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Prof. Stefano Federici Dipartimento di Scienze Umane e della Formazione, Università degli Studi di Perugia 4. La valutazione.

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Presentation on theme: "Prof. Stefano Federici Dipartimento di Scienze Umane e della Formazione, Università degli Studi di Perugia 4. La valutazione."— Presentation transcript:

1 Prof. Stefano Federici Dipartimento di Scienze Umane e della Formazione, Università degli Studi di Perugia 4. La valutazione delle tecnologie assistive Prof. Stefano Federici – A.A Prof. Stefano Federici – A.A

2 2

3 SEGMENTO 1: FATTORE 1 MODELLIZZARE LATA PROCESS 3 SEGMENT 1: FACTOR 1 MODELING THE ATA PROCESS

4 Models of AT delivery in Western countries 4 Public Health System Most of European Countries (e.g. Italy) Private Health System Several Anglo-Saxon Countries (e.g. USA) 2 Models Users of noncommercial advisory service and support on AT (e.g. Center for Assistive Technology in Italy) Clients of commercial provision of AT (e.g. Center for Assistive Technology in USA) Patients of medical center for technical aid (e.g. Dep. of Physical Medicine & Rehabilitation of University of Rochester) Recipients Free of charge In a Public Health System Fee-paying In a Private Health System Product Public Health System Public Health System Private Health System Private Health System chargecharge no charge user patient client Models Recipients Fees

5 5 Scholars from 5 Continents 55 Scholars from 5 Continents Institute for Matching Person & Technology Center for Technical Aid, Leonarda Vaccari

6 5 pillars of the ATA process model 6 5. The role of the psychologist 4. The psychotechnologist 3. The definition of assistive solution (AAATE – 03) 2. The MPT model 1. The ICFs biopsychosocial model

7 The Assistive Technology Assessment process 7

8 Health condition (disorder or disease) Body Functions and Structures ActivitiesParticipation EnvironmentalFactors PersonalFactors The ATA process under the lens of the ICF biopsychosocial model 8 Well-being MPT Medical diagnoses* User driven process ** Support & follow up *** Assistive Solution

9 Limiti e vantaggi di un modello ideale di ATA process 9

10 Summarizing the 3 main elements identified in SEGMENT 1 10

11 Question time – SEGMENT 1 If the goal of the ATA process is to model an effective assessment process for providing an assistive solution, why does (in the phase 4 of the ATA process) the Center provides an Assistive Technology and not an Assistive Solution? –B–B–B–Because in the phase 4 we are referring to the provision of an assistive device, evaluated as needed to reach an assistive solution. –T–T–T–The assistive solution is the entire process and the outcome. 11

12 SEGMENTO 2: FATTORE 2 DIRIGERE LATA PROCESS: LO PSICOTECNOLOGO 12 SEGMENT 2: FACTOR 2 MANAGING THE ATA PROCESS: THE PSYCHOTECHNOLOGIST

13 autonomia interazione participazione Tra lutente e la tecnologia: Lo psicotecnologo 13 Bisogni dellutente psicologopsicologo Caratteristiche della tecnologia Caratteristiche tecnologotecnologo

14 What the Psychotechnologist is and is not 14 Why not? Psychotechnologist evaluates the interaction according to a user-AT-milieu holistic model.Psychotechnologist evaluates the interaction according to a user-AT-milieu holistic model. Psychotechnologist is an expert of assistive solutions.Psychotechnologist is an expert of assistive solutions. Why not? Psychotechnologist is not a clinic/dynamic psychologist.Psychotechnologist is not a clinic/dynamic psychologist. Psychotechnologist has a background in (rehabilitation) psychology.Psychotechnologist has a background in (rehabilitation) psychology.

15 Cosa fa lo psicotecnologo 15 Sistema Tecnologico Strumenti: ATD-PA ATD-PA QUEST, QUEST, SUMI, SUMI, IPDA… IPDA…

16 1.Valutazione dati utente e organizzazione del setting; 2.Preparazione del setting; 3.Processo di abbinamento; 4.Valutazione della soluzione assistiva; 5.Supporto e follow-up. START Centro Ausili Contact User data collection Setting set-up Matching process: - assistive solution proposal - assistive solution user-trial - assistive solution outcome Assistive solution Multidisciplinary team evaluation User Support Follow up User agreement EXIT Multidisciplinary team meeting for: - user data valuation and - setting design Environmental assessment process (see the Usability and Accessibility evaluation diagram) Assistive Technology Provision

17 University courses 17 Modulo 1: Fondamenti Modulo 2: Conoscenze specifiche sulle Tecnologie Assistive Modulo 3: Processi di Assortimento e Fornitura di TA e ICT Modulo 4: Tecnologie Assistive in Pratica e Applicazioni

18 University course 18 Modulo 1: Fondamenti Modulo 2: Introduzione alla Psicotecnologia Modulo 3: Elementi di base e avanzati su Tecnologie Assistive Modulo 4: Soluzioni Assistive

19 Summarizing the 3 main elements identified in SEGMENT 2 Psychotechnologist analyzes and evaluates the user-technology interaction system according to a User-AT-Milieu holistic model; Psychotechnologist investigates the biopsychosocial variables of the users functioning. The new professional figure of the psychotechnologist Psychotechnologist analyzes the person-technology interaction by means of a biopsychosocial approach; Psychotechnologist is involved in different crucial phases of the Assistive Technology Assessment process. The role of the psychotechnologist Assistec – Austria; Bachelor of Science in Psychotechnology for Assistive Solutions. University courses for psychotechnologists 19

20 Question time – SEGMENT 2 20 Does a psychotechnologist have something to do with the method of psychotechnology in the applied psychology proposed by Igor Smirnov to manipulate human mind by means of technology? No, it doesn't! Not at all. As we previously explained, the psychotechnologist does not have anything to do with thought control! No, it doesn't! Not at all. As we previously explained, the psychotechnologist does not have anything to do with thought control! In fact, the current concept of psychotechnology is related to a neologism to explain a new professional figure which investigates the psychological and cognitive components involved in the interaction environment, be it either a physical environment or a Information and Communication Technology one. In fact, the current concept of psychotechnology is related to a neologism to explain a new professional figure which investigates the psychological and cognitive components involved in the interaction environment, be it either a physical environment or a Information and Communication Technology one.

21 21 SEGMENT 3: ASSESSING PERSONAL FACTORS IN A CENTER FOR TECHNICAL AID

22 The Number One Suspect in AT abandonment: Personal factors 22

23 What the personal factors are 23 Health condition (disorder or disease) Body Functions and Structures ActivitiesParticipation EnvironmentalFactors PersonalFactors

24 Why the AT Service provision is an expensive process 24 holistic A holistic rehabilitation technology faces several variables effective An effective rehabilitation technology is an expensive process neglect The rehabilitation technology standard neglect personal factors

25 Return on Investment (ROI) in assessing personal factor 25 Umbra Region Aid and Prosthetic Service Provision Economic waste Economic waste 2009 Matching Aid and Person, financed by the Italian Umbria Region in 2009 Matching Aid and Person, financed by the Italian Umbria Region in 2009 Identify the percentage of AT non-use and the users satisfaction of AT in a national health system. Federici, S., & Borsci, S. (2011). The use and non-use of assistive technology in Italy: A pilot study. In G. J. Gelderblom, M. Soede, L. Adriaens & K. Miesenberger (Eds.), Everyday Technology for Independence and Care: AAATE 2011 (Vol. 29, pp ).Results Mean of non-use 18% Mean of non-use 18% (good!) Main reason of AT non-usePersonal Factors Main reason of AT non-use Personal Factors Umbria population = 908,000

26 How to invest in personal factors Macro-level WHO Develop personal factor categories within the ICFLocal-level Employ psychologist as expert in personal factors – Meloni, F., Federici, S., Stella, A., Mazzeschi, C., Cordella, B., Greco, F., et al. (2012). The Psychologist. In S. Federici & M. J. Scherer (Eds.), Assistive Technology Assessment Handbook (pp ). Boca Raton, FL, US: CRC Press. 26

27 What the psychologist does 1. Identify 1. Identify the users personal factors, priorities, preferences, etc.; 2. advocate 2. advocate the users request; mediator 3. act as mediator between users seeking solutions and the multidisciplinary team; facilitator 4. act as team facilitator among members of the multidisciplinary team; 5. reframe 5. reframe the relationship between the client and his or her family. 27

28 The role of the psychologist in the ATA process Identify Identify Advocate Advocate Mediate Mediate Facilitate Facilitate Reframe Reframe 28 Multidisciplinary team meeting for: - user data valuation and - setting design START Center for Technical Aid Contact User data collection Setting set-up Matching process: - assistive solution proposal - assistive solution user-trial - assistive solution outcome Assistive solution Multidisciplinary team evaluation User Support Follow up User agreement Assistive Technology Provision User/client REQUEST User Actions Request to solve activity limitations Request to solve environmental restrictions Providing history (medical, rehabilitation, support use) and psycho-socio- environmental data User subjective evaluation of technological aids User evaluation of assistive solution Short/Long-term use -Effectiveness -Efficiency -Usability -Personal, emotional, social, comfort with use -Subjective well-being -Benefit Assistive Technology obtained: public health system or public/private insurance ADVOCATEADVOCATE MEDIATEMEDIATE FACILITATEFACILITATE TEAMTEAM FACILITATEFACILITATE TEAMTEAM REFRAMEREFRAME

29 Summarizing the 3 main elements identified in SEGMENT 3 29

30 Question time – SEGMENT 3 Why is the engineer not an expert in personal factors? –T–The engineering curriculum does not typically include this. –B–Because knowing about personal factors is not equivalent to knowing subjective dimensions and individual functioning. –T–Theoretical acknowledge of personal factors does not reveal the psychological and existential side of the individuals functioning. 30

31 31 SEGMENT 4: ASSESSING ENVIRONMENTAL FACTORS IN A CENTER FOR TECHNICAL AID

32 Why assess the environment Health conditions are affected by environmental factors (WHO, 2011, World report on Disability) AT abandonment is affected by environmental factors (Philips & Zhao, 1994; Scherer et al. 2005; Federici & Borsci, 2011) 32

33 What the environment is in the ATA process 33 context Any context in which the AT is used by a person Social and natural environment and artifacts Personal Factors Definition Dimensions Health condition (disorder or disease) Body Functions and Structures ActivitiesParticipation EnvironmentalFactors PersonalFactors EnvironmentalFactors PersonalFactors ICF Contextual Factors ICF

34 ICF Constructs Environment of use Facilitator (AT) Barriers How to assess environment 34 Output Users Performance

35 Measures of Environment and AT impact Mirza, Gosset, & Borsci 2012 How to improve the users performance AT facilitator 35 Decisions for Improving Users Performance Modify EnvironmentModify Environment Modify ATModify AT Modify AT and EnvironmentModify AT and Environment Environment of use Access Use Sustainable

36 Assess the match between AT and environment 36 Accessibility Universal Design Sustainability Ideal fit

37 Assess the match between AT and environment 37

38 How to assess accessibility 38 Accessibility General guidelines Physical access laws Local policies

39 How to assess Universal Design 39 Universal design Principle of UD Effectiveness, efficiency and satisfaction

40 How to assess sustainability 40 Sustainability Sustainable standards / principles Persons needs over the time (changing) Impact AT-Environment (cost of maintenance)

41 Change the environment Change the AT Results Change the AT Change Environment Change AT and environment Change both Environmental Assessment Process AT/end user Universal design Accessibility Sustainability Environment MATCH END EXIT TO Modify the environment in use (Mod–Env) Proposal of a new matching process or strong personalization (Prop–nMP) Climate Impact Impact of environment modification Impact of a new matching process Mod–Env ResultsProp–nMP Results MATCH Mod–Env < Prop–nMT Prop–nMP < Mod–Env END EXIT TO START Contact User data collection Setting set-up Matching process: - assistive solution proposal - assistive solution user-trial - assistive solution outcome Assistive solution Multidisciplinary team evaluation User Support Follow up User agreement Assistive Technology Provision EXIT Multidisciplinary team meeting for: - user data valuation and - setting design Prop–nMP = Mod–Env Environment data collecting Center for Technical Aid

42 Summarizing the 3 main elements identified in SEGMENT 4 42

43 Question time – SEGMENT 4 Must we restart the Environment Assessment process when the result of the process suggests a need to modify or completely change the AT? –Y–Y–Y–Yes, you should. All the steps of the Environment Assessment decision-making process might need to be repeated when a modified or a completely new AT is proposed by the multidisciplinary team. 43


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