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Aims: To explore the person, environment, and occupation-related self-management strategies used by older Hispanic men to cope with disabilities in different types of daily activities. Methods: A concurrent transformative mixed method design (with priority given to the qualitative phase) guided by the Environment and Occupational Performance Model was used to collect and analyze data of 12 participants with functional disabilities. Quantitative data was gathered using the PROMIS Physical Function Short Form-20. Qualitative data was obtained from in-depth semi-structured interviews on participants' self-management strategies. Results: The average T-score (35.96) was below the national average. Participants reported higher levels of functional disabilities in instrumental activities of daily living (IADL), and predominantly used practical social support and change in method of performance to manage their difficulties in self-care, IADL, and functional mobility activities. Conclusions: These strategies may be used with similar populations to design interventions aimed at increasing older Puerto Rican's function.
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INTRODUCTION: Community engagement (CE) is critical for research on the adoption and use of assistive technology (AT) in many populations living in resource-limited environments. Few studies have described the process that was used for engaging communities in AT research, particularly within low-income communities of older Hispanic with disabilities where limited access, culture, and mistrust must be navigated. We aimed to identify effective practices to enhance CE of low-income Hispanic communities in AT research. METHODS: The community stakeholders included community-based organizations, the community healthcare clinic, the local AT project, and residents of the Caño Martín Peña Community in San Juan, Puerto Rico. The CE procedures and activities during the Planning the Study Phase comprised working group meetings with stakeholders to cocreate the funding proposal for the study and address the reviewers' critiques. During the Conducting the Study Phase, we convened a Community Advisory Board to assist in the implementation of the study. During the Disseminating the Study Results Phase, we developed and implemented plans to disseminate the research results. RESULTS: We identified seven distinct practices to enhance CE in AT research with Hispanic communities: (1) early and continuous input; (2) building trusting and warm relationships through personal connections; (3) establishing and maintaining presence in the community; (4) power sharing; (5) shared language; (6) ongoing mentorship and support to community members; and (7) adapting to the changing needs of the community. CONCLUSION: Greater attention to CE practices may improve the effectiveness and sustainability of AT research with low-income communities.
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PURPOSE: To identify: (1) the most frequently used assistive technology (AT) by a sample of community-living older Hispanics; (2) their AT needs; (3) the AT that would not be used by the simple; and (4) the factors associated with the willingness to use AT. MATERIALS AND METHODS: We used a cross-sectional descriptive study design with a purposive sample of 60 individuals 70 years and older living in Puerto Rico. Data collection tools included a socio-demographic questionnaire and the Assistive Technology Card Assessment. We used descriptive statistics to identify the sample AT use and needs, χ2 to determine the frequency distribution of the socio-demographic variables and the Spearman's rank correlation coefficient (rho) to describe the strength of the association between these variables and the willingness to use AT devices. RESULTS: The sample had unmet needs for AT devices for cooking, home tasks and home safety. A higher number of health conditions as well as having low educational levels were associated with willingness to use AT devices. CONCLUSIONS: Policy implications are discussed supporting the role of rehabilitation professionals, state government and community-based programmes, including the Area Agencies on Aging, in providing culturally relevant AT education and accessibility to assistive devices. Implications for rehabilitations Hispanic older adults with functional limitations living independently in Puerto Rico have unmet needs for AT devices to compensate for physical limitations and increase safety performance, predominantly in instrumental activities of daily living. New policies need to be developed to advocate for increased healthcare coverage of low tech AT devices that could be highly beneficial to older people with functional limitations. Community-based programs administered by the state government, the Area Agencies of Aging, or operated through Medicare need to be developed to provide education, training, loans, purchasing, and delivery of low AT devices that can compensate for older people functional limitations.
Assuntos
Pessoas com Deficiência/reabilitação , Hispânico ou Latino , Vida Independente , Tecnologia Assistiva/estatística & dados numéricos , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Masculino , Avaliação das Necessidades , Porto Rico , Características de Residência , Fatores SocioeconômicosRESUMO
Assistive technology (AT) is important for individuals with disabilities' independence and participation in daily life, and there is a lack of valid AT outcome tools for the Puerto Rican population. This pilot study examined the content validity of a new adaptation of the Psychosocial Impact of Assistive Device Scale (PIADS): the Puerto Rican-Spanish PIADS (PR-PIADS). Following standard procedures, the cultural adaptation methodology included a bilingual multidisciplinary committee review of the original (English language) and Spanish versions of the PIADS and pilot testing of the preliminary version of the PR-PIADS with 20 AT users. The committee recommended a total of 58 semantic and conceptual modifications of the Spanish PIADS. Pilot data analysis resulted in 4 additional semantic and conceptual modifications of items that did not reach the minimum content validity ratio of 0.42 for a panel composed by 20 members: competence (0), efficiency (-0.6), performance (-0.95), and eagerness to take chances (-0.6). This pilot study demonstrated evidence of initial content validity of the PR-PIADS. Future research is required before using this tool with greater confidence to address the construct validity and reliability that are also critical to a successful cultural adaptation.