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

Abstract

Adults with spinal cord injury (SCI) use mobile shower commodes (MSCs) to facilitate intimate hygiene, mobility, and neurogenic bowel management. This thesis explored the design, use, and usability of MSCs for this population. The primary original contribution of the thesis was the development and preliminary psychometric assessment of a questionnaire assessing MSC usability.A standardised development methodology, drawn from literature on health measurement scales, was used. Indicators of MSC usability were derived from a comprehensive review of the literature, and interviews with seven Australian adults with SCI and eight occupational therapists experienced in SCI rehabilitation. The questionnaire was drafted using consensus approaches. It subsequently interval] (n = 27); and strong, positive correlations with two established instruments. Usability of MSCs was then described through a retrospective analysis of these data. Overall, the majority of participants rated MSC usability as high to very high across the eMAST 1.0's two subscales.However, over 20% of participants rated usability as very low to low for portability, stability, seat cushioning, and lower leg supports. Analysis of item-level indicators and qualitative comments highlighted specific areas of reduced usability, and identified MSC stability, maintenance and durability, and seating as areas requiring urgent research attention. Findings suggested that by capturing user-identified criteria, the eMAST 1.0 could facilitate comparison and discrimination between MSC designs during refinement and selection. Indicators could also be tracked, allowing item-level usability changes to be detected over time. These findings require validation with larger samples of adults with SCI. Studies involving attendant caregivers, and stakeholders involved in MSC development and service delivery, are also needed. Such approaches could inform further development of the eMAST 1.0, and in turn impact the design, performance, and usability of MSCs in this important area of SCI management.iii Declaration by authorThis thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text. I have clearly stated the contribution by others to jointly-authored works that I have included in my thesis. Analysis and interpretation of the data (5%)Reviewed drafts of writing (50%) xii Friesen, E. L., . Assistive technology devices for toileting and showering used in SCI rehabilitation-a comment on terminology.