Changes in residents’ seating needs and perception of stakeholders since implementation of a provincial wheelchair program
Bibliographic record
Abstract
BACKGROUND: People living in long-term care frequently have inadequate access to properly fitted wheelchairs. This can lead to potential problems with mobility, positioning, comfort, and skin integrity. A provincial programme to provide individually fitted lightweight wheelchairs to residents started in January 2016; however, no research has evaluated programme outcomes. OBJECTIVES: To identify seating needs of residents before and after implementation of a provincial wheelchair programme at two long term care facilities in Vancouver and to explore stakeholders experiences with this programme. METHODS: A pre/post study design was used which involved chart reviews to collect Seating Identification Tool (SIT), and interviews with stakeholders having experience with the provincial programme to gather information on their experiences. SIT data were analysed using a Wilcoxon Signed-Rank test and interviews were analysed thematically. FINDINGS: SIT scores improved by 2 (median) which was statistically significant for the 22 residents with pre/post data available. Prevalence of seating needs decreased on average by 18%. Among the six stakeholders interviewed, themes identified included: wheelchairs/cushions provided addressed many residents' needs; and saved residents and their families money and stress; and there is still ongoing need for more specialised equipment for frail residents (not covered by this programme). CONCLUSION: This study provides some evidence regarding the benefits of the introduction of this programme in two care homes and identifies potential changes that might improve wheelchair seating among residents with more severe seating needs. Further research is required on how these equipment changes might affect their mobility or participation in activities. Implications for rehabilitationThese findings appear to support the provision of lightweight individually fitted wheelchairs and moderate pressure redistribution cushions by occupational therapists in long-term care through this programme.Regular use of the SIT (i.e., on admission, condition change, annual care conference, and as needed) may be beneficial to ensure residents are properly screened for seating needs.Collaboration with the resident appears to be important to ensure equipment on provision and follow-up are meeting residents' needs.Recommend future research on the use of tilt in space wheelchairs for residents' in long-term care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".