Electronic Thesis and Dissertation Repository

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Dr. Jan Miller Polgar

Abstract

Recent research studies have identified that use of large amplitudes of power tilt as a pressure management strategy used by adults who use wheelchairs and are at risk of developing pressure ulcers, was low. While the reason for low use was not identified, a lack of fit between using large amplitudes of tilt and daily life function was speculated as a main reason across studies. Using a post-positivist grounded theory approach, this study explored how power tilt was used in daily life particularly for managing sitting pressures, from the perspectives of five people experienced with using power tilt and six therapists who prescribe power tilt. Data were collected from two in-depth semi-structured interviews and a journal that tracked the context of tilt occurrences throughout each of three days. Theoretical saturation was reached at five and six participants respectively. Data were analyzed in separate groups and then combined using a constant comparative approach. The analysis resulted in the generation of a substantive theory from which the process of using power tilt in the context of daily life can be understood. The abstract, cognitive nature of the process specific to using power tilt for pressure management differed from the tacit and tangible nature of the process for all other daily life uses of power tilt. Contextual elements were identified which affected the use of large amplitudes of tilt such as fear of tipping over, social image and lack of functionality. The critical influence of knowledge related to using tilt for pressure management is highlighted including potential implications for clinical practice. The theory scheme offers a preliminary avenue for examining the transactive relationships of person, environment, technology and occupation that comprise daily life, influencing how power tilt is used. The substantive theory and its associated concepts contribute to the wheelchair technology field, addressing the identified knowledge gap specific to advancing the understanding of how power tilts, and potentially other wheelchair technologies, are integrated in daily life occupations. The substantive theory is preliminary, requiring further research however; potential is demonstrated to also inform the understanding of the person-environment-occupation relationship in the discipline of occupational science.


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