The positioning information that should be provided to caregivers of adults with a physical disability on supply of custom-contoured seating, a Delphi study

Abstract

Purpose

This research aims to identify information that is important to provide on supply of custom-contoured seating. The way this information would be best communicated is also of interest. A two-round e-Delphi study was utilised to explore consensus. A panel of stakeholders from Ireland including experts in positioning clients in custom-contoured seating and caregivers were recruited. The first round consisted of open-ended questions and was analysed using thematic analysis. The second round employed a rating technique and 7-point Likert scale. Consensus was set a priori at 70% agreement. The way information should be communicated and by whom was rated in order of preference.

Materials and methods

Fifteen participants were recruited, nine clinicians and four caregivers. Fifty-two statements under six themes (transfers = 10, positioning = 22, pressure care = 4, general use = 4, post-supply follow-up = 8, functional activity = 4) were generated in round 1 by 13/15 participants. Round 2 was completed by 10/15. 49/52 statements reached consensus and were deemed important. The ways information should be communicated and by whom was identified. Caregivers want individualised information whereas clinicians preferred a more generic approach.

Results and conclusions

There was a high degree of consensus on what information is required to support caregivers. The topics demonstrate the extensive information that should be provided. The preferred delivery method for primary caregivers was hands-on training with the opportunity to practice and take videos. Stakeholders differed in how they would prefer information delivered. Further research should evaluate the method of delivering training and its effectiveness.

IMPLICATIONS FOR REHABILITATION

• Caregivers report a lack of guidance on postural management, which exacerbates their own health problems and results in underutilization of positioning equipment.

• Caregivers should be provided with information on transfers, positioning, pressure care, general chair use, post-supply follow-up, and the impact on functional activities when a new custom contoured seat is supplied.

• The preferred method of providing information to primary caregivers is to use hands-on training with the opportunity to practice and take videos during the supply appointment. Personalised information booklets or group training sessions may be most appropriate for additional caregivers.

Keywords:

• Physical disability
• postural management
• moulded seating
• equipment supply
• caregiver education

Acknowledgements

Thank you to the study participants, their insights were invaluable. I would like to acknowledge the Central Remedial Clinic and specifically, Simon Hall, ATSS Manager, for his support and encouragement throughout this research.

Author contributions

This research was completed by Ruth Hanley as part of an MSc in Rehabilitation (Postural Management). Johnny was the academic supervisor of Ruth Hanley for this study. Johnny Collett is employed and supported by the NIHR Oxford Health Biomedical Research Centre.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

None.