Campeau-Vallerand Charles, Michaud François, Routhier François, Archambault Philippe S, Létourneau Dominic, Gélinas-Bronsard Dominique, Auger Claudine
School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.
JMIR Rehabil Assist Technol. 2019 Oct 26;6(2):e13560. doi: 10.2196/13560.
In order to prevent pressure ulcers, wheelchair users are advised to regularly change position to redistribute or eliminate pressure between the buttocks region and the seat of the wheelchair. A power tilt-in-space wheelchair (allowing simultaneous pivoting of the seat and the backrest of the wheelchair toward the back or front) meets many clinical purposes, including pressure management, increased postural control, and pain management. However, there is a significant gap between the use of tilt as recommended by clinicians and its actual usage. A Web-based electronic health (eHealth) intervention, including a goal setting, monitoring, reminder, and feedback system of the use of power tilt-in-space wheelchairs was developed. The intervention incorporates behavior change principles to promote optimal use of tilt and to improve clinical postprocurement follow-up.
This study aimed to conduct a formative evaluation of the intervention prototype to pinpoint the functionalities needed by end users, namely, power wheelchair users and clinicians.
On the basis of an evaluation framework for Web-based eHealth interventions, semistructured interviews were conducted with power wheelchair users and clinicians. A content analysis was performed with a mix of emerging and a priori concepts.
A total of 5 users of power tilt-in-space wheelchairs and 5 clinicians who had experience in the field of mobility aids aged 23 to 55 years were recruited. Participants found the Web interface and the physical components easy to use. They also appreciated the reminder feature that encourages the use of the tilt-in-space and the customization of performance goals. Participants requested improvements to the visual design and learnability of the Web interface, the customization of reminders, feedback about specific tilt parameters, and the bidirectionality of the interaction between the user and the clinician. They thought the current version of the intervention prototype could promote optimal use of the tilt and improve clinical postprocurement follow-up.
On the basis of the needs identified by power wheelchair users and clinicians regarding the prototype of a power tilt-in-space wheelchair monitoring system, 3 main directions were defined for future development of the intervention. Further research with new wheelchair users, manual tilt-in-space wheelchairs, various age groups, and family caregivers is recommended to continue the formative evaluation of the prototype.
为预防压疮，建议轮椅使用者定期变换姿势，以重新分配或消除臀部区域与轮椅座位之间的压力。电动空间倾斜轮椅（可使轮椅座位和靠背同时向前或向后枢转）满足许多临床需求，包括压力管理、增强姿势控制和疼痛管理。然而，临床医生推荐的倾斜功能使用与实际使用情况之间存在显著差距。为此开发了一种基于网络的电子健康（eHealth）干预措施，其中包括电动空间倾斜轮椅使用的目标设定、监测、提醒和反馈系统。该干预措施纳入了行为改变原则，以促进倾斜功能的最佳使用并改善临床采购后随访。
本研究旨在对干预原型进行形成性评估，以确定最终用户（即电动轮椅使用者和临床医生）所需的功能。
基于基于网络的eHealth干预措施的评估框架，对电动轮椅使用者和临床医生进行了半结构化访谈。采用新兴概念和先验概念相结合的方式进行内容分析。
共招募了5名电动空间倾斜轮椅使用者和5名在移动辅助器具领域有经验的临床医生，年龄在23至55岁之间。参与者发现网络界面和物理组件易于使用。他们还赞赏鼓励使用空间倾斜功能的提醒功能以及性能目标的定制。参与者要求改进网络界面的视觉设计和易学性、提醒的定制、关于特定倾斜参数的反馈以及用户与临床医生之间交互的双向性。他们认为当前版本的干预原型可以促进倾斜功能的最佳使用并改善临床采购后随访。
根据电动轮椅使用者和临床医生对电动空间倾斜轮椅监测系统原型的需求，为该干预措施的未来发展确定了3个主要方向。建议对新的轮椅使用者、手动空间倾斜轮椅、不同年龄组和家庭护理人员进行进一步研究，以继续对该原型进行形成性评估。
