title: Human factors/usability barriers to home medical devices among individuals with disabling conditions: in-depth interviews with positive airway pressure device users.
abstract: BACKGROUND
  Evidence suggests that medical equipment often fails to accommodate the needs of individuals with disabling conditions. Few studies have focused on the accessibility of home medical devices such as positive airway pressure (PAP), which is a type of home medical equipment prescribed for long-term therapy.
  
  
  OBJECTIVE
  The purpose of this study was to explore in detail the types of difficulties experienced by patients with physical/sensory impairments who use PAP devices, as an initial step in designing a questionnaire to survey users about this topic.
  
  
  METHODS
  In this descriptive study, in-depth interviews were conducted with 19 participants (9 patients with physical/sensory impairment and 10 health care providers). Interviews were coded and analyzed for major topics.
  
  
  RESULTS
  Participants detailed the numerous ways in which current PAP devices fail to meet the needs of individuals with physical/sensory impairments (e.g., tremor, poor depth perception, paresis), by requiring patients to perform manually difficult tasks, such as inserting PAP parts through small apertures, attaching parts using a twisting motion, and lifting arms overhead to apply PAP headgear. These demands contributed to patients' frustration with and reduced usage of the home medical device.
  
  
  CONCLUSIONS
  Our findings suggest that home medical devices such as PAP may not be currently designed to meet the needs of some users with physical/sensory impairments. Additional studies are needed to measure the prevalence and impact of impairment-related barriers on PAP adherence for this common medical equipment.
authors.affiliation: David Geffen School of Medicine at University of California, Los Angeles, 16111 Plummer Street (11E), North Hills, CA 91343, USA; Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, 16111 Plummer Street (11E), North Hills, CA 91343, USA. Electronic address: Connie.Fung@va.gov.
authors.forename: Constance H
authors.initials: CH
authors.lastname: Fung
authors.affiliation: Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, 16111 Plummer Street (11E), North Hills, CA 91343, USA.
authors.forename: Uyi
authors.initials: U
authors.lastname: Igodan
authors.affiliation: David Geffen School of Medicine at University of California, Los Angeles, 16111 Plummer Street (11E), North Hills, CA 91343, USA; Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, 16111 Plummer Street (11E), North Hills, CA 91343, USA.
authors.forename: Cathy
authors.initials: C
authors.lastname: Alessi
authors.affiliation: David Geffen School of Medicine at University of California, Los Angeles, 16111 Plummer Street (11E), North Hills, CA 91343, USA; Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, 16111 Plummer Street (11E), North Hills, CA 91343, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Martin
authors.affiliation: David Geffen School of Medicine at University of California, Los Angeles, 16111 Plummer Street (11E), North Hills, CA 91343, USA; Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, 16111 Plummer Street (11E), North Hills, CA 91343, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Dzierzewski
authors.affiliation: Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, 16111 Plummer Street (11E), North Hills, CA 91343, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Josephson
authors.affiliation: David Geffen School of Medicine at University of California, Los Angeles, 16111 Plummer Street (11E), North Hills, CA 91343, USA; Department of Veterans Affairs (VA) Greater Los Angeles Healthcare System, 16111 Plummer Street (11E), North Hills, CA 91343, USA.
authors.forename: B Josea
authors.initials: BJ
authors.lastname: Kramer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D045422:Continuous Positive Airway Pressure; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009068:Movement; D010349:Patient Compliance; D012656:Self-Help Devices / Q000592:standards*; D011795:Surveys and Questionnaires
keywords: Continuous positive airway pressure; Disabled persons; Equipment design; Sleep apnea syndromes