Environmental control systems–the experiences of people with spinal cord injury and the implications for prescribers

Purpose: Environmental control systems (ECSs) can potentially influence comfort, safety, security and independence for people with severe impairment from spinal cord injury (SCI). This study, aimed at informing prescription practises, investigated ECS prescription and utilisation from the consumer perspective.

Methods: Qualitative inquiry, through 15 semi-structured interviews, explored the perspectives of people with high level SCI who use ECSs. Data were coded and clustered to provide a description of their perspectives and interpret lessons for prescribers.

Results: The data were grouped into six coding clusters related to readiness to engage, training, autonomy, utility, utilisation and attitudes towards the ECS. Data revealed variability in readiness to embrace ECSs during rehabilitation, some frustration related to setting up systems and instances of ECSs not being used to their full potential. Some highly motivated participants found reward through perseverance. All participants valued having some level of autonomy and personal security. Significant implications for prescribers are described. Conclusions: Understanding the influence of factors related to devices, personal characteristics and individual context on ECS usage can guide clinicians in prescription and training processes to facilitate maximum and ongoing benefit from ECSs. A culture of follow-up and evaluation is to be encouraged.