Interview Analysis Notes from the interviews were analyzed using inductive thematic analysis common method for interpreting qualitative data identify and

Interview Analysis• Notes from the interviews were analyzed using

inductive thematic analysis

• common method for interpreting qualitative data

• identify and describe themes represented by text

• assignment of theme-based codes to text

• analyze frequency of codes; co-occurrence or other relationships between coded text- quantification minimizes investigator bias

• conducted separately by two investigators (Boyatzis, 1998)

- additional check against investigator bias- discrepancies in interpretation resolved through discussion

©2012 Northwestern University Prosthetics-Orthotics Center for Education and Research AgrAbility NTW — 1

Common Themes

©2012 Northwestern University Prosthetics-Orthotics Center for Education and Research

COSTADAPTATION

EDUCATION

ENVIRONMENTDURABILITY/

UTILITY

AgrAbility NTW — 2

Common Themes


DURABILITY/UTILITY

• Farmers and prosthetists perceive that farmers’ prostheses deteriorate faster and fail more frequently than those of the general population of persons with amputations

• Farmers use their prostheses as tools to carry out farm work • Compared to having an intact limb,

performance of many farm tasks is impeded or limited by use of a prosthesis

• Prosthesis better than no prosthesis

“If a manufacturer says a component should last one year, for me it lasts about 3 months.” — farmer


Common Themes


• Farmers use prostheses under harsh environmental conditions

• Weather, dirt, and rough terrain are hard on prostheses, leading them to break more frequently

• Dust and dirt interferes with motion of movable parts

ENVIRONMENT

• Wet and dirty conditions can be damaging to electric-powered devices• 6/17 farmers with upper limb amputations owned a myoelectric

prosthesis but none used them for farm tasks


Common Themes


ADAPTATION

• Choosing to use a prosthesis is an adaptation to address the challenges of farming with an amputation

• Other adaptations are necessary to compensate for deficiencies in contemporary prosthetic technology:

• routines

• farm equipment

• prosthesis – self modifications

• attitudes

“First, you must have a good attitude, otherwise, you won’t use the device."— farmer


Common Themes


COST

• Adaptations to farm equipment and routines are costly

• Prostheses are expensive, high failure rate further increases costs

• High costs lead to self-repairs, self-maintenance or going without a replacement prosthesis

“An item that costs so much should last longer than it does. Everything is so expensive.” — farmer


Common Themes


COST

• Adaptations to farm equipment and routines are costly

• Prostheses are expensive, high failure rate further increases costs

• Traveling long distances to see prosthetists with the expertise they need further increases out-of-pocket cost


Cost

Insurance coverage status (N=30)

• 15 (50%) - Private insurance

• 6 (20%) - No insurance

• 5 (17%) - Worker’s comp

• 3 (10%) - Medicare/Medicaid

• 1 (3%) - VA


Common Themes


EDUCATION

• Prosthetists are typically not educated about the specific needs of farmers with amputations

• Can lead to inappropriate prosthetic designs (poor utility)

• Many farmers reported that they felt prosthetists did not listen to their concerns and did not understand their daily routine

• Farmers were not consistently educated and trained in the operation of their prostheses


Discussion


• Good agreement in responses between farmers and prosthetists with regard to most themes

• Prosthetists need to work closely with farmers to specially configure their prostheses to minimize the probability of device failure

Farmers considered modifying their own devices to be an indicator of ingenuity

Farmers considered modifying their own devices to be an indicator of ingenuity

Prosthetists occasionally referred to these types of modifications as examples of misuse

Prosthetists occasionally referred to these types of modifications as examples of misuse


Publication


News Coverage


September 2012


Current Work

• Expanded survey

• Education materials

• Device evaluation / design


Expanded Survey


• A larger sample of subjects is needed to appropriately capture diversity and understand challenges of farming with an amputation

• Increase representation of:• Types and levels of

amputation• Types of farming• Specific prosthetic

components used• Geographic regions • Ranchers


Expanded Survey


AgrAbility Projects & Programs


USDA-funded state projects Affiliate programs


Education

• Webinar for experienced CPs and CPOs

• Focus on “best practices” for farmer / rancher

• Available through NUPOC and National AgrAbility Project websites


Device Evaluation / Design

Simplicity is preferred:

• More complicated equipment is generally viewed as not durable• “parts that are too complicated fail”

• Mechanical devices are preferred because they can be cleaned with soap and hot water

• Most farmers interviewed do some of their own repairs or modifications

• When parts need to be repaired “time is money”• can’t send prosthesis away because they don’t have a back-up


Design Criteria• durable materials and construction

• socket design maintains health of limb

• consistent performance within wide temperature range

• resist exposure to corrosive or damaging liquids

• resist exposure to airborne particulates

• withstand cleansing of biological and chemical contaminants

• maintainable by farmer or rancher• cosmetic©2012 Northwestern University Prosthetics-Orthotics Center for Education and Research AgrAbility NTW — 19

Device Evaluation


IPTChampaign, IL

OpenSocket

ToughWare ProstheticsWestminster, CO

ITAL

CJ Socket TechnologiesBeverly, MA

CJ Socket

laminated frame socket

Tomm KristensenOslo, Norway


Wider Application


More durable and adaptable prosthetic components for farmers and ranchers may also benefit persons with amputations who work in other physically demanding occupations such as:

construction forestry fishing mining


Acknowledgements


• This research was funded by the National Institute on Disability and Rehabilitation Research (NIDRR) of the U.S. Department of Education under Grant No. H133E080009. The opinions contained in this publication are those of the grantee and do not necessarily reflect those of the Department of Education.

• The National AgrAbility Project and Breaking New Ground Resource Center at Purdue University (supported under USDA Special Project 2008-41590-04796) for assistance with this study.

• State and regional AgrAbility Projects and Affiliated Programs for assistance in contacting farmers and ranchers.


References


Boyatzis, R. (1998). Transforming Qualitative Information: Thematic Analysis and Code Development. Thousand Oaks: SAGE Publications.

Brown, J. (2003). Amputations: A Continuing Workplace Hazard. http://www.bls.gov/opub/cwc/sh20030114ar01p1.htm. Access Date: 03/21/12.

Bureau of Labor Statistics (2012). National Census of Fatal Occupational Injuries in 2011 (Preliminary Results). USDL-12-1888. News Release, September 20, 2012.

Kircher, R. (2003). Farming with an arm amputation. Oklahoma AgrAbility Newsletter, 2(2), 1-8.

Office of Special Education and Rehabilitative Services (2008). National Institute on Disability and Rehabilitation Research—Disability and Rehabilitation Research Projects and Centers Program—Disability Rehabilitation Research Projects (DRRPs), Rehabilitation Research and Training Centers (RRTCs), and Rehabilitation Engineering Research Centers (RERCs). Federal Register, 73(22), 6132–6146.

Prosthetic Limbs Inadequate for Farmer, Rancher Use. O&P Business News, 21(10), 31-32, Fall 2012.

Waldera, K., Heckathorne, C., Parker, M., Fatone, S (2012). Assessing the prosthetic needs of farmers and ranchers with amputations. Disability and Rehabilitation: Assistive Technology, Early Online.


circa 1918

Contact Info


Craig Heckathorne680 North Lake Shore Dr.NUPOC, Suite 1100Chicago, IL 60611

phone: 312-503-5723

email: [email protected]


High Fatal Work Injury RatesBy Occupation – Preliminary 2011 Data


source: U.S. Bureau of Labor Statistics

Documents

Interview Analysis Notes from the interviews were analyzed using inductive thematic analysis common method for interpreting qualitative data identify and