4.6 Article

Accessibility of Medical Diagnostic Equipment for Patients With Disability: Observations From Physicians

Journal

ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
Volume 100, Issue 11, Pages 2032-2038

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.apmr.2019.02.007

Keywords

Diagnostic equipment; Disabled persons; Examination tables; Medical staff; hospital; Rehabilitation

Funding

  1. Executive Committee on Research, Massachusetts General Hospital
  2. Eunice Kennedy Shriver National Institute of Child Health and Human Development [R01 HD091211-01A1]

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Objective: To explore attitudes and practices of physicians relating to accessible medical diagnostic equipment in serving patients with mobility disability. Design: Open-ended individual telephone interviews, which reached data saturation. Interview recordings were transcribed verbatim for qualitative conventional content analysis. Setting: Massachusetts, the United States, October 2017-January 2018. Participants: Practicing physicians from 5 clinical specialties (N=20). Interventions: Not applicable. Main Outcome Measures: Common themes concerning physical accessibility. Results: Mean SD time in practice was 27.5+12.5 years; 14 practices had height-adjustable examination tables; and 7 had wheelchair-accessible weight scales. The analysis identified 6 broad themes: height-adjustable examination tables have advantages; height-adjustable examination tables have drawbacks; transferring patients onto examination tables is challenging; rationale for examining patients in their wheelchairs; perceptions of wheelchair-accessible weight scales; and barriers and facilitators to improving physical accessibility. Major barriers identified by participants included costs of equipment, limited space, and inadequate payment for extra time required to care for persons with disability. Even physicians with accessible examination tables sometimes examined patients seated in their wheelchairs. Conclusions: Even if physicians have accessible equipment, they do not always use it in examining patients with disability. Future efforts will need to consider ways to eliminate these access barriers in clinical practice. Given small sample size, results are not generalizable to physicians nationwide and globally. (C) 2019 by the American Congress of Rehabilitation Medicine

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