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Psicologia del funzionamento e della disabilità. 4. La valutazione delle tecnologie assistive. Prof. Stefano Federici – A.A . 2012-2013. Segment 1: Factor 1  Modeling the ATA process. Segmento 1: Fattore 1  Modellizzare l’ATA process. 5 pillars of the ATA process model. ATA PROCESS.

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psicologia del funzionamento e della disabilit

Psicologia del funzionamento e della disabilità

4. La valutazione delle tecnologie assistive

Prof. Stefano Federici – A.A. 2012-2013

slide3

Segment 1: Factor 1 Modeling the ATA process

Segmento 1: Fattore 1 Modellizzare l’ATA process

the assistive technology assessment process

Phase 1:

Theuser seeks a solution

Phase 1:

User data collection

The Assistive Technology Assessment process

Phase 2:

Evaluation data

Phase 2:

Theuser checks the solution

Phase 3:

Matching process

Phase 3:

Theuser adopts the solution

Phase 4:

Assistive Technology Provision

and Follow-up of the assistive solution in context

the ata process under the lens of the icf biopsychosocial model
The ATA process under the lens of the ICF biopsychosocial model

Health condition

(disorder or disease)

Body Functions

and Structures

Activities

Participation

Assistive Solution

Medical diagnoses*

User driven process **

Support & follow up ***

ICF – biopsychosocial model

MPT

Well-being

Environmental

Factors

Personal

Factors

limiti e vantaggi di un modello ideale di ata process
Limiti e vantaggi di un modello ideale di ATA process

Limiti 

  • La difficoltà di definire un unico AT system delivery
    • La straordinaria varietà di sistemi sanitari influenza in differenti modi le specifiche caratteristiche che delineano ogni singolo Centro.
  • La comunità scientifica sta perseguendo un AT system delivery che sia sempre piùindividualizzato. Come si usa dire Centratosullapersona.

Vantaggi

  • Emerge come una sintesi di esperienze di modelli regionali.
  • Si condivide un modello teorico e criteri di valutazione.
  • Permette di condividere dati essenziali alla ricerca scientifica.
  • Aiuta a pianificare e valutare politiche nazionali e internazionali.
  • Può aiutare a valutare la qualità dei servizi.
question time segment 1
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?
    • Because in the phase 4 we are referring to the provision of an assistive device, evaluated as needed to reach an assistive solution.
    • The assistive solution is the entire process and the outcome.
slide11

Segment 2: Factor 2  Managing the ata process: the psychotechnologist

Segmento 2: FaTtore 2  dirigere l’ata process: lo psicotecnologo

tra l utente e la tecnologia lo psicotecnologo
Tra l’utente e la tecnologia: Lo psicotecnologo

Caratteristiche

della tecnologia

Bisogni dell’utente

psicologo

tecnologo

what the psychotechnologist is and is not
What the Psychotechnologist is and is not
  • Cognitive ergonomist
    • Evaluates the interaction according to a dualistic reciprocity between two poles: the user system and the artifact system (Norman 1983).
  • Psychologist(in Center for AT provision)

is an expert in

    • personal factors;
    • human relationships and communication;
    • psychological assessment and intervention;
    • dynamic biopsychosocial variables.
  • Why not?
  • Psychotechnologist is not a clinic/dynamic psychologist.
  • Psychotechnologist has a background in (rehabilitation) psychology.
  • Why not?
  • Psychotechnologist evaluates the interaction according to a user-AT-milieu holistic model.
  • Psychotechnologist is an expert of assistive solutions.
cosa fa lo psicotecnologo
Cosa fa lo psicotecnologo
  • Strumenti:
    • ATD-PA
    • QUEST,
    • SUMI,
    • IPDA…

Sistema

Tecnologico

Barriere e facilitatori

Sistema-utente

Sistema socio-ambientale

Prospettiva biopsicosociale

university courses
University courses

Assistec – Austria(Miesenberger, 2006)

  • Corso e-learning;
  • 4 moduli e 17 seminari;
  • Diploma in Esperto in Tecnologie Assistive.

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

university course
University course

Master in Psicotecnologie per Soluzioni Assistive

  • Corso universitario;
  • 4 moduli, 1000 hdi insegnamento frontale, 500 h tirocinio and workshop;
  • Diploma in Esperto in psicotecnologie.

Modulo 1: Fondamenti

Modulo 2: Introduzione alla Psicotecnologia

Modulo 3: Elementi di base e avanzati su Tecnologie Assistive

Modulo 4: Soluzioni Assistive

question time segment 2
Question time – SEGMENT 2
  • 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!
  • 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.
the number o ne suspect in at abandonment personal factors
The Number OneSuspect in AT abandonment: Personal factors
  • Philips & Zhao (1993) Predictors of Assistive Technology Abandonment
  • Scherer et al (2005) Predictors of assistive technology use
  • Dijcks et al (2006) Non-use of assistive technology
  • Lauer et al(2006) Factors in Assistive Technology Device Abandonment
  • Verza et al (2006) Evaluating the need for assistive technology reduces equipment abandonment
  • Federici & Borsci (2011) The use and non-use of assistive technology
what the personal factors are

Health condition

(disorder or disease)

What the personal factors are

Body Functions

and Structures

Activities

Participation

ICF - biopsychososcial model

Environmental

Factors

Personal

Factors

why the at service provision is an expensive process
Why the AT Service provision is an expensive process

The variability is an obstacle because it is a cost

return on i nvestment roi in assessing personal factor
Return on Investment (ROI) in assessing personal factor

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. 979-986).

Results

  • Mean of non-use 18%(good!)
  • Main reason of AT non-use  Personal Factors

ROI

on personal factors

in Umbria Region

=

$ 2,000,000

Umbra Region Aid and Prosthetic Service Provision

Economic waste 2007-09

Economic waste 2009

Umbria population = 908,000

how to invest in personal factors
How to invest in personal factors

Macro-level

  • WHO Develop personal factor categories within the ICF

Local-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. 149-177). Boca Raton, FL, US: CRC Press.

Psychologist

in a AT service delivery process

provides

an appropriate psychological evaluation or a precise clinical intervention with the user/client and/or their significant human context over the course of the whole AT assignment process.

what the psychologist does
What the psychologist does
  • Identifythe user’s personal factors, priorities, preferences, etc.;
  • advocatethe user’s request;
  • act as mediator between users seeking solutions and the multidisciplinary team;
  • act as team facilitatoramong members of the multidisciplinary team;
  • reframethe relationship between the client and his or her family.
the role of the psychologist in the ata process

Psychologist’s role

User Actions

Center for Technical Aid

TEAM

TEAM

START

User/client REQUEST

FACILITATE

The role of the psychologist in the ATA process

Contact

Request to solve activity limitations

Request to solve environmental restrictions

FACILITATE

User data collection

IDENTIFY

Providing history (medical, rehabilitation, support use) and psycho-socio-environmental data

Multidisciplinaryteam meeting for:

- user data valuation and - setting design

NOT

ADVOCATE

Identify 

Advocate 

Mediate 

Facilitate 

Reframe 

User subjective evaluation of technological aids

Setting set-up

Matching process:- assistive solution proposal- assistive solution user-trial- assistive solution outcome

MEDIATE

User evaluation of assistive solution

Assistive solution Multidisciplinaryteam evaluation

NOT

NOT

NOT

Assistive Technology obtained:public health system or public/private insurance

User agreement

NOT

Short/Long-term use

  • Effectiveness
  • Efficiency
  • Usability
  • Personal, emotional, social, comfort with use
  • Subjective well-being

-Benefit

Assistive Technology Provision

REFRAME

User Support

Follow up

question time segment 3
Question time – SEGMENT 3
  • Why is the engineer not an expert in personal factors?
    • The engineering curriculum does not typically include this.
    • Because knowing about personal factors is not equivalent to knowing subjective dimensions and individual functioning.
    • Theoretical acknowledge of personal factors does not reveal the psychological and existential side of the individual’s functioning.
what the environment is in the ata process

Health condition

(disorder or disease)

What the environment is in the ATA process

Body Functions

and Structures

Activities

Participation

Definition

ICF

Contextual Factors

ICF - biopsychosocial model

Environmental

Factors

Personal

Factors

Environmental

Factors

Personal

Factors

Dimensions

how to assess environment
How to assess environment

ICF Constructs

Output

User’s Performance

how to improve the user s performance at facilitator
How to improve the user’s performance  AT facilitator

Measures of Environment and AT impact

Mirza, Gosset, & Borsci 2012

Decisions for Improving User’s Performance

  • Modify Environment
  • Modify AT
  • Modify AT and Environment
assess the match between at and environment
Assess the match between AT and environment
  • Accessibility

Ideal fit

  • Universal
  • Design
  • Sustainability
slide39

Center for Technical Aid

Environmental Assessment Process

Check

the match

Environment data collecting

START

Environment

Contact

Universal design

Accessibility

Sustainability

AT/end user

User data collection

MATCH

ENDEXIT TO

Multidisciplinaryteam meeting for:

- user data valuation and - setting design

YES

NOT

NOT

Check the

impact

Modify the environment in use

(Mod–Env)

Proposal of a new

matching process

or strong

personalization (Prop–nMP)

IF

IF

Setting set-up

Matching process:- assistive solution proposal- assistive solution user-trial- assistive solution outcome

Impact of environment modification

Impact of a new matching process

Climate

Impact

Assistive solution Multidisciplinary team evaluation

Mod–Env Results

Prop–nMP Results

NOT

Take

a decision

MATCH

Mod–Env<Prop–nMT

Prop–nMP

< Mod–Env

IF

IF

EXIT

User agreement

IF

NOT

Prop–nMP

=Mod–Env

NOT

Assistive Technology Provision

Results

Change the AT

ENDEXIT TO

User Support

Change both

Change the environment

Change the AT

Change

AT and

environment

Change Environment

Follow up

question time segment 4
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?
    • 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.
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