Investigation of the Wheelchair Procurement Process for Acquired Brain Injury Survivors & Their Caregivers

PURPOSE: To examine the experiences and priorities of individuals with acquired brain injury (ABI) and their caregivers as they receive their first wheelchair, and to investigate the role self-efficacy and social support can play in self-management tasks after a brain injury.

DESIGN: Longitudinal single group observational study. Data was collected at two time points: prior to discharge from rehabilitation and at 4 months post discharge. All subjects admitted to the rehab hospital with an ABI diagnosis were screened for inclusion. Inclusion criteria: Diagnosis of acquired brain injury, wheelchair recommended for them at discharge, discharge to home, able to speak and read in English. Exclusion criteria: Planned discharge to another country or nursing home, already used wheelchair for mobility.

METHOD: Data was collected at two time points; prior to discharge from hospital and at 4 month follow up. Subject or their caregiver completed a structured interview, the Multidimensional Scale of Social Support, the General Self-Efficacy scale, and the Neuro-QOL. At 4 month follow up, each subject or their caregiver participated in a phone interview which consisted of a structured interview, the Neuro-QOL, and the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST).

RESULTS: 43 subjects completed the initial interview and 21 subjects completed the 4 month follow up interview. Features of wheelchair most important at discharge were safety, comfort, and effectiveness. At 4 month follow up features most important were fit, safety and comfort. Despite self-reported high levels of social support and self-efficacy, many subjects reported challenges with the wheelchair procurement process.

CONCLUSION: These findings contribute to our understanding of the wheelchair procurement process for brain injury survivors. The unanticipated challenges experienced in the process point to the need for more follow up care after rehabilitation.

References

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Hay, C.H., Phillips, D., Jacob, C., Furl, J. (2023). Priorities & challenges of brain injury survivors & their caregivers as they adapt to using a new wheelchair. Am J Occup Ther, 77(2) S1. https://doi.org/10.5014/ajot.2023.77S2-PO117