Predictors of psychological distress and confidence among mobility device users

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Lay summary by Harsirat Naraina

Edited by Crystal Han

This is the lay summary of the original article by ICORD researchers Dr. Ben Mortenson, Dr. Kathleen Martin Ginis, Mike Prescott, Delphine Labbé, and William Miller and their colleagues. Read the original article here.


Mobility devices (e.g., wheelchairs, canes, crutches, walkers, scooters) can increase a user’s independence and ability to navigate their immediate environment, however accessibility issues can affect their ability to access their physical and social environments, which can negatively impact their confidence in navigating these environments. There is conflicting evidence about psychological outcomes among people who use mobility devices.

What was the purpose of the study?

This study examined how intersectional demographic factors (e.g. age, sex, ability) were associated with psychological outcomes such as anxiety and depression in mobility device users. The study also investigated reported confidence levels of mobility device users when they were navigating their physical and social environments, and how the levels of confidence impact their experience during their navigation of these environments. In terms of the mobility device, the researchers investigated factors such as the type of primary device, the amount of training received by the user, and the length of time they had been using their device.

How was the study done?

105 people who used mobility aids participated in this study, including users of mobility scooters (27%), power wheelchairs (26%), manual wheelchairs (25%), walkers (11%), and cane or crutch (12%). Participants reported their symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS), and mobility confidence using the modified Wheelchair Use Confidence Scale (WUCS). The scores of these outcomes were associated with sociodemographic factors including age, sex, motor function, level of education, income, province of residence, and whether or not participants lived alone.

What were the results of the study?

Predictors of anxiety:

Overall, mobility device users had higher levels of anxiety in comparison to the general population. Anxiety was associated with depression. Younger age was associated with higher levels of anxiety. A similar relationship has been observed in the general population. It was concluded that the type of mobility device used was not a significant factor in predicting the level of anxiety.

Predictors of depression:

Mobility device users reported greater levels of depression compared to the general population. Increased age was associated with increased levels of depression in people who use mobility devices, which is he opposite to the relationship between age and depression in the general population. However, increased levels of confidence navigating the social environment was associated with decreased levels of depression in mobility device users.

Predictors of confidence in the physical and social environments:

The authors found that women of older age, as well as walker users, tended to have lower levels of confidence when navigating the physical environment, such as moving around their communities. However, the use of a walker and older age, was associated with increased confidence in navigating their social environment. The authors believe that as mobility device users age, they may be gaining confidence with navigating their social environments.

Why is this study important?

The results of this research can be used to develop better care for mobility device users, such as tailoring interventions depending on demographics. For example, healthcare providers should be mindful of high rates of anxiety and depression among mobility device users and consider way to improve their mobility confidence. This may potential lead to improved psychological outcomes.

This study also encourages further research, specifically focusing on potential interventions and their ability to create improve outcomes for mobility device users. For example, further studies could investigate whether better mobility device training and education could lead to improved social participation and quality of life.