Instructions on Completing the Piads Caregiver Version

When instructing a caregiver on how to complete the PIADS on behalf of a client, stick as closely as possible to the script given below. Do not define the words and phrases which makeup the PIADS items unless the caregiver asks for help.

If the caregiver is not sure how the item applies, tell him/her that if he/she cannot decide whether the assistive device has had a positive or negative effect with regard to that word or phrase, then he/she should put a mark in the "0" box, to indicate no effect.

Be sure the client understands that every item on the PIADS must be answered. There is no "Not Applicable" option. Also, check to see that the caregiver is not responding randomly or giving the same response to each item without sufficient consideration.

If the caregiver asks for a definition for a PIADS item, give the explanation for the item which is in the PIADS glossary. Remind the caregiver that there are no right or wrong answers on the PIADS, and that every item must be answered. The PIADS is all about how he/she feels about each item, and how he/she interprets it in terms of the client's life and experiences. If after you have gone through this explanation the caregiver is still puzzled by an item, encourage him/her to take a guess, and move on to the next item. (Note that the PIADS need not be completed in order of the number beside each item. If the caregiver wants to, he/she can skip an item and come back to it later, so long as all items are answered.)

1. The PIADS Impact Scale is a questionnaire that asks you to describe how an assistive device (give an example appropriate to the caregiver, e.g., wheelchair) affects the life of the person you are raring for and makes that person feel.

2. For each word or phrase, put a mark in the box that best describes these feelings. Mark only one box for each word or phrase, and do not put a mark between boxes.

3. Let's look at a couple of examples of how the questionnaire works when you are describing the client's feelings about one of the words or phrases. Let's look at how you might rate his/her reactions to the word, "competence".

4. If the device has helped him/her to feel very much more competent than he/she feels without it (or before he/she started using it), put a mark in the "3" box.

5. If the device has helped him/her to feel somewhat more competent, but not as competent as you thought he/she might feel, you might put a mark in either the "1" box or the "2" box.

6. If the device has not made him/her feel any more or less competent, put a mark in the "0" box.

7. If the device has made him/her feel quite incompetent (or a lot less competent than he/she used to feel), then put a mark in the "-3" box.

8. If the device has made him/her feel somewhat incompetent (or less competent than he/she used to feel), then you might put a mark in either the "-2" box or the "-1" box.

Additional Notes for Using the PIADS with Clients who have Degenerative Disorders or Traumatic Injuries

If the caregiver appears to be stuck or non-committal, you should try to give encouragement as a means of moving the interview along. This might entail suggesting examples suited to the client's device and personal experiences. For example, for the item, Efficiency, you might ask the caregiver to consider whether writing letters is important to the client, and if so, has a writing aid helped the client to write letters more efficiently than when he/she did not have the device.

Be prepared for resistance from a client or caregiver. Resistance and agitation may arise from their emotional response to the client's diagnosis or prognosis.

Resistance might also result from the number of device questionnaires needed to be filled out, in cases where a client uses more than one device. Exercise good judgment, and be sensitive to the caregiver's level of fatigue, when administering more than one PIADS in a single session. Where possible, allow for short rest periods between assessments. Be patient, and help the caregiver maintain focus when filling out the PIADS, as sometimes the PIADS might prompt an off-topic discussion.

Instructions on Completing the PIADS with A Caregiver for a Client who has Recently Passed Away

See manual, "Instructions on Completing the PIADS: Caregiver Version".

NOTE: The assumption in giving the PIADS in this instance is that the client was using the device prior to the time of death, and since the last PIADS assessment (where applicable). Do not give the PIADS if the client did not use the device since the last PIADS assessment

Explain that in this particular instance, you understand that the client has passed away and you are asking the caregiver to complete the PIADS on behalf of the client.

Explain that you are asking the caregiver to use the scale to indicate how he/she thinks the device affected the client's life in the time just before he/she passed away. Explain that this information will help the researchers discover ways to improve devices for people with conditions similar to that of the loved one.

Instructions to Client/Caregiver on Completing the PIADS Before an Assistive Device is Prescribed

1. Use the standard approach to explaining what the PIADS is and how it is to be completed (see manual).

2. Explain that in this particular instance, the client has not yet received an assistive device, Therefore, what you are asking him/her to do is use the scale to indicate how he/she thinks the device will affect his/her quality of life. Explain that you are collecting this kind of information because you think it might help the research team get a better understanding of what people's concerns and issues are when they are being assessed for assistive technology.

3. In all other respects, the client/caregiver should complete the scale in the usual fashion (e.g., all items must be answered, even if some might seem odd or irrelevant to the client's circumstances).

Script for Completing the PIADS by Telephone

For the next few minutes, I would like to ask you some questions about assistive devices you might be using to help you to do your daily tasks.

(Provide the following definition when the patient doesn't understand what an assistive device is.)

Definition of an Assistive Device: An assistive device is any kind of device or tool that helps you achieve normal or near-normal functioning, such as a walker or wheelchair if you have difficulty walking, or a hearing aid if you have trouble hearing.

Today, I will ask you to tell me your feelings or attitudes about your ____________________<insert device type here>.

I am going to read out a list of words and phrases.

For each word or phrase, I want you to tell me if your_ <insert device type here> has made any difference in your life.

If you tell me that your_<insert device type here> has made a difference, I will then ask you to tell me if it has made things better or worse for you.

You may rank your response on a scale ranging from -3 to +3, with -3 being a lot worse, and +3 being a lot better.

There are no right or wrong answers. Please be as honest as you can when replying. Do you understand what I am asking you to do? Do you have any questions before we begin? Let's begin with the first word or phrase.

"Competence "

(Refer to PADS glossary if respondent has trouble with the meaning of the word or phrase, and follow the directions in the manual for this. No item can be left unanswered. Use 0 (zero) if the respondent cannot decide if there has been an impact.)

Has your _<insert device type here> made you feel more or less competent?

(If respondent says "no", code as 0 (zero) and move onto next item)

(If respondent says "yes, more", then follow up by asking which of the following best describes this impact:)

"Would you say that your_<insert device type here> has made this

Very Much Better for You (code as +3), Just a Little Bit Better for You (code as +1), or Somewhere in Between (code as +2)."

(If respondent says "yes, less", then follow up by asking which of the following best describes this impact.)

"Would you say that your_<insert device type here> has made this

Very Much Worse for You (code as -3), Just a Little Bit Worse for You (code as -1), or Somewhere in Between (code as -2)."

(Repeat this procedure for the rest of the items on the scale.)

We have now finished this questionnaire. Thank you very much for helping us today.

PIADS Background Form - Wheelchairs #_

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