Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-25T19:42:15.704Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevalence and Predictors of Need for Seating Intervention and Mobility for Persons in Long-Term Care*

Published online by Cambridge University Press:  31 March 2010

Melissa C. Bourbonniere ,
Laura M. Fawcett ,
William C. Miller ,
Jennifer Garden  and
William B. Mortenson
Melissa C. Bourbonniere
Affiliation:
Students, Masters of Occupational Therapy, McMaster University (at the time of study)
Laura M. Fawcett
Affiliation:
Students, Masters of Occupational Therapy, McMaster University (at the time of study)
William C. Miller*
Affiliation:
School of Rehabilitation Sciences, University of British Columbia GF Strong Rehabilitation Research Lab, Vancouver, BC Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute University of British Columbia Can-Do Research Unit
Jennifer Garden
Affiliation:
School of Rehabilitation Sciences, University of British Columbia GF Strong Rehabilitation Research Lab, Vancouver, BC
William B. Mortenson
Affiliation:
School of Rehabilitation Sciences, University of British Columbia Purdy Pavilion, Residential Care, Vancouver Coastal Health Research Institute
*
Requests for offprints should be sent to:/Les demandes de tirés-à-part doivent être adressées à: William C Miller, Ph.D., O.T., Vancouver Coastal Health Research Institute, Room 715, 828 West 10th Avenue, Vancouver, BC V5Z 1L8. ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

A descriptive cross-sectional study was conducted to (a) determine the prevalence of need for wheel-chair seating intervention in two long-term care facilities in Vancouver, BC, (b) determine the extent of the residents' independent mobility within these facilities, and (c) explore the relationship between proper wheel-chair seating and positioning and independent mobility. The study population comprised 99 wheel-chair-using older adults. Four trained raters assessed need for seating intervention, using the Seating Identification Tool, and quantified extent and frequency of wheel-chair mobility, using the Nursing Home Life-Space Diameter. Results indicated that (a) there was a low need (overall 22%) for wheel-chair seating intervention in the two facilities, (b) half of the residents were independently mobile in their own rooms and on their units, but independent mobility decreased when greater distances needed to be travelled, and (c) the need for wheel-chair seating intervention was the only significant predictor of extent of independent mobility. These findings suggest that, where there are dedicated staff and equipment resources, the need for wheel-chair seating intervention can be minimized and independent mobility for long-term care residents maximized.

Résumé

Une étude transversale descriptive a été effectuée afin de déterminer la prévalence du besoin de places de fauteuil roulant dans deux établissements de soins de longue durée à Vancouver, en Colombie-Britannique; de déterminer l'étendue de la mobilité autonome des résidents dans ces établissements; et d'explorer la relation entre les places de fauteuil roulant appropriées et le positionnement et la mobilité autonome. La population étudiée comprenait 99 adultes âgés en fauteuil roulant. Quatre évaluateurs expérimentés ont estimé les besoins d'intervention en matière de places à l'aide du Seating Identification Tool (outil de détermination des places) et quantifié l'étendue et la fréquence de la mobilité en chaise roulante à l'aide du Nursing Home Life-Space Diameter (diamètre de l'espace vital dans les centres d'hébergement et de soins de longue durée). Les résultats ont indiqué qu'une intervention était moins pressante pour des places de fauteuil roulant dans les deux établissements; que la moitié des résidents pouvaient se déplacer de façon autonome dans leurs propres chambres et leurs unités, mais que la mobilité autonome diminuait lorsque les distances à parcourir étaient plus grandes; et que le besoin d'intervention en matière de places de fauteuil roulant était le seul prédicteur significatif de l'étendue de la mobilité autonome. Ces résultats suggèrent que, si l'établissement possède des ressources adéquates en matière de personnel spécialisé et d'équipements, le besoin d'une intervention pour des places de fauteuil roulant peut être réduit et que la mobilité autonome des résidents des établissements de soins de longue durée peut être maximisée.

Keywords

agingwheel-chairlong-term careintervention needsvieillissementfauteuil roulantsoins de longue duréebesoins d'intervention
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 26 , Issue 3 , Fall/Automne 2007 , pp. 195 - 204
Copyright
Copyright © Canadian Association on Gerontology 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The authors would like to acknowledge the participants for providing the data; site staff, occupational therapists, and Christina Ekegren for help with subject recruitment and data collection; and Sue Baptiste for co-supervision of the first two authors' masters of science research project in occupational therapy on which this work was based. Salary support for Dr. Miller and trainee funding was provided by the Canadian Institutes of Health Research, Institute of Aging, and the Michael Smith Foundation for Health Research.

References

Bergen, A.F., Persperin, J., & Tallman, T. (1991). Seating systems: Evaluation criteria. Retrieved 29 November 2004 from http://www.wheelchairnet.org/WCN_ProdServ/Docs/TeamRehab/RR_91/9107art5.PDF.Google Scholar
Brandt, A., Iwarsson, S., & Stahle, A. (2004). Older peoples' use of powered wheelchairs for activity and participation. Journal of Rehabilitation Medicine, 36, 70–77.CrossRefGoogle ScholarPubMed
Brechtelsbauer, D.A., & Louie, A. (1999). Wheelchair use among long-term care residents. Annals of Long-Term Care, 7, 213–220.Google Scholar
Buning, M.E., Angelo, J.A., & Schmeler, M.R. (2001). Occupational performance and the transition to powered mobility: A pilot study. American Journal of Occupational Therapy, 55, 339–344.Google Scholar
Clarke, P., & Colantonio, A. (2005). Wheelchair use among community-dwelling older adults: Prevalence and risk factors in a national sample. Canadian Journal on Aging, 24, 191–198.Google Scholar
Davies, A., De Souza, L.H., & Frank, A.O. (2003). Changes in the quality of life in severely disabled people following provision of powered indoor/outdoor chairs. Disability and Rehabilitation, 25, 286–290.Google Scholar
Evans, R. (2000). The effect of electrically powered indoor/outdoor wheelchairs on occupation: A study of users' views. British Journal of Occupational Therapy, 63, 547–553.CrossRefGoogle Scholar
Forward, J.A. (2000). The prevalence of wheelchair and seating intervention needs in long term care in London, Ontario. Unpublished master's project. London, ON: University of Western Ontario.Google Scholar
Frank, A.O., Ward, J., Orwell, N.J., McCullagh, C., & Belcher, M. (2000). Introduction of a new NHS electric-powered indoor/outdoor chair (EPIOC) service: Benefits, risks, and implications for prescribers. Clinical Rehabilitation, 14, 665–673.Google Scholar
Fuchs, R.H., & Gromak, P.A. (2003). Wheelchair use by residents of nursing homes: Effectiveness in meeting positioning and mobility needs. Assistive Technology, 15, 151–163.Google Scholar
Jutai, J.W., Fuhrer, M.J., Demers, L., Scherer, M.J., & DeRuyter, F. (2005). Toward a taxonomy of assistive technology device outcomes. American Journal of Physical Medicine and Rehabilitation, 84, 294–302.Google Scholar
Kleinbaum, D.G., Kupper, L.L., & Muller, K.E. (1988). Applied regression analysis and other multivariable methods. (2nd ed.). Belmont, CA: Duxbury.Google Scholar
Krasilovsky, G. (1993). Seating assessment and management in a nursing home population. Physical and Occupational Therapy in Geriatrics, 11, 25–38.Google Scholar
Miles-Tapping, C., & MacDonald, L.J. (1994). Lifestyle implications of power mobility. Physical and Occupational Therapy in Geriatrics, 12(4), 31–49.CrossRefGoogle Scholar
Miller, W.C., Miller, F., Trenholm, K., Grant, D., & Goodman, K. (2004). Development and preliminary assessment of the measurement properties of the Seating Identification Tool (SIT). Clinical Rehabilitation, 18, 317–325.Google Scholar
Mortenson, W.B., Miller, W.C., Boily, J., Elgood, B., Crawford, E., & Odell, L. (2005). Power mobility and safety: Perceptions of individuals associated with residential facilities. Canadian Journal of Occupational Therapy, 72(3), 142–152.Google Scholar
Pedersen, J.P. (2000). Functional impact of seating modifications for older adults: An occupational therapist perspective. Topics in Geriatric Rehabilitation, 16, 73–85.CrossRefGoogle Scholar
Rader, J., Jones, D., & Miller, L. (1999). Individualized wheelchair seating: Reducing restraints and improving comfort and function. Topics in Geriatric Rehabilitation, 15(2), 34–47.CrossRefGoogle Scholar
Rader, J., Jones, D., & Miller, L. (2000). The importance of individualized wheelchair seating for frail older adults. Journal of Gerontological Nursing, 26, 24–32.Google Scholar
Rappl, L., & Jones, D.A. (2000). Seating evaluation: Special problems and interventions for older adults. Topics in Geriatrics Rehabilitation, 16(2), 63–72.Google Scholar
Redford, J.B. (1993). Seating and wheeled mobility in the disabled elderly population. Archives of Physical Medicine and Rehabilitation, 74, 877–885.Google Scholar
Reid, D., Laliberte-Rudman, D., & Herbert, D. (2002). Impact of wheeled seating mobility devices on adult users' and their caregivers' occupational performance: A critical literature review. Canadian Journal of Occupational Therapy, 69, 261–280.CrossRefGoogle ScholarPubMed
Scherer, M.J. (2001). Measuring subjective quality of life following spinal cord injury: A validation study of the assistive technology device predisposition assessment. Disability and Rehabilitation, 33, 387–393.Google Scholar
Shaw, G., & Taylor, S.J. (1991). A survey of wheelchair seating problems of the institutionalized elderly. Assistive Technology, 3, 5–10.CrossRefGoogle ScholarPubMed
Shields, M. (2004). Use of wheelchairs and other mobility support devices. Health Reports, 15, 37–41.Google Scholar
Smithers, J.A. (1990). A wheelchair society: The nursing home scene. Journal of Aging Studies, 4, 261–275.CrossRefGoogle Scholar
Statistics Canada (2001). A profile of disability in Canada, 2001. Retrieved 15 January 2005 from http://www.statcan.ca/english/freepub/89-577-XIE/index.htm.Google Scholar
Statistics Canada (2004). Population projections for 2001, 2006, 2011, 2016, 2021, and 2026, at July 1. Retrieved 15 January 2005 from http://www.statcan.ca/english/Pgdb/.Google Scholar
Tinetti, M.E., & Ginter, S.F. (1990). The Nursing Home Life Space Diameter: A measure of extent and frequency of mobility among nursing home residents. Journal of the American Geriatrics Society, 38, 1311–1315.Google Scholar
Trefler, E., Fitzgerald, S.G., Hobson, D.A., Bursick, T., & Joseph, R. (2004). Outcomes of wheelchair systems intervention with residents of long-term care facilities. Assistive Technology, 16, 18–27.CrossRefGoogle ScholarPubMed