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SURVEYING SATISFACTION OF INTEGRATED CONTROLS USERS

Jennifer Angelo, Ph.D., OTR Elaine Trefler, M.Ed., OTR, FAOTAUniversity of Pittsburgh

ABSTRACT

Twenty-four persons with severe physical disabilities participated in a telephone survey. The survey focused on their satisfaction with areas related to use of an integrated control device. The number of devices that the respondents could operate increased after procurement of the integrated control. The respondents were generally satisfied with their integrated control device. A moderate correlation coefficient was found between gadget appeal and satisfaction with devices. This sample was self-selected and voluntary. Therefore, additional studies in this area need to be conducted to substantiate these findings.

BACKGROUND

Assistive technology devices are now available that allow persons with severe physical disability to complete tasks that were impossible for them to perform only a few years ago. Users of assistive technology (AT) have an average of four devices (Angelo, 1992). In most cases two are high technology and two are low technology. When the user has severe physically limitations, it is advantageous to have one input device control all the output devices. Integrated controls allow users to operate power wheelchairs, augmentative communication device, computer, environmental control unit, and other devices that are controlled electronically. The advantages of integrated controls are that persons with limited motor control can access several devices without assistance. The user does not need to learn a different operating system for each device. Using an integrated control, persons with physical disabilities do not have to wait for an able-bodied person to complete tasks or wait to have the input device positioned. They can control other output devices such as wheelchairs, communication aids, telephones, computers, televisions, window drapes, unlocking doors, and air conditioners at their will. This increases their level of independence, productivity, and provides more options for individuals who have minimal physical control. In addition, the operation of one control takes less valuable space within the users' reach. The disadvantages may include the need for additional training to understand how to operate the control. It may be difficult for users to remember which device they are currently controlling, and if the controller breaks, the whole system may become inoperable. Integrated control devices are recommended for users when they have only one reliable access site and the optimum input device for each assistive device is the same. In addition, integrated control devices are recommended when the user prefers it for aesthetic, performance, or other subjective reasons. Integrated controls technology has been commercially available for some time. However, information to guide and direct those most likely to benefit from integrated controls is grossly lacking (Guerette & Sumi, 1994). There is little information to guide consumers regarding the important features, to guide clinicians who are prescribing the devices as to what characteristics users should possess to make the match successful, or what features manufacturers should include as new models are developed. This leaves consumers, assistive technology practitioners (ATP), assistive technology suppliers (ATS), and manufacturers with limited knowledge as to how to proceed. Reasons that additional information on integrated control is needed are two-fold. First, information in every aspect is limited. Consumers, ATPs, ATSs, and manufacturers operate on experience and intuition. Those inexperienced in dealing with integrated control have little information to guide. Improved information would benefit all. Second information is needed as abandonment is a problem. More information will improve understanding what need to do be done to ensure successful with using integrated control and reduce abandonment.

METHOD

Sample Twenty-four persons completed a telephone survey. The mean age was 34 years. The age range was 16 years to 59 years. Sixty-seven percent of the respondents had spinal cord injuries, 25% had cerebral palsy, 4% had multiple sclerosis, and 4% had head injuries. Seventy-nine percent were male and 21% female. Eighty-eight percent had no physical control over their body from the neck down and 12% had some control over their arms. Procedures A Likert type ranking scale and open-ended questions were used to collect data. Respondents were located through clinicians in North America at institutions who were known to recommend integrated controls. Clinicians indicated the number of clients for whom they had recommended integrated controls to the investigators. A corresponding number of pre-stuffed, stamped envelopes were mailed to each of the clinicians. The clinicians addressed and mailed the envelopes. The envelopes contained a cover letter explaining the project and a postcard. Persons choosing to participate wrote their name and telephone number on the postcard and mailed it. Once the postcards were received, the respondents were called and interviews were arranged at a convenient time.

RESULTS

Data were analyzed using descriptive statistics and correlation coefficients. Types of disability are reported in Figure 1. The range of years with a disability was from 6 to 39 years. The mean was 12.6 years. The evaluation sessions ranged from less then one hour to more than six hours. The mean for an evaluation session was 5 hours and the median one hour. Forty-two percent had more than one evaluation session. Of those individuals who had more than one evaluation session, the range was from one week to more than two months. Fifty-eight percent felt they were included as team members during the evaluation and 42% indicated they did not feel they were team members. The number of respondents who could operate specified devices increased after receiving an integrated control (Figure 2). Forty-two percent received all the pieces at one time and 58% received them sequentially. Respondents were asked what training method and/or persons they found most helpful. The respondents indicated the following groupings as most helpful. Thirty-five percent indicated trial and error as most helpful, 20% said the vendor, 15% said the manual and trial and error, 15% indicated an unidentified method, and 5% each said reading the manual, an evaluation team member, or a family member. Eighty-three percent indicated they were very satisfied or satisfied with the training and 17% were either dissatisfied or very dissatisfied. Ninety-one percent of the respondents indicated they were either very satisfied or satisfied with their integrated controller. Four percent indicated that they were neither satisfied nor dissatisfied and 4% indicated that they were dissatisfied. The respondents were asked on a scale from 1-5 how well they liked gadgets. Five being liked gadgets a lot and one being did not like gadgets at all. Eighty-three percent of the respondents choose a "four" or "five" on the scale, 8% indicated a "three" and 9% indicated a "two" or a "one." Correlation coefficient were computed for 1) general satisfaction with the number of evaluation sessions, 2) general satisfaction with receipt of devices (one at a time versus all at once), and 3) general satisfaction and gadget appeal. No correlations were demonstrated between satisfaction with number of evaluation sessions or satisfaction with receipt of devices (one at a time versus all at once). However, the correlation coefficient between general satisfaction and gadget appeal was moderate (r=.52)

DISCUSSION

Three areas were identified as leading to satisfaction with the integrated controls from the results of this study. One, the introduction of the integrated controller gave the respondents a method of accessing devices that prior to receiving the integrated controller they were unable to operate. Thus, the integrated controller increased their independence. This may in part explain satisfaction with using the integrated controller. Two, 55% of the respondents used either trial and error, trial and error and the manual. Thus, approximately half of the respondents trained themselves. Another 30% can be identified as using a helper to train using integrated controller. The other 15% used unidentified training methods. Prior to training it may be useful for the assistive technology team to ask the user how they best learn., or how have they trained on other devices? Do they learn by figuring is out on their own, using a manual, or with another person assistance. This information could could be used by assistive technology teams when recommending training methods. Using training methods that appeal the most to users may increase satisfaction. Three, individuals who were satisfied with their integrated controller also liked gadgets. An interest in gadgets may predisposed individuals in working with integrated controls and gaining mastery of them. The respondents in this study were self-selected and volunteers. Therefore, results need to be interpreted cautiously. Further work is needed in order to substantiate these findings. Areas where additional study is needed are 1) increasing the subject pool and 2) studying individuals who abandoned integrated controls.

CONCLUSIONS

This survey demonstrated that persons using integrated controls were generally satisfied with them. This is a useful beginning in this area of research.

REFERENCES

Angelo J. 1992. Satisfaction with Assistive Devices Among Employed Persons. Closing the Gap Presentation, Minneapolis. Guerette, P., Sumi, E. (1994). Integrated control of multiple assistive devices: a retrospective review. Assistive Technology, 67-76.

ACKNOWLEDGMENTS

Funding for this research has been provided by the National Institute on Disability and Rehabilitation Research, U. S. Department of Education, Grant No. H133E300005-95. Opinions expressed in this paper are those of the authors and should not be construed to represent opinions or policies of NIDRR. Jennifer Angelo, Ph.D. O.T.R. Occuaptional Therapy Forbes Tower University of Pittsburgh Pittsburgh, PA 15260