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.

The inter-rater reliability of the Wheelchair Interface Questionnaire.

PURPOSE: Wheelchair outcomes measures are useful to support evidence-based practice in wheelchair provision, especially in low- and middle-income countries (LMIC). The Wheelchair Interface Questionnaire (WIQ) was developed to provide a professional perspective on the quality of the interface between a wheelchair and its user. Studies conducted during the development of the WIQ indicated it has face validity and content validity. The objective of this field study was to conduct a subsequent investigation of the inter-rater reliability of the WIQ at a school for children with disabilities in Kenya. MATERIALS AND METHODS: Eight practitioners with wheelchair experience from disparate cultural backgrounds participated in the study. They evaluated eight wheelchairs and the interface with their users. The interclass correlation coefficient (ICC) of the mean rating for the eight-item dataset was computed using SPSS. RESULTS: The ICC was found to be 0.911, indicating that the WIQ possesses inter-rater reliability. Common comment topics indicated that the qualitative data yielded by the WIQ is meaningful. Informal timing indicated that the WIQ is a brief measure. CONCLUSION: The WIQ is a reliable tool that can meet the need for a professional assessment of the wheelchair-user interface. The reliability of this questionnaire is important because the tool can be used to evaluate the interface between a wheelchair user and their wheelchair, strengthening evidence-based practice in wheelchair provision.Implications for RehabilitationBased on the score of a specific wheelchair interface, a rehabilitation professional could recommend more assessment, seating modification, or wheelchair replacement in order to maximize rehabilitation benefit for a clientThe WIQ could provide evidence-based information to support the need for wheelchair repair or replacement to funders.In large-scale studies involving many of the same wheelchair type in the same setting, the WIQ could be used to identify problems with the interface between that wheelchair type and its intended user population so that manufacturers can make responsive design changes.The WIQ could be used in a clinical setting over time to identify the most common wheelchair interface issues for that setting.

Development of the Wheelchair Interface Questionnaire and initial face and content validity.

BACKGROUND: Because resources are limited in low- and middle-income countries (LMIC), the development of outcome measures is of interest. Wheelchair outcome measures are useful to support evidence-based practice in wheelchair provision. OBJECTIVES: The Wheelchair Interface Questionnaire (WIQ) is being developed to provide a professional perspective on the quality of the interface between a wheelchair and its user. This article discusses the development of the WIQ and its face and content validity. METHOD: During field studies in Kenya, we sought to include professional report data on the wheelchair-user interface that could be analysed to inform design changes. None of the existing measures was focused on the interface between users and their wheelchairs. The WIQ was developed to meet this need. To investigate face and content validity, 24 experienced wheelchair professionals participated in a study that included two rounds of an online survey and a focus group in Kenya. RESULTS: Responses were categorised by topic and the WIQ was modified following each iteration. Participants affirmed the usefulness of a brief professional report measure to provide a snapshot of the user-wheelchair interface. Participants emphasised the importance of brevity, wide applicability and provision of specific feedback for wheelchair modification or design changes. The focus group agreed that the final version provided useful data and was applicable to virtually all wheelchair users in LMIC. CONCLUSION: These preliminary studies indicate initial face and content validity of the WIQ as a method for providing a professional perspective on the interface between a user and his or her wheelchair. KEYWORDS: Outcome measure; wheelchair assessment; user-wheelchair interface; wheelchair appropriateness; professional report.