How much equipment is prescribed for people with spinal cord injury in Australia, do they use it and are they satisfied 1 year later?

Abstract

Background and purpose: The purpose of this study was to determine the amount and type of equipment prescribed to aid mobility and self-care for patients with spinal cord injuries (SCI) in Australia and to determine how frequently the equipment is used 1 year later and whether patients are satisfied with it. Methods: A consecutive series of 61 patients admitted for rehabilitation to two Sydney SCI units were recruited. All mobility and self-care equipment worth more than $AU50 prescribed by therapists before patients' discharge was recorded. This included wheelchairs, commodes, shower chairs, hoists, electric beds, pressure-relieving cushions, bed mattresses, slideboards, walking aids, orthoses, electrical stimulation systems and other pieces of notable exercise equipment. Patients were interviewed 1 year later and asked about each piece of equipment they had been prescribed. Specifically, they were asked about how frequently they had used each piece of equipment and whether they were satisfied with it. Data were analysed using descriptive statistics. Results: Three hundred and fourteen pieces of equipment, including 68 wheelchairs, were prescribed for the 61 patients. Most of the equipment (226/314) was used more than 20 times in the 2 months preceding the 1-year review. Most patients were satisfied or highly satisfied with the majority of equipment prescribed, although patients were very dissatisfied or only partly dissatisfied with 18/314 pieces of equipment. Discussion: Patients were generally satisfied with the equipment they were prescribed. There was a small amount of equipment prescribed that was not used 1 year later or with which patients were dissatisfied.

"It's more than just a wheelchair that gets wet …": Usability of mobile shower commodes for adults with spinal cord injury

“…As expected, the home was the primary environment of MSC use Harvey et al, 2012) and recommendations to assess the user's routine at home (McIntosh et al, 2005;Queensland Spinal Cord Injuries Service, 2012), rather than in controlled laboratories (Berg Rice, 2008) or clinical settings Hoenig et al, 2007), appear…”

“…Policy can significantly impact funding and reimbursement for AT devices and AT services, including services for AT service, funding, and ongoing maintenance Cooper, , 2009Friesen, Walker, et al, 2015;Harvey et al, 2012;Layton et al, 2015;. This is particularly evident in the Australian context where the National Disability Insurance Scheme (NDIS) is currently being developed and trialled Layton et al, 2015;.…”

“…Dissatisfaction with MSCs, and concerns about their safety during use, are reported across the literature Harvey et al, 2012;. Activities such as transferring between a bed or wheelchair and the MSC, and leaning or reaching to access showering supplies or to undertake digital stool removal and intimate hygiene, are associated with an increased risk of falls (Malassigné, Nelson, Amerson, Salzstein, & Binard, 1993;Zejdlik, 1992).…”

“…Follow up in the short-or long-term after AT device specification and delivery, for example by an AT practitioner, has also been shown to reduce dissatisfaction and non-use of AT devices Lenker et al, 2005;Martin et al, 2011). Follow up by AT practitioners can also help to determine if changes to the AT system are needed Berg Rice, 2008;Harvey et al, 2012;Lenker et al, 2005). As with all AT devices Lenker, Harris, Taugher, & Smith, 2013;Lenker et al, 2005), researchers, policy makers and funders are demanding evidence of outcomes of MSC provision .…”

“…This suggests studies on MSCs should explore their use and performance in the home environment Friesen et al, 2013;Harvey et al, 2012). Separately, researchers and clinicians are seeking to understand the process of AT device selection and refinement during service delivery (Bernd et al, 2009;Friederich et al, 2010;Lenker et al, 2013;Martin et al, 2011).…”