Patients’ Satisfaction with Lower-limb Prosthetic and Orthotic Devices and Service delivery in Sierra Leone and Malawi

Abstract

BackgroundPeople with disabilities have the right to personal mobility and available and affordable assistive technology, according to the Convention of Rights of Persons with Disabilities. The aims were to investigate similarities and differences between Sierra Leone and Malawi concerning participants’ mobility and satisfaction with their lower-limb prosthetic or orthotic device and related service delivery, and to identify variables associated with patients’ satisfaction with assistive devices and associated services in the entire study group from these two low-income countries.MethodsQuestionnaires, including QUEST, were answered by 222 patients in Sierra Leone and Malawi.ResultsEighty-six per cent of assistive devices were in use, but half needed repair. One third of participants reported pain when using their assistive device. A higher percentage (66%) of participants in Sierra Leone had difficulties or could not walk at all on uneven ground compared with 42% in Malawi. The majority in both countries had difficulties or could not walk at all up and down hills, or on stairs. Participants in both countries were quite satisfied (mean 3.7–3.9 of 5) with their assistive device. Participants were most dissatisfied with: comfort (46%), dimensions (39%), and safety (38%) of their assistive device. In Sierra Leone participants were less satisfied than in Malawi with service delivery (mean 3.7; 4.4, p < .001). Access to repairs and servicing of their assistive device was considered the most important item. In Sierra Leone patients were less satisfied with follow-up services (41%) than patients in Malawi were (22%). The strongest association with satisfaction with assistive device was pain, and for satisfaction with service, country. The general condition of devices and the ability to walk on uneven ground were associated with both satisfaction with assistive devices and service received.ConclusionsParticipants reported high levels of use and mobility with their assistive device, in spite of pain and difficulties walking on uneven ground, which were also associated with the level of satisfaction with the assistive device. Access to repairs and follow-up services were the most important to patients, and should be addressed. Country was associated with satisfaction with service, with participants in Sierra Leone significantly less satisfied.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2044-3) contains supplementary material, which is available to authorized users.

A conceptual framework for orthotic and prosthetic education

“…after 2006) (Table 2). Ten studies 37,38,40,41,55,59,60,70,87,101 used the Orthotic & Prosthetic User Survey (OPUS) or Quebec User Evaluation of Satisfaction with Assistive Technology (Quest 2.0). Both measures evaluate patient perspectives about professional service.…”

Kronik Engelli Bireylerde Ortez Ve Yardımcı Cihaz Memnuniyetinin Araştırılması

“…Buna bağlı olarak yardımcı cihaz/ortez kullanım memnuniyetini, süresini, konforunu ve etkisini artıracak çözüm odaklı stratejiler geliştirilmesine yardımcı olmaktır. [15]. Yardımcı cihazların tamiri ve bakımı için bakım servislerine ulaşım oldukça önemlidir.…”

“…tekerlekli sandalyeden memnuniyetin kullanım kolaylığı, güvenlik ve aktivite katılımı ile bağlantılı olduğunu ve az miktarda da bakım servisleri ile ilişkili olduğunu bildirmişlerdir [14]. Magnusson ve ark., yardımcı cihazdan memnuniyetsizliğin en çok rahatlık, boyutu ve güvenlikten kaynaklandığını söylemişlerdir [15]. Yardımcı cihazların tamiri ve bakımı için bakım servislerine ulaşım oldukça önemlidir.…”

“…Sierra ve ark. yaptıkları çalışmada, bireyler yardımcı cihazlarının rahatlığından, boyutundan ve güvenliğinden memnun olmazken, cihazın dayanıklılığının, tamir ve bakım servislerine ulaşımın oldukça önemli olduğu vurgulanmıştır [15]. Bireylerin yardımcı cihazlarını daha fazla kullandıkları bildirilirken daha fazla ağrı yaşadıkları, basamak ve zeminde yürümede zorlandıkları görülmüştür.…”

“…Bireylerin yardımcı cihazlarını daha fazla kullandıkları bildirilirken daha fazla ağrı yaşadıkları, basamak ve zeminde yürümede zorlandıkları görülmüştür. Ağrının yardımcı cihazdan memnuniyet düzeyini etkileyen en güçlü faktör olduğu görülmüştür [15]. Ayrıca cihazların kullanılmamasının bir diğer nedeni ise, cihazın zaman içerisinde uygunsuz hale gelmesidir [6].…”