How service users feel about the appearance of assistive equipment

1. How service users feel about the appearance of assistive equipment Natasha Parsons

2. Introduction • Why is it relevant to OT? • What evidence is available? • Summary and justification for the project • Gaps for further research

3. Relevance to OT • Functional design of equipment • ‘Inclusive design’ • Impact on occupational participation and independence

4. Literature review: findings • Attitude towards assistive equipment linked to utilisation (Brooks, USA, 1991) • Population: USA, adults, range of equipment • Mostly beneficial and a ‘key to normality’ • 32% found them restricting, 32% inconvenient, and only 11% were proud of them.

5. Literature review: findings (cont.) • Successful incorporation of equipment into self–image led to greater participation in occupations (Lund and Nygard, 2003) • Population: Sweden, adults, range of equipment • Concern with the negative image of the device was limited to the first mobility device and was temporary (Pippin and Fernie, 1997) • Population: USA, elderly, walking frames

6. Literature review: findings (cont.) • Products that are most visible as disability aids are often the most stigmatised (Mann and Tomita, 1998) • Population: USA, elderly, range of equipment • Products that fit with dominant values associated with functioning were well received e.g. computer technology (Lupton and Seymour, 2000) • Population: Australia, adults, range of equipment

7. Literature review: findings (cont.) • Appearance of the device is an important factor in deciding whether or not to use it. This not only applied to personal devices but also devices for the home (Hirsch et al, 2000) • Population: USA, elderly, range of equipment • More choice leads to more interest in appearance (Pugh and Stansfield, 1989) • Population: UK, adults, adapted cups

8. Summary and justification for project • Acceptance of equipment depends on incorporation of equipment into a self-image of independence, rather than disability • People feel stigmatised when using ‘visible’ equipment  More thoughtful design likely to lead to more acceptance of equipment and increased occupational participation

9. Areas for further research • Investigate occupational participation with equipment designed with function and form in mind. • Demographic variations • Refusal rates

10. References • Barber, Johan (1996). The design of disability products: a psychological perspective, British Journal of Occupational Therapy, 59(12), 561-564 • Brooks, Nancy A. (1991). Users’ responses to ADs for physical disability, Social Science Medicine, 32(12), 1417-1424 • Chamberlain E., Evans N., Neighbour K., Hughes J. (2001). Equipment: is it the answer. An audit of equipment provision, British Journal of Occupational Therapy, 64(12), 595-600 • Christie, I. and Mensah-Coker, G (1999) An inclusive future? Disability, social change and opportunities for greater inclusion by 2010, DEMOS, London • Hawkins, Rachael and Stewart, Sandra (2002). Changing rooms: the impact of adaptations on the meaning of home for a disabled person and the role of occupational therapists in the process, British Journal of Occupational Therapy, 65(2), 81-87 • Hirsch, T., Forlizzi, J., hyder, E., Goetz, J., Stroback, J., Kurtz, C. (2000). The ELDer project: social, emotional, and environmental factors in the design of eldercare technologies, ACM Conference on Universal Usability, 72-79 • Hocking, Claire (1999). Function or feelings: factors in abandonment of ADs, Technology and Disability, 11, 3-11 • Kronlof, Greta H. and Sonn, Ulla (1999). Elderly women’s way of relating to ADs, Technology and Disability, 10, 161-168. • Lau, Cynthia and O’Leary, Stephanie (1993). Comparison of computer interface devices for persons with severe physical disabilities, American Journal of Occupational Therapy, 47(11) 1022-1029 • Lund, Maria L. and Nygard, Louise (2003). Incorporating or resisting ADs: different approaches to achieving a desired occupational self-image, OTJR: Occupation, Participation and Health, 23(2), 67-75

11. References (cont.) • Lupton, Deborah and Seymour, Wendy (2000). Technology, selfhood and physical disability, Social Science and Medicine, 50, 1851-1862 • Mann, William C. and Tomita, Machiko (1998). Perspectives on ADs among elderly persons with disabilities, Technology and Disability, 9, 119-148 • Mulcahey, M. J. (1992). Returning to school after a spinal cord injury: perspectives from four adolescents, American Journal of Occupational Therapy, 46(4), 305-312 • Pape, T. L-B., Kim, J., Weiner, B. (2002). The shaping of individual meanings assigned to assistive technology: a review of personal factors, Disability and Rehabilitation, 24(1/2/3), 5-20 • Pippin, Ken and Fernie, Geoffrey R. (1997). Designing devices that are acceptable to the frail elderly: a new understanding based upon how older people perceive a walker, Technology and Disability, 7, 93-102 • Pope, C and Mays, N. (2001) Qualitative Research in Health Care, BMJ Publishing group • Pugh, Moyra and Stansfield, Sharon (1989). Drinking equipment: preparing a DEAP report, British Journal of Occupational Therapy, 52(11), 416-420 • Winchcombe, M. and Silver, D. (2000) Into the mainstream, bringing products for easier living out of the disability closet, DLCC, Manchester. • Department of Health (2000) The NHS Plan: a plan for investment; a plan for reform • Department of Health (2001) Guide to Integrating Community Equipment Services • Department of Health (2001) Community Equipment Services • The Audit Commission (2002) Fully Equipped

12. Email: Natasha.Parsons@gmail.com