Piads Assistive Tech

Day and Jutai described the basic psychometric properties of the PIADS, based on a sample of eyewear devices users (n=307). Internal consistency was assessed using Cronbach's alpha. Values were .95 for the PIADS total score and .92, .88, and .87 for the Competence, Adaptability, and Self-esteem subscales, respectively. Sixty respondents completed the PIADS twice, about a month apart. None of the f tests comparing the two assessments reached significant differences (p values ranging from .77 to .85), indicating the stability of the scale. Construct validity was examined using a Principal Component Analysis of the data from 307 subjects. The results yielded three distinct subscales, accounting for 61.1% of the total variance. This 3-dimensional structure was confirmed in replication studies involving 150 eyewear device users and 92 wheelchair users. Construct validity was further demonstrated in an examination of the association of the PIADS with a measure believed to tap environmental impact on emotional responses: the Pleasure, Dominance and Arousal (PAD) scale. The Pearson correlation coefficients (rp) were significant at the 0.05 level between the PIADS subscales and the Pleasure (rp .46 to .59) and Dominance subscales (rp .21 to .34) but not with the Arousal subscale (rp .06 to .17). The results were interpreted as supporting the discriminant validity of the PIADS.

Validity was further supported by a study of the scale's ability to distinguish the responses from eyeglass wearers and contact lens wearers, in which group patterns of response were consistent with predictions from the literature. Demers and colleagues found that both the three subscales and total scale of the French translation of the PIADS had good test-retest reliability (ICC of .77 to .90) and internal consistency (.75 to .94). Concurrent validity with the source (original, English) PIADS also produced acceptable coefficients (.77 to .83). Comparisons between PIADS scores and qualitative data obtained through interviews with device users indicate a high degree of reflection of user concerns and issues in the PIADS. User expectations of psychosocial impact from device use accurately predict their experiences following device adoption.

The studies summarized in the Table have demonstrated that the PIADS is a reliable, valid, and responsive measure, with good clinical utility. The PIADS is a sensitive measure of the impact of a wide range of ATs, in populations of adults who have various forms of disability and medical condition. Highlights from the research findings to date include:

o The psychosocial impact of assistive devices can be reliably assessed in a standardized way across diverse populations of device users. o The PIADS is capable of predicting device retention and abandonment. o Patterns of psychosocial impact vary across populations of device users. o Devices associated with stigma produce predictable patterns of psychosocial response. o The psychosocial impact of assistive devices is dissociable from the effects of illness and disabling condition.

o The overall agreement between user self-report and caregiver report of device impact on the user is surprisingly good. o The PIADS is sensitive to clinically and functionally important variables associated with the user's condition and device capabilibes.

Other projects are currently underway to: (1) develop versions of the PIADS suitable for young children and for adults who have cognitive difficulties; (2) examine the validity of translations of the PIADS into languages other than English; (3) investigate psychosocial factors in the long-

term device use and discontinuance for various populations of device users. At present, the only translated version of the PIADS is Canadian French.

The ability of the PIADS to predict abandonment and retention has prompted examination of how the PIADS can best be used to advance the knowledge base in this area. Theories thus far considered include personal control and self-efficacy. They are possibly the most promising psychological conceptualizations for developing a user-focused, environmentally sensitive understanding of AT adoption and retention. When AT is successful in helping people maintain or regain control, important results are increased self-efficacy and decreased negative emotional reactions to disability. These effects in turn are hypothesized to enhance subjective well-being. They are forms of psychosocial impact that are measured in the PIADS.

The PIADS is a reliable and valid tool that appears to have significant power to predict important AT outcomes. It can and should be used both deductively and inductively to build and test theory about the psychosocial impact of assistive technology. Further investigation is needed into the relationships among the PIADS and other validated outcome measures. Researchers are encouraged to keep the PIADS, authors informed about their findings (see contact information page).

Psychosocial Impact PiadsPiads Questionnaire

Table 3: PIADS Questionnaire Version 3.0

Psychosocial Impact of Assistive Devices Scale (PIADS) Today's Date: _

moil til/day/year

(last name, then first name)

Diagnosis:__Dale of Birth:_

month/day/year

The form is being filled out at (chwsi one) 1. □ home 2. □ a clinic 3. □ other (describe): The form is being filled out by (choose out) I. □ the client, without any help 2. D the client, with help from the caregiver (e.g., client sliowed or told caregiver what answers to give) 3. □ the caregiver on behalf of the client, without any direction from the client 4. □ other (describe): _ ___ _

Each -word or phrase below describes how using an assistive device may affect a user. Some might seem unusual but it is important that you answer every one of the 26 items. So, for each word or phrase, put an "X" in the appropriate box to show how you are affected by using the_(device name).

Decreases -3 -2 -1 0_1_2 3 Increases

1)

competence

p

p

a

p

o

a

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