Tuersley Lorna, Quaye Naa Amua, Pisavadia Kalpa, Edwards Rhiannon Tudor, Bray Nathan
Centre for Health Economics and Medicines Evaluation (CHEME), School of Health Sciences, Bangor University, Gwynedd, United Kingdom.
Academy for Health Equity, Prevention and Wellbeing (AHEPW) School of Health Sciences, Bangor University, Gwynedd, United Kingdom.
PLoS One. 2025 Jan 10;20(1):e0312967. doi: 10.1371/journal.pone.0312967. eCollection 2025.
Personal wheelchair budgets (PWBs) are offered to everyone in England eligible for a wheelchair provided through the National Health Service (NHS) to support their choice of equipment. The WATCh (Wheelchair outcomes Assessment Tool for Children) and related WATCh-Ad for adults are patient-centred outcome measures (PCOMs) developed to help individual users express their main outcome needs when obtaining a wheelchair and rate their satisfaction with subsequent outcomes after receiving their equipment. Use was explored in a real-world setting, aiming to produce guidance for use alongside the PWB process.
Three wheelchair service provider organisations across four sites participated. Staff and users completed surveys about their experience of assessments using the WATCh and/or WATCh-Ad. Selected patients were interviewed after receipt of their equipment, and staff were interviewed after experiencing a number of assessments. Thematic analysis was undertaken using the tool, survey and interview data. Results of pre- and post-equipment provision were presented graphically.
Information on 75 assessments by 15 staff was obtained. Three-quarters of users or their carers rated the use of the tools in the assessment process as 'helpful' or 'very helpful'. Staff reported that the WATCh or WATCh-Ad had been considered 'useful' in developing individual care plans in around 1 in 3 cases and affected the prescription in 1 in 4 cases. Concerns were expressed about the length of time taken to administer the tools in clinic. However, some staff noted this reduced with more hands-on experience and by providing the tools to users in advance of the appointment.
The WATCh and WATCh-Ad PCOMs are suitable for routine use by wheelchair service providers to assist the assessment process. It is recommended that tool materials are provided in advance to users/carers and that staff are allowed time to develop their ways of working with them.
在英格兰，个人轮椅预算（PWBs）提供给所有有资格通过国民医疗服务体系（NHS）获得轮椅的人，以支持他们选择设备。儿童轮椅结果评估工具（WATCh）及相关的成人版WATCh-Ad是以患者为中心的结果测量工具（PCOMs），旨在帮助个体用户在获取轮椅时表达其主要结果需求，并对收到设备后的后续结果满意度进行评分。在实际环境中对其使用情况进行了探索，旨在生成与个人轮椅预算流程配套使用的指南。
来自四个地点的三家轮椅服务提供商组织参与其中。工作人员和用户完成了关于使用WATCh和/或WATCh-Ad进行评估的经验的调查。部分选定患者在收到设备后接受了访谈，工作人员在经历多次评估后接受了访谈。使用该工具、调查和访谈数据进行了主题分析。以图表形式呈现了设备提供前后的结果。
获得了15名工作人员进行的75次评估的信息。四分之三的用户或其护理人员将工具在评估过程中的使用评为“有帮助”或“非常有帮助”。工作人员报告称，在约三分之一的案例中，WATCh或WATCh-Ad被认为在制定个人护理计划方面“有用”，在四分之一的案例中影响了处方。有人对在诊所使用这些工具所需的时间长度表示担忧。然而，一些工作人员指出，随着实践经验的增加以及在预约前向用户提供这些工具，所需时间会减少。
WATCh和WATCh-Ad PCOMs适用于轮椅服务提供商的常规使用，以协助评估过程。建议提前向用户/护理人员提供工具材料，并给予工作人员时间来改进使用这些工具的工作方式。
