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The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 20): An overview of recent progress

January 2002

Authors:

Université de Montréal

. The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) is a 12-item outcome measure that assesses user satisfaction with two components, Device and Services. Psychometric properties have been tested with respect to test-retest stability. alternate-form equivalence. internal consistency, factorial composition and nomological validity. Examples of results obtained with the first version of the tool in outcome studies in Europe and North America support the importance and relevance of the satisfaction measure.

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Exploring Factors for Prescription and Validation of Actuated Upper Limb Devices: a Cross-sectional Survey of Allied Health Professionals

Article

Full-text available

Sep 2024

BACKGROUND Actuated devices can be beneficial for individuals with upper limb muscle weakness, offering extra force and grip. Utilising this type of assistive device can facilitate daily activities, thereby enhancing independence and overall quality of life. The development of actuated assistive devices has been growing, and current literature shows promise in their clinical use. However, they are not yet medically recommended by global guidelines and councils. Studies have suggested why assistive devices have barriers to access, but actuated devices have not been a focus in these discussions. OBJECTIVE(S) To address this issue, a survey was conducted among professionals who prescribe and assess upper limb assistive devices. The survey aimed to gather their opinions and quantify the factors that might contribute to the limited use of actuated devices in the field. METHODOLOGY A web-based cross-sectional study was designed using Qualtrics, contained 25 items and was conducted between October 2023 and January 2024. The survey was piloted, validated, and ethically approved. Results were statistically analysed, and open questions underwent thematic analysis. FINDINGS 87 Allied Health Professionals (AHPs) contributed to the survey, with a completion rate of 69% (60/87). Survey respondents predominately worked from the USA (72%). The survey revealed that 66% of respondents felt they did not have sufficient access to assistive devices and 58% indicated that outcome measures could be improved. They also noted that actuated devices needed to better meet user-centric needs. Barriers to prescribing these devices included a lack of awareness, experience and standardised prescription methods. In addition, the limited time with patients made decision-making and validation of an actuated device difficult. CONCLUSION AHP's have experience prescribing assistive devices but do not have access, knowledge, or clinical methods to assess the use of actuated devices. Future designs for actuated devices should focus on wearability, comfort, user satisfaction, safety and ease of use.

Enhancing museum accessibility for blind and low vision visitors through interactive multimodal tangible interfaces

Article

Full-text available

Feb 2025
INT J HUM-COMPUT ST

This research explores how Interactive Multimodal Tangible Interface (IMTIs) exploiting advanced technologies such as 3D printing and microcontrollers to enhance museum experiences for blind and low vision (BLV) visitors. It investigates the potential for these technologies to create more inclusive and engaging museum environments. Four IMTIs were developed in collaboration with two blind volunteers, with each IMTI using a different interaction technique (autoplay, pushbuttons, and scanning sensors) developed in the pilot phase and having a different shape to align with the museum installation being presented. After refining the concepts, three of the four IMTIs were redesigned and developed into high-quality IMTIs and evaluated by BLV visitors (n=30). The results showed a clear preference among BLV visitors for using pushbuttons to operate the IMTI. Additionally, the research identified key areas for improvement, including 3D printing techniques for producing replicas, audio guide content, and design decisions that can enhance users' sense of control over the IMTI. These findings offer valuable insights for the future development of tactile replicas that promote contextual understanding, while contributing to a more inclusive and engaging museum experience.

A soft wearable exoglove for rehabilitation assistance: a novel application of knitted shape-memory alloy as a flexible actuator

Article

Full-text available

Mar 2024

We developed the knitted shape-memory alloy (SMA) as a flexible actuator and applied it to a soft wearable exoglove for rehabilitation assistance. Based on user needs and anthropometric data, we custom-designed the exoglove for three hemiplegic patients using the knitted-SMA actuator and evaluated its bending performance, gripping force and wearability under the four simulation conditions (S1–S4). To address the specific needs, both SMA plain- and double-knit modules were applied to the exoglove based on the patients’ finger joint range of motion (ROMs). The joint ROMs of all fingers increased by 13.71% and the skin temperature increased by 2.21 °C after actuating the glove ( p = 0.006). The gripping force increased as much as 55.01%, when compared to the baseline. All patients were able to don and doff the developed glove independently, and positively evaluated their subjective satisfaction and thermal perception. The findings suggested the potential of the knitted SMA for the future development of soft wearable robots.

Brain-computer interface enhanced by virtual reality training for controlling a lower limb exoskeleton

Article

Full-text available

Apr 2023

This study explores the use of a brain-computer interface (BCI) based on motor imagery (MI) for the control of a lower limb exoskeleton to aid in motor recovery after a neural injury. The BCI was evaluated in ten able-bodied subjects and two patients with spinal cord injuries. Five able-bodied subjects underwent a virtual reality (VR) training session to accelerate training with the BCI. Results from this group were compared with a control group of five able-bodied subjects, and it was found that the employment of shorter training by VR did not reduce the effectiveness of the BCI and even improved it in some cases. Patients gave positive feedback about the system and were able to handle experimental sessions without reaching high levels of physical and mental exertion. These results are promising for the inclusion of BCI in rehabilitation programs, and future research should investigate the potential of the MI-based BCI system.

Users’ Perceptions About Lower Extremity Orthotic Devices: A Systematic Review

Article

Nov 2022
ARCH PHYS MED REHAB

Objective To systematically review perceptions from adults, children, and caregivers in scientific and open sources to determine how well lower extremity orthotic devices (LEODs) meet users’ Functional, Expressive, Aesthetic, and Accessibility (FEA2) needs. Data Sources Scientific source searches were conducted in the National Library of Medicine (PubMed/ MEDLINE) and Web of Science; open source searches were conducted in Google Search Engine in April 2020. Study Selection Inclusion criteria were reporting of users’ perceptions about a LEOD, experimental or observational study design, including qualitative studies, and full text in English. Studies were excluded if the device only provided compression or perception data could not be extracted. 173 scientific sources of 3440 screened were included (total of 1108 perceptions); 36 open sources of 150 screened were included (total of 508 perceptions). Data Extraction Users’ perceptions were independently coded by two trained, reliable coders. Data Synthesis Across both source types, there were more perceptions about functional needs, and perceptions were more likely to be positive related to functional than expressive, aesthetic or accessibility needs. Perceptions about expression, aesthetics, and accessibility were more frequently reported and more negative in open versus scientific sources. Users’ perceptions varied depending on users’ diagnosis and device type. Conclusions There is significant room for improvement in how LEODs meet users’ FEA2 needs, even in the area of function, which is often the primary focus when designing rehabilitation devices. Satisfaction with LEODs may be improved by addressing users’ unmet needs. Individuals often choose not to utilize prescribed LEODs even when LEODs improve their function. This systematic review identifies needs for LEODs that are most important to users and highlights how well existing LEODs address those needs. Attention to these needs in the design, prescription, and implementation of LEODs may increase device utilization.

Assessing user experience with BMI-assisted exoskeleton in patients with spinal cord injury

Conference Paper

Jul 2022

Spinal Cord Injury (SCI) refers to damage to the spinal cord that can affect different body functionalities. Recovery after SCI depends on multiple factors, being the rehabilitation therapy one of them. New approaches based on robot-assisted training offer the possibility to make training sessions longer and with a reproducible pattern of movements. The control of these robotic devices by means of Brain-Machine Interfaces (BMIs) based on Motor Imagery (MI) favors the patient cognitive engagement during the rehabilitation, promoting mechanisms of neuroplasticity. This research evaluates the acceptance and feedback received from patients with incomplete SCI about the usage of a MI-based BMI with a lower-limb exoskeleton. Clinical Relevance- Patients experienced satisfaction when using the exoskeleton and levels of mental and physical workload were withing reasonable limits. In addition results from the BMI were promising for the inclusion of this type of systems in rehabilitation programs.

Validity, reliability, and user perspectives of the newly developed joint angle measurement system with inertial measurement unit sensors

Preprint

Apr 2025

Purpose: We aimed to evaluate the applicability of the newly developed joint angle measurement system consisting of six-axis inertial measurement unit sensors and tablet-based application that measure and store angular velocity and acceleration data for estimating joint angles. Materials and Methods: The tablet-based application was used to calculate the orientation angles from angular velocity and acceleration data measured using a single sensor. The relative angles were calculated using the data from multiple sensors. In experiment 1, the validity and reliability of calculated angles was examined using a test device. In experiment 2, the angles of five joints were calculated in four healthy participants using attached inertial measurement unit sensors; the angles were compared with universal goniometer-measured values. In experiment 3, usability and satisfaction were evaluated with the System Usability Scale (SUS) and a Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST)-like scale. Results: In experiment 1, the mean difference of the time-series data between those obtained by the developed system and test device was <0.2 degree for all axes. In experiment 2, the mean difference of the integrated data was 0.2 degree. The mean difference for all joints was <5 degree, indicating that the measurement system is comparable to the universal goniometer. In experiment 3, the median SUS and QUEST-like scale scores were 81 and 4.0, respectively, indicating high usability and satisfaction. Conclusion: The newly developed joint angle measurement system has high accuracy in measuring angles and sufficient validity in application to human joint angles, with high usability and user satisfaction.

Stakeholders and Contextual Factors in the Implementation of an Assistive Robot Arm for Persons With Tetraplegia: A Deductive Content Analysis of Focus Group Interview (Preprint)

Article

Aug 2024

Background Tetraplegia imposes significant challenges on affected individuals, caregivers, and health care systems. Assistive technologies (ATs) such as assistive robotic arms have been shown to improve the quality of life of persons with tetraplegia, fostering independence in daily activities and reducing caregiver burden. Despite potential benefits, the integration of AT innovations into daily life remains difficult. Implementation science offers a systematic approach to bridge this know-do gap. Objective This study aimed to (1) identify and involve relevant stakeholders; (2) identify relevant contextual factors (barriers and facilitators); and (3) suggest a general outlook for the implementation of AT, specifically an assistive robotic arm, into the everyday private lives of individuals with tetraplegia in Switzerland. Methods A qualitative design was used, involving 3 semistructured online focus group interviews with 8 stakeholder groups, including persons with tetraplegia as well as those who could provide perspectives on engineering or technology, legal matters, nursing or care, therapy, social counseling, social insurance, and political considerations. The interviews were analyzed using the Focus Group Illustration Mapping tool, and the data were aligned with the domains of the Consolidated Framework for Implementation Research. Results 3 focus group interviews comprising 22 participants were conducted, and data were mapped onto 21 constructs across the Consolidated Framework for Implementation Research domains. Identified barriers were customization to users’ needs, safety concerns, and financing issues for the high AT costs. The collaboration with different stakeholders, including those who provided perspectives on political engagement, proved crucial. Identified facilitators included the enhancement of autonomy for persons with tetraplegia, improvement of quality of life, reduction of caregiver dependency, and addressing health care labor shortages. The implementation outlook involved the formation of an experienced team and the development of an implementation plan using hybrid type 1 and type 2 designs that incorporate both qualitative and quantitative implementation and innovation outcomes. Conclusions Robotic arms offer promising benefits in terms of improved participation for users, while high costs and regulatory complexities as to who will assume these costs limit their implementation. These findings highlight the complexities involved in implementing AT innovations and the importance of addressing contextual factors. A specific framework for the implementation of AT is needed to ensure the successful integration in Switzerland and other countries with comparable social and health insurance systems.

Initial validation and feasibility of a Standardized Navigation Of Winter Mobility & Accessibility Network (SNOWMAN) course for wheelchairs

Article

Sep 2024

Many Canadian manual wheelchair users face many challenges in winter months such as slippage on ice- or snow-covered ramps, snow windrows, and casters becoming stuck in deep or hard packed snow. These barriers impact wheelchair users' ability to participate in the community. This study aimed to evaluate the validity and feasibility of a winter wheelchair obstacle course known as the Standardized Navigation Of Winter Mobility & Accessibility Network (SNOWMAN). The results demonstrated that the SNOWMAN course authentically represented real-world winter conditions, as confirmed by participant responses and qualitative feedback from four manual wheelchair users. The course was comprehensive, covering a range of winter obstacles typically encountered by wheelchair users. Construct validity was established by differentiating performance between manual wheelchairs and a motorized platform with snow tracks, showcasing varying completion times and device satisfaction levels. Feasibility was also assessed, with the administration protocol being mostly adhered to, safety measures implemented, and usability scores meeting acceptable thresholds. The SNOWMAN course showed promise for evaluating wheelchair adaptations and devices for winter conditions, as well as training users in winter mobility skills. Future research directions include comparing different wheeled mobility devices, exploring adaptations for usability in winter, and developing new technology tailored for challenging terrains and winter conditions. The SNOWMAN course could serve as a valuable tool for both research and clinical applications in enhancing winter mobility for wheelchair users.

Use of patient centred outcomes measures alongside the personal wheelchair budget process in NHS England: a mixed methods approach to exploring the staff and service user experience of using the WATCh and WATCh-Ad Tools

Preprint

Full-text available

Aug 2022

Background and Objective Personal wheelchair budgets (PWBs) are offered to everyone in England eligible for an NHS wheelchair, to support their choice of equipment. The WATCh (Wheelchair outcomes Assessment Tool for Children) and related WATCh-Ad tool for adults are patient centred outcomes measures (PCOMs) developed to help individual users express their main outcome needs when obtaining a wheelchair and rate their satisfaction with subsequent outcomes after receiving their equipment. We explored their use in a real-world setting, aiming to produce guidance for use alongside the PWB process. Methods Three wheelchair service provider organisations across four sites participated. Staff and users completed surveys about their experience of the WATCh and/or WATCh-Ad tools used in the assessments. Towards the end of the study, selected patients were interviewed after receipt of their equipment, and staff were interviewed after experiencing a number of assessments. Thematic analysis was undertaken using the tool, survey and interview data. Results Information on 75 assessments by 15 staff was obtained. Over three-quarters of users or their carers rated the use of the tools in the assessment process as ‘helpful’ or ‘very helpful’. Staff reported that use of the WATCh tools had been considered ‘useful’ in developing individual care plans in around 1 in 3 cases and affected the prescription in 1 in 4 cases. Concerns were expressed around the length of time taken to administer the tools in clinic, although some staff noted this reduced with more hands-on experience, and by providing the tools to users in advance of the appointment. Conclusions The WATCh and WATCh-Ad PCOM tools are suitable for routine use by wheelchair service providers to assist the assessment process. It is recommended that tool materials are provided in advance to users/carers, and that staff are allowed time to develop their ways of working with them.

Assistive devices as an early childhood intervention: evaluating outcomes

Article

Aug 1999
Tech Disabil

Understanding and assessing consumer satisfaction in rehabilitation

Article

Jan 1997

Stability and reproducibility of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST)

Article

Jan 1999

Wheelchair Seating Aids: How Satisfied Are Consumers?

Article

Jun 1999

The purpose of this study was to evaluate user satisfaction with wheelchair seating aids. A modified version of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST) was used to assess satisfaction of 24 subjects who owned a modular-type seating device integrated in a powered wheelchair. The results of this QUEST-based approach revealed that the variable comfort was identified as the most important consumer criterion yet it was evaluated as the least satisfying. There were statistically significant (p < 0.05) gender differences in the degree of importance and the degree of satisfaction scored on several variables as well as significant differences between subjects living at home and subjects living in institutions. The results support the value of consumer opinion and challenge the assumptions of assistive technology professionals. This study underscores the appropriateness of assessing consumer satisfaction in a systematic and ecologically valid manner.

Measuring the psychosocial impact of assistive devices: The PIADS

Article

Jan 1996

Assistive devices (ADs) are considered essential to the health and well-being of all people but especially people with sensory or physical disabilities. These include such products as wheelchairs, low vision aids, prosthetic limbs, and hearing aids. Since current quality of life measures are inadequate for assessing the impact of ADs, a questionnaire to measure the psychosocial impact of ADs on users was developed and standardized. Factor analysis yielded three factors. This led to the creation of three subscales that measure the impact along the domains of competence, adaptability, and self-esteem. The results show that the scales have good reliability. To examine utility, the scales were used to compare two competing ADs - eyeglasses and contact lenses. These results show that the subscales have good validity. Clinical studies are now in progress.

An international content validation of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST)

Article

Aug 1999
Occup Ther Int

The Quebec User Evaluation of Satisfaction with assistive Technology (QUEST) is an outcome assessment tool designed to identify the sources of user satisfaction and dissatisfaction with assistive technology. This paper presents the results of an international content validation study of the QUEST that was conducted as part of the ongoing development of this assessment instrument. A questionnaire developed to measure the relevance of QUEST items and to critique the administration procedures was completed by an international group of 12 assistive technology experts from the United States, the Netherlands and Canada. At the test level, the findings revealed that the QUEST was adequately sampled in terms of embracing all the important facets of satisfaction with assistive technology. At the item level, however, it was revealed that changes needed to be made to the wording of the satisfaction variables and to the administration procedures for the QUEST in order to ensure optimal content validity. A limitation of the study is the heterogeneity of the testing sites that may have reduced the chances of reaching consensual agreement among the content experts. It is recommended that future studies consider alternative methods such as factorial analysis to support the findings of this study. Copyright © 1999 Whurr Publishers Ltd.

Functional outcomes of wheelchair seating and positioning in the elderly nursing home population /

Article

Jan 2000

Thomas M. Bursick

Includes bibliographical references (leaves 100-103). Thesis (M.S.)--University of Pittsburgh, 2000. Graduate School of Public Health.

The Measurement of patient satisfaction

Article

Oct 1992

Roy Carr-Hill

Many applied health service researchers launch into patient satisfaction surveys without realizing the complexity of the task. This paper identifies the difficulties involved in executing patient satisfaction surveys. The recent revival of interest in 'satisfaction' and disagreements over the meaningfulness of a unitary concept itself are outlined, and the various perspectives and definitions of the components of satisfaction are explored. The difficulties of developing a comprehensive conceptual model are considered, and the issues involved in designing patient satisfaction surveys--and the disasters that occur when these issues are ignored--are then set out. The potential cost-effectiveness of qualitative techniques is discussed, and the paper concludes by discussing how health care management systems could more effectively absorb the findings of patient satisfaction surveys.

Measuring patients' satisfaction with nursing care

Article

Feb 1992

Assessing patients' satisfaction with the care they receive is assuming greater importance and satisfaction with nursing is no exception. The kinds of study in which patient satisfaction has been used as an outcome are considered and show the range of conceptualizations and the general lack of rigour in its measurement. It is argued that research methods are often flawed by using inappropriate measures and greater care is warranted in their selection. Where appropriate measures do not exist, only then is the costly process of developing new assessments warranted. Some of the necessary steps in arriving at reliable and valid measures of patient satisfaction are discussed in the context of asking particular research questions.

Patient Satisfaction—Does it Matter?

Article

Feb 1991
Qual Assur Health Care

H Vuori

The paper aims at answering the question: Has the measurement of patient satisfaction improved the quality of care? After concluding that there is no evidence in the literature, the paper proceeds to look at why the evidence is lacking. Four factors seem to explain it: the objectives, the focus and the originator of the patients satisfaction studies and measurements and difficulties related to the interpretation of the findings. The last part of the paper analyses why patient satisfaction should be taken seriously although we do not know whether its measurement improves the quality of care. They include the fact that the patients are partners in health care; they literally feel in their skin whether care is good or bad. They are also the best judges of certain aspects of care, such as amenities and interpersonal relations. The second reason is the transformation of health care from a sellers' market to a consumers' market where the satisfaction of the patients' needs is part of the definition of quality. Finally, there is the ideological reason that, in a democratic society, the patients should have the right to influence decisions and activities influencing them. Measurement of patient satisfaction realizes the principle of community participation in health care.

The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 20): An overview of recent progress

Abstract

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