Preliminary test-retest reliability of the Wheelchair Satisfaction Questionnaire.

PURPOSE: Economic realities in lower-and-middle-income countries (LMICs) present an increased need for outcome measures for wheelchair efficacy, as these measures enable optimized use of funds. As the provision level of wheelchairs is low in these areas, and many wheelchairs are inappropriate for their intended users, use of funds based on evidence is especially necessary. The Wheelchair Satisfaction Questionnaire (WSQ) was designed to be a snapshot of a wheelchair user's level of satisfaction with their wheelchair. The WSQ is comprised of 16 visual analogue scale questions. Each question includes an option for a qualitative explanatory comment. The current study examined initial test-retest reliability of the WSQ. MATERIALS AND METHODS: The WSQ was administered twice to the same set of wheelchair users who were secondary students at a school for students with disabilities. A demonstration was given to the participants to explain how to mark the analogue scale. Participants were instructed to answer each item honestly and without peer input. A one-week time span separated test and retest. Scores for both sessions were entered into SPSS. An interclass coefficient of 0.70 or above indicates acceptable test-retest reliability. RESULTS: The ages of participants ranged from 13 to 24, with a mean age of 17.86 years. Sixty-five participants completed the questionnaire fully in both test and retest and were included in this study. A high degree of reliability was found between scores from both tests. The interclass coefficient was r(63) = .863, p = .01, indicating statistically significant agreement between test and retest. CONCLUSION: The results support the WSQ as a reliable measure, confirming the WSQ as a reliable tool for user feedback on wheelchair function. Because the WSQ is designed to provide user feedback with enough granularity to give data on particular aspects of wheelchair structure and function, data can facilitate repair and modifications to wheelchair parts. Studies using the WSQ to assess specific wheelchair types could indicate consistent patterns of user satisfaction and dissatisfaction, revealing relevant design issues. The WSQ is designed to give wheelchair users a voice that can empower user centred modification and design changes to facilitate improved health, opportunity, and social interaction.Implications for RehabilitationResults from the WSQ could enable manufacturers to utilize user feedback to improve the design of wheelchairs for use in LMIC's, and providers could be better-informed in the selection of wheelchair types for specific environments.The WSQ could provide immediate user feedback to inform wheelchair modification and selection to best serve a particular user.The WSQ could be used in clinical settings over time to collect longitudinal data from wheelchair users, which could identify the most commonly perceived reasons for user dissatisfaction in a particular clinical setting.

Face and content validity for the Wheelchair Satisfaction Questionnaire.

PURPOSE: Because outcomes studies are known to facilitate effective use of funds, economic realities in lower-resource countries increase the need for outcome measures for wheelchair effectiveness in these areas. Effective use of funds based on evidence is especially needed since the level of wheelchair provision is low, and many wheelchairs are inappropriate for their intended users. There are very few existing wheelchair specific assistive technology outcome measures. The Wheelchair Satisfaction Questionnaire (WSQ) was designed to be a snapshot of a wheelchair user's level of satisfaction with their wheelchair. The current studies examined the development of the WSQ and its initial face and content validity. MATERIALS AND METHODS: The WSQ is comprised of 16 visual analogue scale questions; each question includes a qualitative explanatory comment. In study 1, 15 adult users of manual wheelchairs completed the WSQ and then the completed a follow-up questionnaire which collected feedback on each question. In study 2, 15 secondary school student users of manual wheelchairs in Kenya completed the same procedure used in study 1. RESULTS: High mean satisfaction scores on the follow-up questionnaire support face and content validity in both studies. CONCLUSION: The WSQ has the potential to give wheelchair users a quantifiable voice on wheelchair function. Data obtained from the WSQ also has the potential to provide data from wheelchair users to wheelchair manufacturers and providers, leading to better design and provision.Implications for RehabilitationBased upon the score of a specific item, manufacturers could improve design of wheelchairs for use in lower-and-middle-income countries, and providers could be better-informed as to models sent to specific environments.The WSQ could provide evidence-based information to support improved provision and design.The WSQ could be used in a clinical setting over time to identify the most common interface problems in that particular setting.

Evaluation of pelvic floor symptoms and sexual function in primiparous women who underwent operative vaginal delivery versus cesarean delivery for second-stage arrest.

OBJECTIVES: This study aimed to compare the prevalence and severity of pelvic floor symptoms and sexual function at 1 year postpartum in women who underwent either operative vaginal delivery (OVD) or cesarean delivery (CD) for second-stage arrest. METHODS: In this cohort study, women with second-stage arrest in their first pregnancy who delivered between January 2009 and May 2011 at 2 different institutions were identified by an obstetric database using International Classification of Diseases, Ninth Revision, codes. Validated questionnaires evaluating pelvic floor symptoms and sexual function were administered. Subjects were dichotomized into those who underwent an OVD or a CD. Additional analyses by intent-to-treat and stratification of vacuum versus forceps operative deliveries were performed. RESULTS: Of the 109 women who completed the 1-year postpartum symptom questionnaires, 53 (48.6%) had a successful OVD, 20 (18.3%) failed OVD and underwent CD, and 36 (33%) underwent CD only. There were no differences between those who had a successful OVD and those who underwent a CD in either pelvic floor function or sexual function, but bulge symptoms were more common in the OVD group (7.5% vs 0, P = 0.05). When analyzed by intent-to-treat (planned OVD vs planned CD), pelvic floor symptoms remained similar between groups. However, those in the planned CD group reported higher orgasm and overall sexual satisfaction scores. CONCLUSIONS: In this sample of primiparous women with second-stage arrest, mode of delivery did not significantly impact pelvic floor function 1 year after delivery, except for bulge symptoms in the OVD group and sexual satisfaction in the planned CD group.