of it.
The MPT is the first theoretical model that has focused on the involvement of the per-
son with a disability in the process of assigning the aid. Because the lived experience
of disability is subjective and unique, there is need for a comprehensive user-centered
evaluation that gives the user the opportunity to express preferences and individual and
psychosocial characteristics (Scherer 2005).
According to Scherer (2002), only through a thorough evaluation can the following be
identified:
• The need to change the environment or support from others to enable use of the
AT,
• The impact of related limitations,
• The balance between the functional capabilities and limitations,
• The need for training and the identiication of contexts for trial use (home, school,
and work),
• The most cost-eficient AT for the user in terms of usability and aesthetics, and
• The extent to which the AT meets the needs of the consumer at follow-up and the
existence of any unforeseen and undesirable side effects.
The ultimate goal of the selection/assignment process is to improve the performance
and quality of life of the individual, in which a quality lifestyle and wellness means “the
entire universe of human life domains, including physical, mental and social features that
constitute what may be called a good life” (ICF 2001). If the aid does not perform this func-
tion, it will not, or rather should not be, used.
3.2.3 The MPT Process and Measures
Table 3.1 lists the MPT process and measures with their intended purpose. It endeavors to
follow the GOOD principles.
