RESUMEN
BACKGROUND: Environmental control systems (ECS) are devices that enable people with severe physical limitations to independently control household appliances. Recent advancements in the area of environmental control technology have led to the development of ECS that can be controlled through mainstream smart-devices. There is limited research on ECS within Australia and no known research addressing smart-device ECS. The current study sought to explore users' experiences with smart-device ECS within Australia. METHODS: The study followed a single embedded case study method. Participants (n = 5) were existing ECS users with a cervical spinal cord injury. Data were collected through semi-structured interviews with participants, reflexive journals and field notes. An inductive approach was used to analyze the data thematically. RESULTS AND CONCLUSIONS: The experience of using a smart-device ECS presented both opportunities and costs to users. The opportunities included: independent control, choice, peace of mind, connection, effective resource use, and control over smart-phone functions and applications. The associated costs included: financial, time, frustration, and technical limitations. While findings are similar to previous research into traditional ECS this study indicates that smart-device ECS also offered a new opportunity for users to access mainstream smart-device functions and applications. Future research should investigate methods and resources that practitioners could utilize to better support new users of smart-device ECS. Implications for Rehabilitation As with traditional environmental control systems, users of smart environmental control systems report increased independence, choice and control. Smart-device environmental control systems provide users with access to mainstream smart-device functions and applications, which facilitate connection to family and the outside world. The costs to the user of smart-device environmental control systems include monetary and time investment, dealing with technical limitations and resulting frustration. Prescribers and installers must consider ways to mitigate these costs experienced by users.
Asunto(s)
Médula Cervical/lesiones , Computadoras de Mano , Personas con Discapacidad/rehabilitación , Dispositivos de Autoayuda , Traumatismos de la Médula Espinal/rehabilitación , Adulto , Costos y Análisis de Costo , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Queensland , Teléfono Inteligente , Factores de Tiempo , Interfaz Usuario-Computador , Adulto JovenRESUMEN
PURPOSE: Environmental control systems (ECSs) can potentially influence comfort, safety, security and independence for people with severe impairment from spinal cord injury (SCI). This study, aimed at informing prescription practises, investigated ECS prescription and utilisation from the consumer perspective. METHODS: Qualitative inquiry, through 15 semi-structured interviews, explored the perspectives of people with high level SCI who use ECSs. Data were coded and clustered to provide a description of their perspectives and interpret lessons for prescribers. RESULTS: The data were grouped into six coding clusters related to readiness to engage, training, autonomy, utility, utilisation and attitudes towards the ECS. Data revealed variability in readiness to embrace ECSs during rehabilitation, some frustration related to setting up systems and instances of ECSs not being used to their full potential. Some highly motivated participants found reward through perseverance. All participants valued having some level of autonomy and personal security. Significant implications for prescribers are described. CONCLUSIONS: Understanding the influence of factors related to devices, personal characteristics and individual context on ECS usage can guide clinicians in prescription and training processes to facilitate maximum and ongoing benefit from ECSs. A culture of follow-up and evaluation is to be encouraged. Implications for Rehabilitation A variety of factors may influence whether a person with severe impairment from spinal cord injury fully utilises and persists with using an environmental control system (ECS). Findings from this study illustrate the importance of client readiness for prescription and the influence of client perceptions of value, convenience and aesthetics on ECS use. Prescribers should seek to understand what each client needs to become engaged and proficient with ECS use. Prescribers should be knowledgeable about suggested ECSs. Prescribers should prepare clients for potential difficulties in establishing reliable ECS use and establish support mechanisms to facilitate perseverance until effective ECS use is established.