A conceptual framework to assess effectiveness in wheelchair provision

Abstract

BackgroundCurrently, inadequate wheelchair provision has forced many people with disabilities to be trapped in a cycle of poverty and deprivation, limiting their ability to access education, work and social facilities. This issue is in part because of the lack of collaboration among various stakeholders who need to work together to design, manufacture and deliver such assistive mobility devices. This in turn has led to inadequate evidence about intervention effectiveness, disability prevalence and subsequent costeffectiveness that would help facilitate appropriate provision and support for people with disabilities.ObjectivesIn this paper, we describe a novel conceptual framework that can be tested across the globe to study and evaluate the effectiveness of wheelchair provision.MethodThe Comparative Effectiveness Research Subcommittee (CER-SC), consisting of the authors of this article, housed within the Evidence-Based Practice Working Group (EBP-WG) of the International Society of Wheelchair Professionals (ISWP), conducted a scoping review of scientific literature and standard practices used during wheelchair service provision. The literature review was followed by a series of discussion groups.ResultsThe three iterations of the conceptual framework are described in this manuscript.ConclusionWe believe that adoption of this conceptual framework could have broad applications in wheelchair provision globally to develop evidence-based practices. Such a perspective will help in the comparison of different strategies employed in wheelchair provision and further improve clinical guidelines. Further work is being conducted to test the efficacy of this conceptual framework to evaluate effectiveness of wheelchair service provision in various settings across the globe.

Quality of wheelchair services as perceived by users in rural Bangalore district, India: a cross-sectional survey

“…Variables were selected according to their correspondence with independent, dependent and confounding variables as proposed by Kamaraj et al [16] and relevance to the research question. The QUEST (and related variables) are related to the independent variable described in the framework, however for this study this variable is considered as dependent, being an outcome variable.…”

“…This seems, and is, paradoxal but is explained by an etymological reason. Kamaraj et al [16] write in their article that "factors pertaining to the wheelchair constituted the first domain of the independent variables. The factors pertaining to the wheelchair and the eight steps from WHO were discussed under two domains of independent variables."…”

“…A framework ( Figure 1) that has been conceptualized by Kamaraj et al [16] lays bare the complex interdependencies of different characteristics, both personal and service specific, that determine the effectiveness of the wheelchair provision services.…”

Preliminary steps of the development of a Minimum Uniform Dataset applicable to the international wheelchair sector

“…The information could be used to accredit wheelchair services in a similar manner as how the Joint Commission and Commission on Accreditation of Rehabilitation Facilities International use the Uniform Dataset for Medical Rehabilitation in the US in their service accreditation processes [60]. Aggregated data also may be used to prove the conceptual framework that was developed to illustrate the factors that affect the cost effectiveness of wheelchair provision [61]. Last, the MUD may contribute to understanding at a system's level the demand and supply of wheelchair products and services that can inform procurement, innovation, and drive investment [29,62].…”

Editorial

“…Human resources for the assistive technology sector (domain 4) is the focus of several manuscripts, including the works by Fung et al ( 2017 ) who describe an opportunity for integrating wheelchair services training into academic programmes worldwide, Norris ( 2017 ) who describes the benefits of peer training for wheelchair users and Munera et al ( 2017 ) who describe the development of wheelchair services training of trainers programme being published by the WHO. The manuscript by Kamaraj et al ( 2017 ) provides a conceptual framework for assessing the need and impact of wheelchair services provision based on a range of variables and fits within domain 5.…”