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User preferences for neural prostheses to restore bladder function

Sanders, Patricia M.H. (2008) User preferences for neural prostheses to restore bladder function.

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Abstract:Lesions of the upper motor neurons, caused by injury or disease, can leave people with bladder dysfunction, which has a major negative impact on quality of life (Westgren & Levi 1998, Snoek et al. 2004). Previous studies revealed that restoration of bladder function is highly appreciated by persons with spinal cord injury (SCI) (Anderson 2004, Snoek et al. 2005). Several different neural prosthetic solutions to restore bladder function are in development, with differing characteristics such as invasiveness, effectiveness and side effects. These characteristics can influence the willingness of patients to be treated with a certain technique. However, it is not known how these factors influence individual's choices of whether to use neural prostheses or which approach to choose. An advanced appreciation of potential user preferences can assist in device design, and will increase the acceptance of users towards these techniques. This study was designed to determine the relative importance of different neural prosthesis characteristics from persons with SCI. A survey using a choice based conjoint analysis was used to determine utility weights for individual characteristics. Chosen characteristics for this analysis were: invasiveness, effect on continence, effect on voiding, side effects, user friendliness, and costs (willingness to pay). Three levels were set for every characteristic. Surveys were completed by persons with SCI at two academic affiliated medical systems' SCI outpatient and inpatient rehabilitation centers. 66 individuals with chronic SCI completed the survey. Of all respondents, 19.7% did not want to have a neural prosthesis at all. Of all attributes, side effects had the largest relative importance on subject choices (.32), followed by the effect on continence (.25) and voiding (.20). A comparison of current designs revealed that neural prostheses having characteristics consistent with rhizotomy-free sacral root stimulation were preferred (48.9% first choice) over pudendal afferent nerve stimulation (45.3% second choice) and sacral root stimulation with rhizotomy (56.6% third choice). This study revealed that in their choice for a neural prosthesis, persons with SCI first focus on the side effects, and then on the effect on bladder function. Invasiveness, user friendliness and costs are less important in the decision making process. Therefore, a design with minor side effects and a major positive effect on bladder function, like the rhizotomy-free sacral root stimulation, is most likely to be accepted by persons with SCI.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/59273
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