- Title
- Powered mobility devices and occupational participation for people with a body mass index over 30
- Creator
- Kemmis, Emma
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2022
- Description
- Masters Research - Master of Philosophy (MPhil)
- Description
- The increasing prevalence of obesity is a global issue, with the World Health Organization estimating that more than 650 million adults are impacted by obesity. In Australia, 67% of adults were categorised as overweight or obese in 2017-2018. Obesity is associated with the development of noncommunicable diseases (NCD), including diabetes, hypertension, musculoskeletal disorders (particularly arthritis), sleep apnoea and some cancers. Those living with obesity are impacted by both physical and psychological issues. The physical consequences of living with obesity can lead to decreased mobility and reduced occupational participation. Occupational therapy aims to work with people to enable participation in their chosen occupations. One means of enabling improved occupational participation is through the use of a powered mobility device (PMD). In this thesis, the term occupational participation is defined as engagement in work, play or activities of daily living. The term PMD includes powered wheelchairs and mobility scooters. Although previous studies have demonstrated that for people with a NCD, PMDs can improve occupational participation, there is a paucity of research about the use of PMDs for people with obesity. Thus, the aim of this research is to understand how the use of a PMD shapes occupational participation and QoL from the perspective of people with obesity. The study was contextualised within New South Wales, Australia a multi-methods approach was used for this work to gain a holistic overview of the topic. The research included study 1 scoping review, study 2 a quantitative survey and study 3, semi-structured interviews with people who were obese and who used a PMD. In study 1, due to limited evidence regarding the use of a PMD for those in the obese population, the scoping review explored how a PMD contributed to occupational participation and QoL for those with NCD. This work was published in the British Journal of Occupational Therapy 2021. Forty-one articles met the inclusion criteria. The most common method of data collection used in 17 studies was nonstandardised study-specific semi-structured interviews. Across the 41 studies, 28 different outcome measures were used to measure occupational participation and QoL. An overarching theme of enhanced QoL was identified with a strong link to enhanced mobility through the use of a PMD. Seven subthemes were identified: (i) independence, (ii) enabling participation in instrumental activities of daily living, (iii) enhanced social participation and leisure, (iv) environmental barriers to occupational participation, (vi) powered mobility device (PMD) performance concerns impacting occupational participation and (vii) overcoming risk of harm through PMD training. The aim of studies 2 and 3 was to explore the participants’ perspectives of how the provision of PMD shapes occupational participation and QoL for people with obesity The findings of the scoping review were used to guide the survey content. For study 2, I developed a study-specific survey that incorporated two tools: the SF-12v2™ Health survey, a broad generic measure of health status, and the Assistive Technology Outcome Profile for Mobility (ATOP/M), a 28-item self-report measure which evaluates the impact that mobility devices have on people’s ability to engage in activities. Short-answer questions were included to explore PMD use. The survey was completed by 9 participants so the results must be interpreted with caution. There is scope for this survey to be repeated post-Covid 19 when circumstances are better suited for recruitment. Physical and mental health scores were both low on the SF-12v2™ (35.8 and 44.29 respectively) placing results in the 25th percentile. The ATOP/M results appeared to indicate that the PMD reduced the self-perceived difficulties in activities and participation for users. Participants reported that the PMD had a positive effect on occupational participation with activities including shopping, attending doctors’ appointments and visiting friends. The third study used a qualitative phenomenological approach which explored the participants’ lived experiences and perceptions of how the provision of a PMD shaped occupational participation and QoL for people with obesity. Semi-structured interviews were conducted to obtain an in-depth understanding of participants’ perspectives on the use of PMD. A total of seven adults who used a PMD and had a BMI over 30 were interviewed for the study. Thematic analysis led to three themes that describe the positive experiences associated with using a PMD: 1) autonomous mobility; 2) enhanced occupational participation; and 3) improved self-efficacy created increased confidence in relation to participation. In addition, two themes emerged that were barriers to usage of PMDs: 1) physical environmental barriers; and 2) transportation of the PMD. These barriers were exacerbated due to the large size of the bariatric PMD. In summary, the findings from the three studies indicates that if physical barriers and transport issues can be overcome a PMD can enhance mobility and provide freedom, independence and improve QoL for people with obesity. The gains in mobility increase engagement in occupational participation as the PMD provides autonomous mobility allowing a person to engage in an increased range of activities. The participants perceived that their increased occupational participation had a positive effect on their self-efficacy and mental wellbeing with an overall improvement in QoL. The use of PMDs was hampered by physical environmental barriers and difficulties transporting the PMD which bear further discovery. This study was contextualised in NSW and future research is warranted to further investigate how a PMD affects occupational participation and QoL for the wider Australian and international population.
- Subject
- wheelchair; obesity; electric wheelchair; mobility scooter; powered mobility device; occupational therapy
- Identifier
- http://hdl.handle.net/1959.13/1512830
- Identifier
- uon:56671
- Rights
- Copyright 2022 Emma Kemmis
- Language
- eng
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