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2023 HSR&D/QUERI National Conference Abstract

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4018 — Women Veterans’ Experiences with Mobility Assistive Technology

Lead/Presenter: Pooja Solanki,  COIN - Hines
All Authors: Solanki PA (Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital), Dicianno BE (University of Pittsburgh, Pittsburgh VA Medical Center) Koontz AM (University of Pittsburgh, Pittsburgh VA Medical Center) Gatto NJ (University of Pittsburgh, Pittsburgh VA Medical Center) Quinby EJ (University of Pittsburgh, Pittsburgh VA Medical Center) Clarke LL (Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital) Berryman KL (Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital) Weaver FM (Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr VA Hospital, Loyola University)

Objectives:
The purpose of this study was to conduct a needs assessment to learn about women Veterans’ needs, priorities, preferences, and experiences with mobility assistive technology (AT). Devices studied included wheelchairs, scooters, walkers, canes, prosthetics, and orthotics.

Methods:
Women Veterans receiving care from the Veterans Health Administration who received mobility AT in the last 5 years, identified from VA’s corporate data warehouse, were invited to participate in an anonymous online survey. The surveys included questions regarding demographics, training, ability to participate in various activities, and three validated questionnaires that focused on functional mobility, user satisfaction, and psychosocial impact of assistive devices. A subset of Veterans volunteered to participate in semi-structured telephone interviews about their experiences with their AT. Interviews were audio recorded, transcribed, and relevant themes were coded using NVivo.

Results:
700 women Veterans participated in the survey and 11 Veterans completed telephone interviews. Respondents were 50-69 years of age (70%). The three most frequent disabilities women reported were Neuromuscular/Osteoarthritis/Rheumatoid Arthritis, Multiple Sclerosis (MS), and spinal cord injury (SCI) (60%; 27%; 17%). The primary AT most commonly used were canes, walkers, and manual or power wheelchairs. (26%; 24%; 24%). Activities for which their mobility device did not meet their needs included housework, leisure, and social activities (20%; 20%; 17%). Several themes related to patients’ experiences with their mobility AT were identified. In general, women expressed satisfaction with the durability and comfort of their mobility AT. Yet, women identified several concerns with the procurement process including long wait times and feeling like they could not qualify for the same devices that male Veterans could. Women Veterans reported there were limited mobility AT design options for women, noting that they feel “whoever is designing things forget that they are women.” Veterans described that their mobility device did not meet their needs for self-care and housework such as the inability to elevate the wheelchair to prepare food.

Implications:
Barriers to the mobility AT procurement process, education, and design emerged as the overarching themes that underlie a need for improvement. Women Veterans felt there was a need to customize mobility equipment to better fit women’s bodies and needs. Women felt they were limited by what activities they were able to do with their device. Concerns regarding vulnerability, disparities and aesthetics came out during the interviews.

Impacts:
Issues identified with mobility devices included both gender specific and those of concern to individuals who use AT in general. Considerations specific to gender have not been addressed in the female Veteran population.