Article

Environmental control systems (ECSs) can potentially influence comfort,
safety, security and independence for people with severe impairment from spinal
cord injury (SCI). This study, aimed at informing prescription practises,
investigated ECS prescription and utilisation from the consumer perspective.
METHODS: Qualitative inquiry, through 15 semi-structured interviews, explored the
perspectives of people with high level SCI who use ECSs.
Data were coded and
clustered to provide a description of their perspectives and interpret lessons
for prescribers. RESULTS: The data were grouped into six coding clusters related
to readiness to engage, training, autonomy, utility, utilisation and attitudes
towards the ECS. Data revealed variability in readiness to embrace ECSs during
rehabilitation, some frustration related to setting up systems and instances of
ECSs not being used to their full potential. Some highly motivated participants
found reward through perseverance. All participants valued having some level of
autonomy and personal security. Significant implications for prescribers are
described. CONCLUSIONS: Understanding the influence of factors related to
devices, personal characteristics and individual context on ECS usage can guide
clinicians in prescription and training processes to facilitate maximum and
ongoing benefit from ECSs. A culture of follow-up and evaluation is to be
encouraged. Implications for Rehabilitation A variety of factors may influence
whether a person with severe impairment from spinal cord injury fully utilises
and persists with using an environmental control system (ECS). Findings from this
study illustrate the importance of client readiness for prescription and the
influence of client perceptions of value, convenience and aesthetics on ECS use.
Prescribers should seek to understand what each client needs to become engaged
and proficient with ECS use. Prescribers should be knowledgeable about suggested
ECSs. Prescribers should prepare clients for potential difficulties in
establishing reliable ECS use and establish support mechanisms to facilitate
perseverance until effective ECS use is established.

Langue : ANGLAIS