Patient perceptions of environmental control units: experiences of Veterans with spinal cord injuries and disorders receiving inpatient VA healthcare

Abstract

ECUs were well-accepted by persons with spinal cord injuries/disorders (SCI/D) in the inpatient setting, and increased patients' perceptions of independence. To maximise usability and satisfaction, facilities should ensure that comprehensive training on ECU use and features available is offered to all patients, and resources are available for timely troubleshooting and maintenance. Implications for rehabilitation An environmental control unit (ECU) is a form of assistive technology that allows individuals with disabilities (such as spinal cord injuries and disorders [SCI/D]) to control functional and entertainment-related aspects of their environment. ECU use can increase functioning, independence and psychosocial well-being among individuals with SCI/D, by allowing users to reclaim control over day-to-day activities that are otherwise limited by their disability. Our study results indicate that, among persons with SCI/D, ECUs are well-accepted and increase perceptions of independence. To maximise usability and patient satisfaction, facilities should ensure that comprehensive training on how to use ECUs and what features are available is offered to all patients, and resources are available for timely troubleshooting and maintenance.

Funding and Access to Assistive Technologies: Electronic Aids to Daily Living

“…28 While not in scope for this review, there has been study of the perspectives and experiences of those using EADL and ATs, such as environmental control units (ECU). 14,69,70 Devices such as ECUs have been found to be well-accepted and to increase perceptions of independence 69 and that for some clients with spinal cord injuries, small changes in activity levels can have important meaning -particularly for those with more severe injuries. 71 Similar to the findings of this report, factors such as client readiness, client's personal values, the reliability of the technologies (particularly those that control functions important to safety -such as doors), and proficiency with the technologies for both the care provider and client have been found to be important to the successful use of ECUs in studies of user perspectives as well.…”

A Heuristic Evaluation of Usability for Environmental Control Units’ Eye-Tracking Interfaces at Veterans Affairs Spinal Cord Injuries and Disorders Centers

“…The team of evaluators used the eye-tracking mode to simulate patient interactions via four tasks that were previously identified by research as the most important and common activities for which patients use the system (McDonald, Boyle, & Schumann, 1989;Etingen et al, 2017). In order to evaluate the system interface, evaluators used the eye-tracking system to navigate through the steps necessary to: 1) complete a phone call, 2) compose an email, 3) switch television channels, and 4) adjust the bed settings.…”

“…End-users (i.e., veterans) perceive ECUs to be useful tools for carrying out common tasks, yet consistently point out interface issues that affect usability and user experience outcomes (Etingen et al, 2017). This work expanded on six specific heuristic violations in ECUs' design and their consequences for performance, ranging from relatively minor to catastrophic.…”

“…Caregivers therefore lose time better spent ensuring and coordinating patient care on technical issues with the device. While veterans have reported relatively high satisfaction with these systems (71%), only 42% of those individuals surveyed felt that this interface satisfied their need for independence (Etingen et al, 2017). Such low satisfaction is most likely due to the prevalence of usability problems inherent to the system.…”

Aging With Disability: Populations, Programs, and the New Paradigm An Introduction to the Special Issue

“…For example, rehabilitation researchers tend to come from medical backgrounds and may emphasize physical aspects of disability. At times, this has led to the unfortunate shorthand of medical rehabilitation researchers to conflate a particular health condition with disability (e.g., “disabilities such as SCI” [Etingen et al, 2018; Molton, Jensen, Nielson, Cardenas, & Ehde, 2008; Nightingale et al, 2018] or “disabilities such as MS” [Pack, Szirony, Kushner, & Bellaw, 2014]). This kind of inadvertent medicalization is anathema to those in disability studies, who tend to emphasize disability primarily as a social construction (Logan, Bogart, Ross, & Woekel, 2018) regardless of the cause or nature of impairment.…”