Item Analysis of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST)

The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) is an outcomes assessment tool designed to measure satisfaction with assistive technology in a structured and standardized way. The purpose of this article is to present the results of an analysis of the 24 items comprising QUEST and to explain how a subset of items demonstrating optimal measurement performance was selected. The criteria against which the items were measured were general acceptability, content validity, contribution to internal consistency, test–retest stability, and sensitivity. The items that ranked best in terms of these measurement properties were submitted to factorial analysis in order to complete the item selection. The first series of analyses reduced the item pool approximately by half, and the second series of analyses led to the final selection of 12 items. Factor analysis results suggested a bidimensional structure of satisfaction with assistive technology related to the assistive technology device (eight items) and services (four items). The 12-item revised version that will result from this study should prove to be a reliable and valid instrument for measuring outcomes in the field of assistive technology.     

Development of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST)

This study's purpose was to develop a clinical instrument designed to evaluate user satisfaction with assistive technology devices. This paper describes the methodology used to develop the instrument entitled the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST). Based on the theoretical and practical foundations of assistive technology as well as on the concept of satisfaction, preliminary versions of the instrument were created and examined by a panel of team participants. After the panel's recommendations were incorporated, a pretest of the revised instrument was conducted and the final French version of QUEST emerged. The originality of QUEST lies in its inter-activeness and user-directed approach to assessing satisfaction with assistive technology. From a set of 27 variables, the user is asked to indicate the degree of importance he/she attributes to each of the satisfaction variables and then to rate his/her degree of satisfaction with each of the variables considered (quite or very) important. While QUEST remains a clinical instrument undergoing pilot testing, it holds much promise in our quest for a reliable and valid means of assessing assistive technology outcome from the user's perspective.     

Validation of the Greek version of the device subscale of the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 (QUEST 2.0)

The purpose of the study was to evaluate the device subscale of the QUEST 2.0 instrument and provide evidence for the validity and reliability of the Greek version. To this end, a cross-cultural adaptation was performed. Field test studies were conducted to validate the appropriateness of the final outcome. Data were drawn from a study of 115 subjects who had been administered the GR-QUEST questionnaire. Ratings related to the different items were statistically analyzed. The exploratory factor analysis with varimax rotation conducted revealed a three factors structure of the device subscale in contrast with previous studies. Our “Safe Use” subscale contains the items adjustments, safety and effectiveness of the original instrument, the “Fit to Use” subscale contains the dimensions, weight and ease of use items, and the “Endurance” subscale contains the items durability and comfort of the original questionnaire. Reliability measures (ICC=0.949, Pearson´s correlation=0.903, Cronbach´s α=0.754) yielded high values. Test-retest outcome showed great stability. Based on the results, the GR-QUEST can be considered as a valid and reliable instrument and thus it can be used to measure the satisfaction of patients with assistive devices, while it is applicable to the Greek population. Further assessment of the services subscale is needed.     

Reliability,validity, and applicability of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0) for adults with multiple sclerosis

Purpose : To investigate the measurement properties of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0) with respect to test-retest stability, alternate form reliability, construct validity and applicability. Method : Data on satisfaction and quality of life impacts of mobility devices were obtained from 81 community-based adults with Multiple Sclerosis, using the QUEST 2.0 and the Psychosocial Impact of Assistive Devices Scale (PIADS). Subjects were assigned to four groups and a second QUEST 2.0 was administered one week later. Groups differed with respect to the format and the order in which alternate forms were presented. Measures of association were calculated between QUEST 2.0 and PIADS (n = 81) and between QUEST 2.0 alternate forms (n = 48). Respondents' reactions were considered. Results : The device subscale, services subscale, and total QUEST 2.0 scores achieved good test-retest stability (ICC 0.82, 0.82, 0.91). Alternate-form equivalence (ICC 0.89, 0.76, 0.91) was lower for services. The positive correlations between QUEST 2.0 and the three PIADS dimensions were fair to moderate for device and total QUEST 2.0 (r p 0.34 to 0.45) and fair with services (r p 0.27 to 0.30). The tool was positively received, with some restrictions for the services subscale. Conclusions : These findings on the psychometric properties of the QUEST 2.0 reinforce the relevance of the device subscale as an important outcome measure for assistive technology MS users. Further assessment of the services subscale is needed.     

Reliability, validity, and applicability of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0) for adults with multiple sclerosis

Purpose : To investigate the measurement properties of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0) with respect to test-retest stability, alternate form reliability, construct validity and applicability. Method : Data on satisfaction and quality of life impacts of mobility devices were obtained from 81 community-based adults with Multiple Sclerosis, using the QUEST 2.0 and the Psychosocial Impact of Assistive Devices Scale (PIADS). Subjects were assigned to four groups and a second QUEST 2.0 was administered one week later. Groups differed with respect to the format and the order in which alternate forms were presented. Measures of association were calculated between QUEST 2.0 and PIADS (n = 81) and between QUEST 2.0 alternate forms (n = 48). Respondents' reactions were considered. Results : The device subscale, services subscale, and total QUEST 2.0 scores achieved good test-retest stability (ICC 0.82, 0.82, 0.91). Alternate-form equivalence (ICC 0.89, 0.76, 0.91) was lower for services. The positive correlations between QUEST 2.0 and the three PIADS dimensions were fair to moderate for device and total QUEST 2.0 (r p 0.34 to 0.45) and fair with services (r p 0.27 to 0.30). The tool was positively received, with some restrictions for the services subscale. Conclusions : These findings on the psychometric properties of the QUEST 2.0 reinforce the relevance of the device subscale as an important outcome measure for assistive technology MS users. Further assessment of the services subscale is needed.     

Reliability, validity, and applicability of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0) for adults with multiple sclerosis

PURPOSE: To investigate the measurement properties of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0) with respect to test-retest stability, alternate form reliability, construct validity and applicability. METHOD: Data on satisfaction and quality of life impacts of mobility devices were obtained from 81 community-based adults with Multiple Sclerosis, using the QUEST 2.0 and the Psychosocial Impact of Assistive Devices Scale (PIADS). Subjects were assigned to four groups and a second QUEST 2.0 was administered one week later. Groups differed with respect to the format and the order in which alternate forms were presented. Measures of association were calculated between QUEST 2.0 and PIADS (n = 81) and between QUEST 2.0 alternate forms (n = 48). Respondents' reactions were considered. RESULTS: The device subscale, services subscale, and total QUEST 2.0 scores achieved good test-retest stability (ICC 0.82, 0.82, 0.91). Alternate-form equivalence (ICC 0.89, 0.76, 0.91) was lower for services. The positive correlations between QUEST 2.0 and the three PIADS dimensions were fair to moderate for device and total QUEST 2.0 (r(p) 0.34 to 0.45) and fair with services (r(p) 0.27 to 0.30). The tool was positively received, with some restrictions for the services subscale. CONCLUSIONS: These findings on the psychometric properties of the QUEST 2.0 reinforce the relevance of the device subscale as an important outcome measure for assistive technology MS users. Further assessment of the services subscale is needed.     

The validity and applicability of the Chinese version of the Quebec User Evaluation of Satisfaction With Assistive Technology for people with spinal cord injury

The Quebec User Evaluation With Assistive Technology (Version 2.0; QUEST 2.0) has become an important outcome assessment to capture user satisfaction in the field of assistive technology. The purpose of this study is to investigate the psychometric properties of the Chinese version of the QUEST 2.0 (C-QUEST) in terms of content and substantive and factor validity and to explore its applicability on user satisfaction on mobility and equipment among Chinese people with spinal cord injury. A group of six expert members were invited to evaluate the content validity and translation quality of the 12-item C-QUEST. The revised version, along with the brief version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF [HK]), was administered on user satisfaction of people with spinal cord injury in the community. The content validity and item performance were evaluated to be satisfactory. Exploratory factor analysis with varimax rotation agreed with the bidimensional structure of Device and Services in the construct of user satisfaction (61.06% variance explained). Items in WHOQOL-BREF (HK) were shown to have positive and moderate correlations with C-QUEST Device items (r = .412-.567, p < .05) but no significant associations with the Services items (p > .05). The 12-item C-QUEST was shown to be a valid and relevant instrument to capture the user satisfaction among Chinese people with spinal cord injury in the context of mobility and seating equipment.     

Test–retest reliability and agreement of the Satisfaction with the Assistive Technology Services (SATS) instrument in two Nordic countries

Abstract

Purpose: The purpose of this study was to investigate test–retest reliability, agreement, internal consistency, and floor- and ceiling effects of the Danish and Finnish versions of the Satisfaction with the Assistive Technology Services (SATS) instrument among adult users of powered wheelchairs (PWCs) or powered scooters (scooters). Method: Test–retest design, two telephone interviews 7–18 days apart of 40 informants, with mean age of 67.5 (SD 13.09) years in the Danish; and 54 informants with mean age of 55.6 (SD 12.09) years in the Finnish sample. Results: The intra-class correlation coefficient varied between 0.57 and 0.93 for items in the Danish and between 0.41 and 0.93 in the Finnish sample. The percentage agreement varied between 54.2 and 79.5 for items in the Danish and between 69.2 and 81.1 in the Finnish sample, while the Cronbach’s alpha values varied between 0.87 and 0.96 in the two samples. A ceiling effect was found in all items of both samples. Conclusions: This study indicates that the SATS may be reliably administered for telephone interviews among adult PWC and scooter users, and give information about aspects of the service delivery process for quality development improvement purposes. Further psychometric testing of the SATS is required.     

Effect of the Assistive Technology Professional on the Provision of Mobility Assistive Equipment

ObjectiveThe purpose of this study was to examine factors associated with variability in satisfaction with functional mobility (as measured by the Functional Mobility Assessment [FMA]) in users of mobility devices. Our primary hypothesis was that device type and Assistive Technology Professional (ATP) involvement will be the most significant predictors of FMA score. Our secondary hypothesis was that ATP involvement is associated with use of more custom-fitted manual wheelchairs and group 3 and 4 power wheelchairs.DesignRetrospective cohort study.SettingData were collected from equipment suppliers who collaborate with clinicians to administer the FMA and associated Uniform Data Set within various settings (ie, rehabilitation clinic, school, supplier place of business).ParticipantsA data set of 4743 cases was included in the analysis (N=4743).InterventionsNot applicable.Main Outcome MeasuresFMA questionnaire collected at baseline, client age, gender, primary diagnosis, years since disability onset, device type, device age, living situation, ATP involvement, and geographic area.ResultsOrdinal logistic regression modeling showed that geographic area, device type, ATP involvement, primary diagnosis, gender, age, device age, and years since onset of disability significantly predicted the variance in FMA scores at P<.05. Device type was the most significant predictor of variance in FMA score. Involvement of an ATP had a significant effect on the type of device that participants used (χ²²⁰=1739.18, P<.001; odds ratio, 0.589; 95% confidence interval, 0.49-0.708). If an ATP was involved, there were significantly higher proportions (all P<.05) of individuals using custom-fitted manual wheelchair and high-end groups 3 and 4 power wheelchairs prescribed compared with when no ATP was involved or when involvement was uncertain.ConclusionsThe relationship between ATP involvement and functional outcome supports the concept that ATP certification recognizes demonstrated competence in analyzing the needs of consumers with disabilities and selection of appropriate mobility assistive equipment with improved functional outcomes.     

特殊教育学生辅助技术适配的方法与步骤

该文在大量查阅和研究国外相关信息和研究成果的基础上,给出了特殊教育教师为学生选择辅助技术必须了解的辅助技术产品知识,给出了辅助技术适配过程中教师、语言治疗师、物理治疗师、作业治疗师、辅助技术专家等所需关注的评估内容,以及辅助技术适配评估的模式、步骤与方法。     

肢残儿童四类辅助器具满意度调查①

目的调查肢残儿童四类辅助器具使用情况.方法采用整群抽样的方法,以照看者为对象,对2009年~2011年为残疾儿童免费配发的轮椅、助行器、站立架、矫形器四类辅助器具使用满意度开展问卷调查,包括辅助器具质量、使用、售后服务等.结果和结论残疾儿童及其照看者对使用的辅助器具满意.相对其他三种辅助器具,矫形器满意度较低.     

现代辅助产品基础综述

作者简要综述辅助产品的定义、对象、作用、分类、选用原则和特色等基础知识供参考。     

脑性瘫痪儿童辅助技术产品的进展：功能特征与典型产品

脑瘫儿童辅助技术产品品种丰富,功能繁多,涉及姿势、移动、沟通、教育、生涯发展等方面。功能精准与功能整合正成为体位保持、移动辅助技术产品的发展趋向;辅助沟通装置形成多个技术系列的产品;在教育、社会技能以及职业生涯等领域的辅助技术中,具有各种功能的软件是其重要组成部分;计算机信息技术、开关技术在脑瘫辅助技术领域的大量应用,为该领域带来了革命性的变化。     

Challenges and opportunities to prevent transfusion errors: a Qualitative Evaluation for Safer Transfusion (QUEST)

BACKGROUND: One of the most frequent causes of transfusion‐associated morbidity or mortality is the transfusion of the wrong blood to the wrong patient. This problem persists in spite of the incorporation of numerous procedures into the pretransfusion checking process in an effort to improve patient safety. A qualitative study was undertaken to understand this process from the perspective of those who administer blood products and to identify concerns and suggestions to improve safety. STUDY DESIGN AND METHODS: Twelve focus group discussions and seven individual interviews were conducted at six hospitals in five countries (n = 72 individuals). Health care professionals from a variety of clinical areas participated. Data analysis identified common themes using the constant comparison method. RESULTS: Five major themes emerged from the analysis: the pretransfusion checking process, training, policy, error, and monitoring. Findings include the following: staff were aware and appreciative of the seriousness of errors and were receptive to continuous monitoring, the focus was on checking the bag label with the paperwork rather than the bag label with the patient at the bedside, training methods varied with most perceived to have minimal effectiveness, and access to policies was challenging and keeping up to date was difficult. Other factors that could contribute to errors included high volume of workload distractions and interruptions and familiarity or lack of familiarity with patients. CONCLUSIONS: Multiple factors can contribute to errors during the pretransfusion checking limiting the effectiveness of any individual intervention designed to improve safety. Areas of further research to improve safety of blood administration were identified.     

辅助技术-特殊教育发展值得关注的新趋势

辅助技术正在成为现代特殊教育领域的一个关键词汇，是特殊教育发展中一个值得关注的新趋势。作者在介绍辅助技术设施与辅助技术服务含义的基础上，探讨辅助技术与教育技术的联系，以及辅助技术的应用对特殊教育技术层面与观念层面的改变，提出加强辅助技术应用的建议。     

Development of the new Family Impact of Assistive Technology Scale

Children with physical disabilities generally require more care, attention and direct supervision than children without disabilities. Research demonstrates that these higher care-giving demands are associated with poorer psychological and physical health states for parents and other family members. Assistive technologies may have a role in mitigating caregiver stress and burden by improving functional performance, social interaction and autonomy in children with physical disabilities. In this paper, we report on the initial development and testing of the Family Impact of Assistive Technology Scale - a new measure designed to detect the multidimensional effect of assistive device use on families who have young children with disabilities. To study the content validity and face validity of the Family Impact of Assistive Technology Scale, we conducted structured evaluations of the proposed constructs and items with 14 clinical experts and parents of young children with cerebral palsy. Experts agreed that the Family Impact of Assistive Technology Scale contains the key variables needed to study the effect of assistive technology use on child and family functioning. Parents concurred that items on the preliminary version were relevant and clear. Further research is planned to estimate the reliability and other aspects of validity of the Family Impact of Assistive Technology Scale.     

美国残疾人辅助技术法及其对我国的启示

《美国残疾人辅助技术法》是保障残疾人权益的重要法律。作者回顾了该法产生的历史背景，并通过对该法和《残疾人康复法案》等相关法律的保障措施的分析，为我国残疾人事业的发展和相关法律的制定寻找可供借鉴之处。