Ignorance of Integrative Process: Reason for Abandonment of Assistive Devices - Research Paper Example

Ignorance of Integrative Process: Reason for Abandonment of Assistive Devices of the of the High frequency in abandonment of the assistive devices by people suffering from disabilities has been a reason of concern in world of occupational therapy. User’s dissatisfaction with the function and performance of the assistive devices has been noted as the reason for abandonment. To reduce the rate of abandonment, identifying the internal and external factors related to the user is necessary. The literature review of the researches conducted to know the external factors, which lead to abandonment of the assistive devices by the user, is done. The literature review reveals that apart from user experiencing problem with devices, the external factors that cannot be controlled by the user play a major role in abandonment of the assistive devices. The importance of focusing on modification of these external factors, while taking decisive steps to reduce the rate of abandonment of assistive devices by the users, is highlighted. Introduction Assistive devices (AD) are tools for making the lives of people with disability easy, comfortable and safe. Unfortunately, it has been found that the frequency of abandonment of AD by people experiencing disability is very high (Kintsch & DePaula, 2002, p.1). Studies show that 8% of life saving devices, and 75% of hearing aids, are abandoned by the users suffering from the relative disabilities (Kintsch & DePaula, 2002, p.2). The aim of this research paper is to review the literature of the research studies conducted to find the reasons behind the abandonment of the AD by the users. It is natural to consider that it is the deficiency in the equipment that leads to its abandonment. However, the literature review revealed that there are various reasons related to user and his surroundings that lead to abandonment of the AD. Hence, if the rate of abandonment of AD is to be reduced, then occupational therapists need to focus on acceptance of the AD as a ‘process,’ and not just a one time thing, as success of assistive technology devices can be achieved only when the factors related to the user and his environment are considered while developing the device, and integrating it in his daily life. Advantages In section 3 of the 1998 Tech Act, the Congress has defined the assistive technology as “any item, piece of equipment, or product system, whether acquired commercially or off the shelf, modified or customized, that is used to increase, maintain, or improve the functional capabilities of a person with a disability” (Robitaille, 2010, p. 3). The AD have proved to be beneficial in innumerable ways. There are no barriers of age, disability, and health challenges as AD can be helpful in all cases of disabilities (Robitaille, 2010, p. 4). For example, the use of scan-and-speak software can help a person who is blind to read his own e-mails rather than asking his partner to do it for him (Robitaille, 2010, p. 4). A person, who is deaf, can make phone calls in sign language over the internet, without help from other person (Robitaille, 2010, p. 4). In this way, AD brings independence, self-confidence and self-esteem in lives of people who are disabled (Robitaille, 2010, p. 4). The barriers to education and employment are broken with the help of AD (Robitaille, 2010, p. 4). Sadly, “finding the right devices and gadgets, for the right purpose, at the right price,” is a challenge for both, individual users and their therapists (Robitaille, 2010, p. 4). This is where the unfavorable and disadvantageous factors of the AD begin to appear. Disadvantages It has been found that the success of AD does not depend solely on the devices. There are various other factors related to the AD that have proved to be disadvantageous. The aspects of usability, compatibility, cost-effectiveness, reliability and appeal of the device to the user, can prove to be a source of disadvantages of the AD (De Jonge, Scherer & Rodger, 2007, p. 42). At the same time, social factors also play a major role in creating disadvantages of AD that user experiences. Hence, the disadvantages can be understood in detail by looking at the reasons for which the users abandon the AD. Social Stigma Researchers Parette and Scherer (2004) conducted a literature review to understand the impact of stigma on the use of AD (p.217). In their article titled “Assistive Technology Use and Stigma,” they have conducted a study to know what areas of stigma affect the decision making related to AD (Parette & Scherer, 2004, p.217). The areas they have focused on are aesthetics/cosmetics of the device, gender and age appropriateness, acceptance by the society, sublimation and professional deference, acceptance of disability by teachers and principles of universal design (Parette & Scherer, 2004, p.219). According to the researchers, if the user experiences stigma in these areas, then the user’s chances of using the AD decreases. According to Crandall (2000), it is common among human beings to experience stigma (Parette & Scherer, 2004, p.217). Study by Zimmer and Chappell (1999) has revealed that individuals who acquire disabilities in later life experience stigmatization which are associated with the usage of AD (Parette & Scherer, 2004, p.217). As a result, the elder people either avoid using the AD or do not use it regularly (Parette & Scherer, 2004, p.217). Sadly, the stigma is also experienced by young people and hence, they are found avoiding the use of hearing aids (Parette & Scherer, 2004, p.218). The social participation of young people gets hampered due to stress related to the decision of using AD (Parette & Scherer, 2004, p.218). This further leads to the hampering of self-image as they lose confidence and experience low self-esteem due to consciousness and stigma (Parette & Scherer, 2004, p.218). According to Scherer (2000), users of AD feel deviant and stigmatized as they think themselves to be ‘different’ from others due to their disability being visible because of the AD (Parette & Scherer, 2004, p.219). This leads to social withdrawal, and lack of development of social and intimate relationships (Parette & Scherer, 2004, p.219). This shows that the cosmetics/aesthetics of the AD affects the social acceptability of the user, which in turn, results in the abandonment of AD (Parette & Scherer, 2004, p.219). Other area that affects the use of AD is gender and age. Sadly, even though women are found to be more comfortable, open and efficient in using AD, their involvement in “design and development of such products is very small” (Parette & Scherer, 2004, p.219). Scherer (2003) has found that compared to the elder people with disabilities, young people and adolescents with disabilities are more concerned with the appearance of the AD (Parette & Scherer, 2004, p.219). Another aspect that impacts the use of AD is the public acceptability (Parette & Scherer, 2004, p.219). Pippin and Fernie (1997) have found that if people around the user do not accept the AD and its functions, then the user and his family abandons the AD (Parette & Scherer, 2004, p.219). The cultural background of the users is also known to influence the use of AD. For example, people from minor ethnic background expect that they should get immediate results and relief by using the AD (Parette & Scherer, 2004, p.220). If they do not get it, then they abandon the AD even without trying it for some time. Also, teachers and peer acceptance has been found to have a major impact on the use of AD (Parette & Scherer, 2004, p.221). According to Stuart (1998), , the negative impact of stigma is decreased when the teachers take the initiatives in explaining the functioning of the AD, and the support others can provide to the person using the AD, to the peers of the user (Parette & Scherer, 2004, p.221). If teachers ignore these initiatives, then students are more likely to abandon the use of AD. Hence, skilled and caring teaches are needed, who are aware of the use of AD and its functions (Parette & Scherer, 2004, p.221). The other important aspect to remember while designing AD is that the universally designed products may reduce stigma as they are accepted well (Parette & Scherer, 2004, p.222). From their research study, researchers Parette and Scherer (2004) concluded that if the areas related to social stigma are considered while designing the AD and while training the users and their family members in use of AD, then the chances of abandonment of the AD can be reduced. This needs awareness and removal of prejudices against the AD. This shows that adapting the AD in daily life can take time. However, social stigma is not the only reason for abandonment of the AD. Dissatisfaction of Consumers In their article, “Toward the development of consumer-based criteria for the evaluation of assistive devices,” researchers Andrew Batavia and Guy Hammer have stated that the success of the AD depends on the satisfaction of needs of the consumers who are disabled (Batavia & Hammer, 1990, p.425). In their article, the authors have discussed the research conducted on groups of long-term users consisting of “the panel of consumer experts with mobility impairments and the panel of consumer experts with sensory impairment” (Batavia & Hammer, 1990, p.426). The purpose of the study was to provide an informative basis for improvement in the design, manufacture and the selection of devices by identifying the factors which are given priority and preference by the long-term users while assessing their AD (Batavia & Hammer, 1990, p.427). The aim was to reduce the level of technology abandonment and dissatisfaction, and also preserve the scarce resources of individuals, insurers, government and society at large, by encouraging the production of consumer friendly AD (Batavia & Hammer, 1990, p.427). It was found that in the initial period of using the devices, the needs related to the AD are not adequately known by people who are disabled (Batavia & Hammer, 1990, p.426). This makes them to go through abandonment of dissatisfactory AD till the time they get one which helps in fulfilling most of their needs (Batavia & Hammer, 1990, p.426). Unfortunately, in this process of finding the right AD, the financial resources are exhausted, and users experience frustration and dissatisfaction due to lack of adequate guidance regarding the choice of right AD (Batavia & Hammer, 1990, p.426). This leads to abandonment of the AD. Moreover, when shopping for the device the next time, the users usually forget the positive and negative factors they experienced with their previous devices, which leads them to repeat the mistake of choosing the devices which are not compatible with their needs (Batavia & Hammer, 1990, p.426). Overall, the results of the research revealed that on an average, the four most important factors for assessment of all the AD were the effectiveness, affordability, operability and dependability of the devices (Batavia & Hammer, 1990, p.433). The study concludes that as satisfaction of consumers is important when assessing the success of the device, the factors that consumers value most should be given high importance while designing and manufacturing the devices. However, it is important to know that good quality of the device does not guarantee success. Failure to Integrate the Assistive Devices The success of the integration of the assistive tool in daily life depends on various steps (Kintsch & DePaula, 2002, p.1). An important research with the help of empirical study and direct observation was carried out by researchers Anja Kintsch and Rogerio DePaula (Kintsch & DePaula, 2002, p.1). Identifying the recurring features of abandonment and what steps can be taken to avoid it was the aim of the study (Kintsch & DePaula, 2002, p.1). The authors have discussed the study in their article titled “A Framework for the Adoption of Assistive Technology.” The researchers found that the success of the AD depends not only on the user attributes but also on the factors like developer, assistive technology specialist attributes, and caregiver attributes (Kintsch & DePaula, 2002, p.2). The study revealed that the success of AD depends on how well the device is integrated in user’s life. It was found that it is through the ‘process’ consisting of four phases, i.e. the development, the selection, learning and the integration of the AD in user’s life, that the success of the devices can be achieved (Kintsch & DePaula, 2002, p.5). According to Watson and Wilson (2003), the AD is successful and accepted when it helps the users in doing the activities that have meaning for the them, or match their cognitive and functional abilities (Cowan & O’Sullivan, 2005, p.408). Scherer and Galvin (1996) found that apart from making the devices highly customizable, the developers should develop the tools that are “durable, meet user’s aesthetic preferences” and are easy to use (Kintsch & DePaula, 2002, p.2). Hence, the process of integration, i.e. developing the user friendly AD, and training the user and his family to integrate the AD in daily life, is essential in reducing the abandonment of AD. Conclusion The literature review of the research studies discussed above proves that success of the AD does not depend solely on the user or the quality of the AD. The social and the environmental factors play a major role in its success and user’s satisfaction. The job of the therapist does not finish with introducing the device to the user. Training and practice of not only the user, but also his family members, is necessary for the successful integration of the AD in user’s daily life. Hence, if the rate of abandonment of AD is to be reduced, then occupational therapists need to understand that integration of the AD is the ‘process,’ and training the user and his family members with care and love is important if this process is to be completed successfully. References Batavia,A.I. & Guy, S. H. (1990). Toward the development of consumer-based criteria for the evaluation of AD. Journal of Rehabilitation Research and Development, 27(4), 425-436. Cowan, M.K. & O’Sullivan, B. (2005). Assistive technology and adaptive equipment. In S.Ryan & K. Sladyk (Eds.), Ryans Occupational therapy assistant: Principles, Practice issues, and techniques (4th ed.). Thorofare, NJ: SLACK Incorporated. De Jonge, D., Scherer, M.J. & Rodger, S. (2007). Assistive technology in the workplace. St. Louis, MO: MOSBY Elsevier. Kintsch, A., & DePaula, R. (2002). A framework for the adoption of assistive technology. SWAAAC 2002: Supporting Learning Through Assistive Technology, E3. Parette, P., & Scherer, M. (2004). Assistive technology use and stigma. Education and Training in Developmental Disabilities, 39(3), 217-226. Robitaille, S. (2010). The illustrated guide to assistive technology and devices: Tools and gadgets for living independently. New York, NY: Demos Medical Publishing. Read More