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RehabMeasures Instrument

Quebec User Evaluation of Satisfaction with Assistive Technology

Purpose

The QUEST 2.0 evaluates a patient's satisfaction with various assistive technologies.

Link to Instrument

Instrument Details

Acronym QUEST 2.0

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Cost Description

The original QUEST (Version 1.0) can be found in:
Demers, L., Weiss-Lambrou, R., et al. (1996). "Development of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST)." Assist Technol 8(1): 3-13.

Diagnosis/Conditions

  • Arthritis + Joint Conditions
  • Brain Injury Recovery
  • Cerebral Palsy
  • Parkinson's Disease & Movement Disorders
  • Pulmonary Disorders
  • Spinal Cord Injury
  • Stroke Recovery
  • Vestibular Disorders

Key Descriptions

  • 12 item instrument used to assess satisfaction with a specific assisitive device; eight of these items assess characteristics of that assistive device in terms of the following dimensions:
    1) Dimensions (size)
    2) Weight
    3) Adjustments
    4) Safety
    5) Durability
    6) Simplicity of use
    7) Comfort
    8) Effectiveness
  • The remaining four items assess service and include:
    1) Service delivery
    2) Repairs and service of the device
    3) Professionalism of service
    4) Follow-up service
  • Participants are asked to rate their satisfaction for the device on a five point scale that ranges from "not satisfied" at all to "very satisfied."
  • Finally, participants are asked to choose the three most important items related to the assistive device in question.

Number of Items

12

Time to Administer

5-30 minutes

Required Training

No Training

Age Ranges

Adolescent

13 - 17

years

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by the Rehabilitation Measures Team; Updated with references from the TBI population by Sue Saliga, PT, DHSc, CEEAA and the TBI EDGE task force of the Neurology Section of the APTA in 2012.

ICF Domain

Environment

Measurement Domain

Motor

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

 

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

TBI EDGE

NR

NR

LS

LS

LS

 

Recommendations for use based on ambulatory status after brain injury:

 

Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant

TBI EDGE

N/A

N/A

N/A

N/A

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

TBI EDGE

No

No

No

Not reported

Considerations

The assessment can be either self-administered or administered by a clinician.

Translations available include:

  • English 
  • French 
  • Dutch
  • Norwegian
  • Portuguese
  • Japanese
  • Chinese (2 versions, C-QUEST and T-QUEST)

Experimental version consisted of 24 items, item analysis (Demers et al. 2000) resulted in 12-item scale, the QUEST 2.0

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Multiple Sclerosis

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Normative Data

Multiple Sclerosis: (Demers et al, 2002; QUEST 2.0; n = 83; mean age = 47.8 (9.4) years, types of devices used: Manual wheelchair = 47%, Powered wheelchair = 20%, Scooter = 14%, Regular walker = 12%, Wheeled walker = 7%, English and French speaking sample)

 

Quest 2.0 Norms with MS Patients:

Dimension

n

Mean (SD)

Min-Max Score

Device

81

4.17 (0.62)

2.13 ±5.00

Service

75

3.98 (0.75)

2.25 ±5.00

Spinal Injuries

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Normative Data

SCI patients who use manual wheelchair: (Bergstrom & Samuelsson, 2006; n = 124; mean age = 49.7 (15.6) years; SCI characteristics not reported)

  • Average (Standard Deviation) score = 3.99 (1.0)

  • Ease of adjustment (mean = 3.80, SD = 1.1) and comfort (mean = 3.77, SD = 1.0) were rated as least satisfying

  • Ease of use was rated most satisfying (mean = 4.42, SD = 0.7)

Manual wheelchair user Satisfaction:

 

 

 

Question

% Responding "somewhat satisfied" or less

% Responding "quite satisfied" or "very satisfied"

Mean (SD)

Service delivery

38

62

3.74 (1.2)

Repair service

28

72

3.97 (1.2)

Professional service

26

74

3.90 (1.1)

Follow-up

45

55

3.43 (1.2)

Construct Validity

Chronic SCI: (Chan & Chan, 2007; n = 31; mean age = 41.68 (11.17) years; mean time since injury = 3.79 (3.72) years; ASIA Classification, A = 70.99%, B = 9.68%, C = 3.23%, D = 16.13%, Chinese Sample)

 

QUEST (Chinese translation, C-QUEST) and WHO QoL-BREF scores:

 

 

 

 

 

 

 

QUEST

WHO QoL BREF

 

 

 

 

 

Services

General

Physical

Psychological

Social Relationship

Environment

Device

0.416*

0.412*

0.508*

0.344

0.460*

0.567*

Services

--

0.120

0.307

0.023

0.242

0.333

WHO QoL-BREF

 

 

 

 

 

 

General

--

--

0.352

0.375*

0.032

0.293

Physical

--

--

--

0.482*

0.452*

0.692*

Psychological

--

--

--

--

0.548*

0.577**

Social Relationship

--

--

--

--

--

0.509**

*p < 0.05; **p < 0.01

 

 

 

 

 

 

 

Assistive Technology Users (Demers et al, 2000; n=150)

Assistive Device Users (Wessels et al, 2003; n=2002; mean age=58.0(15.7); gender=female 60.7%-Dutch Version (D-QUEST))· Factor analysis results suggested a bidimensional structure of satisfaction with assistive technology related to the assistive technology device (eight items) and services (four items)

 

Type of assistive Device

Assistive Device: correlation mean satisfaction 8 aspects and general satisfaction (Spearman’s rho)

Service: Correlation mean satisfaction and general satisfaction (Spearman’s rho)

Aids for personal care

0.77*

0.74*

Orthoses/Shoe adpatations

0.82*

0.79*

Hearing Aids

0.79*

0.81*

Optical Aids

0.68*

0.74*

Aids for diabetics

0.68*

0.71*

Home Furnishings

0.72*

0.87*

Elastic compression stockings

0.75*

0.78*

Prostheses

0.82*

0.84*

Aids for communication and information

0.79*

0.88*

Aids for personal mobility

0.75*

0.83*

Total

0.78*

0.81*

 

*Excellent validity for all items; *Correlation is significant at the 0.000 level (2-tailed)

Wheelchair Usage

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Normative Data

Wheelchair users across residential settings: (Karmarkar et al, 2009; n = 132; mean ages ranged from 63.23 (5.6) to 83.8 (5.4) years)

Satisfaction with manual wheelchairs across settings:

 

 

 

 

QUEST composite scores

VA NH (n = 48)

Private NH (n = 25)

Community dwelling (n = 27)

p

Device Total

3.9 (0.15)

2.9 (0.28)

4.3 (0.25)

0.009*

Services Total

3.6 (0.18)

2.8 (0.38)

4.4 (0.29)

0.020

QUEST total

3.9 (0.15)

2.9 (0.30)

4.3 (0.25)

0.006

VA NH = Veteran's Administration Nursing Home
Private NH = Private Nursing Home

 

 

 

 

Older Adults and Geriatric Care

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Test/Retest Reliability

Community Dwelling Assistive Devise Users: (Mao et al, 2010; (alpha = 105; ICC = 36); mean age = 38.9 to 33.5 years; mean time using device ranged from 2.6 to 3.3 years, The T-QUEST (Taiwanese version) has one additional item, Cost)

T-QUEST Cronbach's alpha and ICC's:

 

 

 

 

 

Domain

Items

Strength

Alpha

Strength

ICC

Device

Device Dimension

Weight

Adjustments

Safety

Durability

Easy to use Comfort

Effectiveness

Excellent

0.87

Excellent

0.97

Services

Service delivery

Repairs/maintenance

Professional services

Follow-up services Cost*

Excellent

0.84

Excellent

0.97

Total

 

Excellent

0.90

Excellent

0.95

* The Cost item is specific to the T-QUEST

 

 

 

 

 

Assistive Technology Users-Diagnosis unknown (Demers et al, 2000; n=85; 7-11 days in between testing)

  • Items with the highest item-total correlations were follow-up services (Weighted Kappa=0.64), simplicity of use (0.63 ), effectiveness (0.63),and adjustments (0.67 )
  • The lowest item-total correlation was for cost (0.17 )

Item

Test Retest Reliability

P<0.01

 

Comfort

0.51

Adequate

Dimensions

0.74

Adequate

Professional Service

0.61

Adequate

Follow-Up Services

0.56

Adequate

Simplicity of Use

0.52

Adequate

Effectiveness

0.62

Adequate

Repairs/Servicing

0.51

Adequate

Durability

0.69

Adequate

Adjustments

0.52

Adequate

Safety

0.58

Adequate

Service Delivery

0.61

Adequate

Weight

0.63

Adequate

Multi-Purposefulness

0.58

Adequate

Transportation

0.42

Adequate

Maintenance

0.42

Adequate

Training

0.62

Adequate

Device compatibility

0.61

Adequate

Appearance

0.48

Adequate

Installation

0.49

Adequate

Cost

0.55

Adequate

Effort

--

---

Motivation

--

---

Reaction of Others

--

---

Social Circle Support

--

---

Non-Specific Patient Population

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Interrater/Intrarater Reliability

Mobility Devise Users: (Demers et al, 1999; n = 97)

  • Excellent: Device subscale = 0.80

  • Adequate: Services subscale = 0.76

  • Excellent: Total scale alpha = 0.82

Internal Consistency

Assistive Device Users (Demers et al, 2000; n=150; Diagnosis unknown))

  • Items with the highest item-total correlations were follow-up services (r=0.64), simplicity of use (r= 0.63 ), effectiveness (r= 0.63),and adjustments (r=0.67 )
  • The lowest item-total correlation was for cost (r=0.17 )

 

Assistive Device Users (Wessels et al, 2003; n=2002; mean age=58.0(15.7); gender=female 60.7%-Dutch Version (D-QUEST))

 

Type of assistive Device

Device Related Aspects

 

Service Related Aspects

 

 

N

Alpha

N

Alpha

Aids for personal care

90

0.89

Excellent

51

0.82

Excellent

Orthoses/Shoe adpatations

87

0.90

Excellent

148

0.84

Excellent

Hearing Aids

110

0.85

Excellent

178

0.82

Excellent

Optical Aids

26

0.85

Excellent

34

0.78

Excellent

Aids for diabetics

68

0.82

Excellent

94

0.81

Excellent

Home Furnishings

41

0.88

Excellent

44

0.85

Excellent

Elastic compression stockings

34

0.68

Poor

41

0.73

Adequate

Prostheses

74

0.89

Excellent

126

0.83

Excellent

Aids for communication and information

18

0.92

Excellent

46

0.82

Excellent

Aids for personal mobility

112

0.84

Excellent

49

0.77

Adequate

Total

660

0.88

Excellent

811

0.84

Excellent

Content Validity

Initial items were assessed by a team of 11 individuals who represented both consumers and stakeholders of assistive technologies (Demers, et al. 1996)

Assessed by 12 content experts from 11 facilities in the United States, Canada and the Netherlands and 150 device users (no information on diagnosis) (Demers et al, 2000)

  • Only two items were very weakly rated by a substantial proportion of content experts, namely installation (#19; 38%) and reaction of others (#23; 31%); the largest proportion of items (n = 18, 75%) was considered of primary importance by more than half the respondents
  • From the users' point of view, analyses revealed that 19 of the 24 items generated a mean importance score above 4.00 (based on a 5 point rating scale, 1-no importance; 5-very important); based on this cutoff, the items weakly rated were training, appearance, cost, reaction of others, and social circle support

Face Validity

The measure was developed with the assistance of subject matter experts including users of assistive technologies.

Bibliography

Bergstrom, A. L. and Samuelsson, K. (2006). "Evaluation of manual wheelchairs by individuals with spinal cord injuries." Disabil Rehabil Assist Technol 1(3): 175-182. Find it on PubMed

Chan, S. C. and Chan, A. P. (2007). "User satisfaction, community participation and quality of life among Chinese wheelchair users with spinal cord injury: a preliminary study." Occup Ther Int 14(3): 123-143. Find it on PubMed

Demers, L., Ska, B., et al. (1999). "Stability and reproducibility of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST)." Journal of Rehabilitation Outcomes Measurement 3(4): 42-52. 

Demers, L., Weiss-Lambrou, R., et al. (1996). "Development of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST)." Assist Technol 8(1): 3-13. Find it on PubMed

Demers, L., Weiss-Lambrou, R., et al. (2000). "Item analysis of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST)." Assist Technol 12(2): 96-105. Find it on PubMed

Karmarkar, A. M., Collins, D. M., et al. (2009). "Satisfaction related to wheelchair use in older adults in both nursing homes and community dwelling." Disabil Rehabil Assist Technol 4(5): 337-343. Find it on PubMed

Mao, H. F., Chen, W. Y., et al. (2010). "Cross-cultural adaptation and validation of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0): the development of the Taiwanese version." Clin Rehabil 24(5): 412-421. Find it on PubMed

Wessels, R. and Witte, L. P. D. (2003). "Reliability and validity of the Dutch version of QUEST 2.0 with users of various types of assistive devices." Disability & Rehabilitation 25(6): 267-272.