Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
Assistive Technology Center, Ohio State University Wexner Medical Center, Columbus, OH, USA.
Disabil Rehabil Assist Technol. 2022 Nov;17(8):853-871. doi: 10.1080/17483107.2022.2111609. Epub 2022 Aug 16.
Complex rehabilitation technologies (CRT) support independence for individuals with disabilities by enabling mobility for function, employment, education, and independent living. CRT service delivery is evolving, with changes to funding, provider qualifications, consumer needs, and technological advances. This scoping review investigated service delivery processes for individuals with disabilities who have a mobility impairment, while specifically identifying best practices, barriers, and unique features of health delivery policies and practices.
We used a framework described by Colquhoun for conducting scoping reviews, a six-step process that includes: 1) identifying the research question, 2) identifying studies, 3) selecting studies 4) data charting, 5) reporting results and 6) consultation. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was also used for reporting results of the review.
Common categories were identified and organised into a hierarchical structure of four categories and 16 sub-categories. The primary categories included "policy", "consumer", "service delivery", and "wheeled mobility devices". The sub-categories described funding sources, consumer and professional populations, service delivery guidelines, and types of mobility devices. Analysis indicated the data were from 21 countries and 14 combinations of funding sources, and the articles were primarily descriptive studies.
This scoping review identified evidence from various countries, health systems, and stakeholder. Currently, this process does not proactively address the needs of individuals with mobility disabilities. The scoping review provides the foundation for the development of a novel policy on the provision of CRT services and devices to address these needs.Implications for RehabilitationExamination of national and international service delivery practices in diverse clinical and funding environments indicate various challenges and opportunities for improvement.CRT consumers are negatively impacted by current service delivery practices, including long wait times, lack of specialised clinical expertise, and limited consumer education opportunities.More consistent and widespread research is needed within the CRT provision industry to grow evidence-based practice related to complex rehabilitation technology and individuals with disabilities.
通过实现功能、就业、教育和独立生活的移动能力，为残疾人士提供复杂康复技术（CRT）以支持其独立性。随着资金、供应商资格、消费者需求和技术进步的变化，CRT 服务的提供正在发生变化。本范围审查旨在研究具有行动障碍的残疾人士的服务提供流程，同时明确最佳实践、障碍以及健康提供政策和实践的独特特征。
我们使用了 Colquhoun 描述的框架来进行范围审查，这是一个包括六个步骤的过程：1）确定研究问题，2）识别研究，3）选择研究，4）数据图表，5）报告结果，6）咨询。还使用了系统评价和荟萃分析扩展的首选报告项目（PRISMA-ScR）来报告审查结果。
确定了常见类别，并将其组织成四个类别和 16 个子类别的层次结构。主要类别包括“政策”、“消费者”、“服务提供”和“轮椅移动设备”。子类描述了资金来源、消费者和专业人群、服务提供指南以及各种移动设备的类型。分析表明，数据来自 21 个国家和 14 种资金来源的组合，并且这些文章主要是描述性研究。
本次范围审查从不同国家、卫生系统和利益相关者中确定了证据。目前，该过程并未主动解决行动障碍人士的需求。该范围审查为制定提供 CRT 服务和设备的新政策提供了基础，以满足这些需求。
在各种临床和资金环境下，对国家和国际服务提供实践的检查表明了改进的各种挑战和机会。CRT 消费者受到当前服务提供实践的负面影响，包括长时间等待、缺乏专业临床专业知识和有限的消费者教育机会。需要在 CRT 供应行业内进行更一致和更广泛的研究，以增加与复杂康复技术和残疾人士相关的循证实践。
