| Outcomes of seating-mobility interventions are necessary in the field of assistive technology to benefit consumers, practitioners, and third-party payers. Outcomes allow consumers to assure their improved or maintained function resulted from receiving the most appropriate technology. Practitioners need quantifiable outcomes to validate the purpose and significance of seating-mobility interventions, and third-party payers need outcomes to justify reimbursement of practitioners' seating-mobility recommendations for technology users. For these reasons, a self-report and a performance-based observation instrument were developed to quantify consumer function related to seating-mobility interventions. The Functioning Everyday with a Wheelchair (FEW), a self-report questionnaire, was developed from consumer input based on self-care, productivity, and leisure goals identified in interviews with manual and power wheelchair users. Consumers then validated the FEW categories, and self-administered the first version. The results indicated that wheelchair users have unmet needs in their seating-mobility systems. In a second study to determine test-retest reliability, an intraclass correlation coefficient (ICC) of 0.92 indicated the instrument was highly reliable in measuring seating-mobility goals over time. To ensure that the FEW items reflected goals perceived by consumers as most important for function in their wheelchairs/scooters, the FEW was cross-validated with five samples of consumers' goals. Cross-validation of the FEW with consumers' goals revealed 15 new items for inclusion in Version 2.0. The FEW, Version 2.0 was administered twice to seating-mobility users to establish test-retest reliability. Version 2.0 demonstrated a high level of reliability (ICC = 0.86) in its measurement of seating-mobility goals over time. Next, a criterion-referenced, performance-based observation tool matched to the FEW, Version 2.0 for use in the home/community was developed. The FEW-Performance (FEW-P) was designed using the International Classification of Functioning, Disability and Health (ICF) performance qualifier, and its structure was based on the Performance Assessment of Self-Care Skills (PASS). Trained raters administered the FEW-P to seating-mobility users. The FEW-P demonstrated content validity, internal consistency, and excellent interrater reliability (ICC = 0.98). The FEW and the FEW-P were designed to provide objective data to demonstrate the effectiveness of seating-mobility technology in meeting consumer needs, and justifying the benefits of prescribed seating-mobility interventions to third-party payers. |
