Comparison Of 3D Panoramic Photography-Based Home Evaluation Protocol Versus On-Site Home Assessment

Objectives:The purpose of this study was to compare effectiveness,feasibility and consistency of 3D panoramic photography-based home evaluation protocol(3D PhoHA)with on-site home assessment(OsHA).Methods:A total of 40 post-stroke patients from four regional hospitals in Kunming Yunnan were recruited for this study.This was a quasi-experimental study.Home images were taken by participants' caregivers using 3D panoramic photograph shooting program based on the OsHA protocol.Training was provided to 4 occupational therapists to independently rate 3D PhoHA or OsHA.The four occupational therapists were randomly assigned to 2 groups as independent evaluators.For 3D PhoHA,occupational therapist rated the 3D panoramic photograph and measurements of participants'homes provided by patient's caregivers.The 40 participants were randomly assigned into two groups.For OsHA,the home environment of 20 participants was assessed by on-site therapist A and D independently in conventional home visits,while therapist B and C independently assessed the 3D panoramic photograph.Then visa-versus,the home environment of 20 other participants was assessed by on-site therapist B and C independently,therapist A and D independently assess the 3D panoramic photograph.The Home Accessibility Facilities and Related Equipment form was used for home evaluation.The order in which the two assessments were performed were randomly assigned.Normality of data was conducted using SPSS software to compute Kappa analysis and the Intra-Class Correlation Coefficient(ICC)statistics.The cost of the two assessment methods is analyzed by Mann Whitney U test.Results:1.Entrance to the door:A total of 13 items,including 4 not tested(NT)items,and Kappa value>0.6,achieved 66.6%of effective evaluation.The consistency of the three items(Overweight of the door,brightness,slippery surfaces)was a low value(0.042,0.348,0.254),and the McNemar test p value was 1;2.Hallway:A total of 7 items,including 1 NT items,and Kappa value>0.6,achieved 66.6%of effective evaluation,and the McNemar test p value was 1.The item with Kappa value less than 0.6 is mainly due to poor brightness and slippery surfaces.3.Bathroom:A total of 30 items,including 3 NT items,and Kappa value>0.8,achieved 63.0%of effective evaluation,McNemar test p value>0.05.The item with Kappa value less than 0.6 was mainly due to bathroom floor slippery,installed sink was an inappropriate height.4.Bedroom:A total of 30 items,including 3 NT items,and Kappa value>0.8,achieved 63.0%of effective evaluation,McNemar test p value>0.05.The item with Kappa value less than 0,6 was mainly due to bedroom brightness and slippery floor.5.Kitchen:A total of 9 items,Kappa value>0.8,reached 68.7%of the effective assessment,McNemar test p value>0,05.It shows that the 3D panoramic photo has excellent consistency with the home visiting evaluation environment in residential access assessment.Items with a Kappa value less than 0.6 are mainly kitchen shades,floor slippery/floor materials without skid resistance.6.3D panoramic photo assessor and home visiting evaluator rated the McNemar-Bowker P value and McNemar P value of environmental grading more than 0.05.There is no significant difference between the two assessment methods for the evaluation of home environment,and the consistency is high with a p value>0.05.7.The interrater reliability(ICC)between 3D-PhoA and OsHA was 0,86(95%CI 0.79-0.91,p<0.001).8.Cost-benefit analysis:the cost of 3D panoramic photos will be reduced by 56.6%compared to the cost of home visits;the cost of time cost will save 2.3 times the cost of the 3D panoramic photo assessment.(P<0.001)9.The feedback from 35 of the patients' family members or caregivers(92.1%)using the 3D panorama camera was that the 3D panorama camera was easy to operate.The feedback from 3 patients,family members(7.9%)was the 3D panorama camera inconvenient(because the Bluetooth remote control failed).A total of 34 patients'family members(89.5%)answered that they had already used the experience of mobile phone camera.Conclusions:In the assessment of family environment,using home environment assessment compare to home visit assessment based on 3D panoramic photograph,the two have moderate to high consistency in understanding the furniture or equipment of the participants' home environment.As a result,the home environment assessment of the 3D PhoHA has the cost benefit advantage.Improving those items with a low Kappa value using 3D panoramic photography assessment method has a big potential to replace conventional on-site home visits.