The Impact of Assistive Technologies on Quality of Life and Psychosocial Well-Being

Introduction

Quality of life (QoL) is a comprehensive term to describe a person’s experiences of health and illness; it is a personal, dynamic and amorphous concept. There are multiple ways to assess QoL: measuring physical health and functional ability, emotional assessment, measuring psychological well-being, and assessing social well-being. While some QoL factors can be measured objectively, there is evidence to support the utility of measuring subjective well-being (Mroczek & Kolarz, 1998). The multidimensionality of QoL presents a challenge to researchers: causal factors are interrelated and affect overall well-being. A person’s subjective well-being will also change over the lifespan due to health status and life events; therefore, any QoL assessment must be considered a snapshot of well-being at that point in time and at least occasional reassessment is necessary. Quality of life is personal because needs, desires and priorities are different from person to person. Quality of life assessment is used to supplement objective, or clinical, measures of medical conditions. The increasing usage arises from a shift in contemporary healthcare organizations from a medical care model to a person-centered, social care model (Walsh & O’Shea, 2008). In a social care model, importance is placed on disease outcomes, satisfaction with treatment, and how patients feel. Assessing treatment, services, assistance, and outcomes is especially important for people who have a chronic medical condition, such as a disability, and is understudied. A disability occurs when a person, in an environment, cannot complete a task. For example, a wheelchair user (person) would have difficulty ascending (task) a flight of stairs (environment). Elevators and wheelchair ramps are examples of assistive devices that enable a wheelchair user to navigate not just the environment, but tasks within environments. An additional area of QoL research that needs to be further developed is the impact of assistive devices on a person’s life (i.e., how a person’s life is changed because of using or not using a device or service that accommodates a disability). The Technology Related Assistance for Individuals with Disabilities Act of 1988 (the United States Tech Act) defines an assistive device as “any item, piece of equipment, product, or system, whether acquired commercially off the shelf, modified or customized, that is used to increase, maintain or improve functional capabilities of individuals with disabilities”. This broad definition is by design and highlights the unique needs of individuals and classifies a device as assistive whether it was originally developed to accommodate for a disability. AbleData, an online database of assistive technology resources and information, contains information on over 35,000 assistive technology devices and products. For the purposes of this chapter the terms “assistive device”, “assistive technology” and “assistive technological device”, all common terms in the industry and scientific literature, are referred to synonymously as “assistive technology (AT)”. As important as the devices themselves is the procurement process. People cannot be satisfied or dissatisfied with a product if they cannot obtain it; therefore, researchers are also examining the QoL impact of AT services (Jutai, Fuhrer, Demers, Scherer, & DeRuyter, 2005).