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- Sund, Terje
(författare)
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Powered Mobility Devices in a Nordic Context: Service Delivery, Effectiveness and Methodological Development
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis has contributed to the methodological development in the field of assistive technology and has generated new knowledge about the effectiveness and the service delivery process when powered mobility devices are provided to adult first time users in a Nordic context. Some of the results have been used to investigate the relationship between the three key elements of Donabedian’s conceptual model when scooters are provided to users from two Nordic countries, Denmark and Norway. As most of the results from the psychometric testing of the SATS and NOMO 1.0 were above the recommended levels, both instruments can be reliably administered in studies among adult users of powered mobility devices in Nordic context. The factor analysis of the need for assistance and frequency scales of the NOMO 1.0 identified unidimensionality for the first scale and multi-dimensionality for the other. However, further psychometric testing is required for the NOMO 1.0 regarding the validity. As for the SATS, the instrument needs to go through a basic investigation of its validity. There is a need to consider the wording of the items in order to avoid, for example, double-barrel questions. A factor analysis should be carried out in order to establish the dimensionality and to see if there is a need for item reduction. In other words, a revision of the instrument is needed. Concerning the NOMO 1.0, (further validity studies) a confirmatory factor analysis is needed. Reliability and validity studies are needed for the study-specific questionnaires used in the SATS study. All three instruments need to be psychometrically tested in other user groups of assistive devices than powered mobility devices and in other cultures than the Nordic countries. Supporting previous research, this thesis showed that the powered mobility device interventions increase mobility-related participation in daily life among adult users in a Nordic context. Mobility became easier for several aspects, and buying groceries and go for a walk/ride were carried out more frequently. Men, scooter users, and users with poor self-reported health seem to benefit the most from the interventions. Assessments and administrative work were accomplished in almost all the cases, while the other steps of the service delivery process were carried out to a various degree when scooters were provided to users in Denmark and Norway. More time was spent on assessments, administration and total time in the Danish sample. The user satisfaction with different aspects of the service delivery process was high. However, there was no association between time spent in the service delivery process and use satisfaction and effectiveness. The finding that there were differences in time spent on the service delivery process between samples from two countries with structural differences confirm the assumption that structure of the services predicts the time spent in the service delivery process. Different rules regulating the area seem to be an important explanation for the time differences. The expected association between the structure, the time spent in the service delivery process and the outcomes in terms of user satisfaction with the service delivery process and effectiveness was not found.
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- Sund, Terje, et al.
(författare)
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Psychometric properties of the NOMO 1.0 tested among adult powered-mobility users
- 2017
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Ingår i: Canadian Journal of Occupational Therapy. - : SAGE Publications. - 0008-4174 .- 1911-9828. ; 84:1, s. 34-46
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Tidskriftsartikel (refereegranskat)abstract
- Background. The Nordic Mobility Related Outcome Evaluation of Assistive Device Intervention (NOMO 1.0) instrument evaluates the effectiveness of mobility devices in assessing mobility-related participation, captured by three scales (Need for Assistance, Frequency, and Ease/Difficulty) and one index (Participation Repertoire). Purpose. This study aimed to investigate a range of psychometric properties of the NOMO 1.0 in a sample of adult powered mobility device (PMD) users. Method. Data collected from PMD users (N = 248) in Denmark, Finland, and Norway as part of a larger study were analyzed using state-of-the-art statistical methods. Findings. The acceptability and applicability of the NOMO 1.0 items were generally within recommended values. Some floor/ceiling effects were found and the reliability was acceptable for only the Frequency scale. The factor analysis identified one component for the Need for Assistance scale and six components of the Frequency scale. Implications. The NOMO 1.0 should be used for research purposes and not for clinical practice. Better reliability should be established for the Need for Assistance and Ease/Difficulty scales prior to further psychometric testing to establish the validity of the NOMO 1.0.
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- Sund, Terje, et al.
(författare)
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The relationship between the key elements of Donabedian's conceptual model within the field of assistive technology.
- 2015
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Ingår i: Studies in Health Technology and Informatics. - 0926-9630. - 9781614995654 - 9781614995661 ; 217: Assistive Technology, s. 485-490
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Konferensbidrag (refereegranskat)abstract
- Previous research has suggested that there is a relationship between the three key components of Donabedian's conceptual model for quality assessments: structure of care, process, and outcome of care. That is, structure predicted both process and outcome of care, and better processes predict better functional outcomes and user satisfaction. The results in this study involving samples of Danish and Norwegian scooter users indicate that structure predicts what goes on in the service delivery process. However, the results do not support that structural differences or differences in the service delivery process predict the outcomes of the scooter interventions.
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