Stier Carly D, Chieu Ivan B, Howell Lori, Ryan Stephen E
a Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Ontario , Canada.
b Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada.
Disabil Rehabil Assist Technol. 2017 Jul;12(5):450-456. doi: 10.3109/17483107.2016.1139634. Epub 2016 Jun 13.
This study examined parent-reported change in the functional performance of four school-aged children with wheeled mobility needs who had used a new adaptive seating system for 6 weeks.
The collective case study involved four mothers whose children, ages 6-9 years, received a new adaptive seating system for a manual wheelchair or stroller. Mothers completed the Family Impact of Assistive Technology Scale for Adaptive Seating (FIATS-AS) at the time their child received a new seating system, and then after 6 weeks of daily use. Other questionnaires, health records, and semi-structured interviews provided additional data about the seating interventions and their functional effects on individual children and their families.
The FIATS-AS detected overall functional gain in one family, and both gains and losses in 2-7 dimensions for all families. Functional status and change scores showed consistency with measures of seating intervention satisfaction, global functional change, and home participation. Interview themes also suggested consistency with change scores, but provided a deeper understanding of important factors that influenced adaptive seating outcomes.
This study supports the need to explore further the complexity, temporality and meaningfulness of adaptive seating outcomes in individual children and their families. Implications for Rehabilitation Assistive technology practitioners need to adopt practical measurement strategies that consider the complexity, temporality, and meaningfulness of outcomes to make evidence-informed decisions about how to improve adaptive seating services and interventions. Health measurement scales that measure adaptive seating outcomes for service applications must have adequate levels of reliability and validity, as well as demonstrate responsive to important change over time for individual children and their families. Needs-specific measurement scales provide a promising avenue for understanding functional outcomes for individual children and youth who use adaptive seating systems.
本研究调查了4名有轮式移动需求的学龄儿童在使用一种新型适应性座椅系统6周后，家长报告的其功能表现的变化。
这项集体案例研究涉及4位母亲，她们6至9岁的孩子获得了用于手动轮椅或婴儿车的新型适应性座椅系统。母亲们在孩子收到新座椅系统时，以及在每天使用6周后，完成了适应性座椅辅助技术家庭影响量表（FIATS - AS）。其他问卷、健康记录和半结构化访谈提供了关于座椅干预及其对个别儿童及其家庭功能影响的额外数据。
FIATS - AS检测到一个家庭整体功能有所提升，所有家庭在2至7个维度上有增有减。功能状态和变化分数与座椅干预满意度、整体功能变化和家庭参与度的测量结果一致。访谈主题也显示与变化分数一致，但更深入地理解了影响适应性座椅效果的重要因素。
本研究支持有必要进一步探索个别儿童及其家庭中适应性座椅效果的复杂性、时效性和意义。对康复的启示辅助技术从业者需要采用切实可行的测量策略，考虑结果的复杂性、时效性和意义，以便就如何改善适应性座椅服务和干预做出基于证据的决策。用于服务应用的测量适应性座椅效果的健康测量量表必须具有足够的信度和效度，并且要证明对个别儿童及其家庭随时间的重要变化有反应。针对特定需求的测量量表为理解使用适应性座椅系统的个别儿童和青少年的功能结果提供了一条有前景的途径。
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