Human factors/usability barriers to home medical devices among individuals with disabling conditions: In-depth interviews with positive airway pressure device users

Constance H. Fung, M.D., M.S.H.S., Uyi Igodan, B.A., Cathy Alessi, M.D., Jennifer L. Martin, Ph.D., Joseph M. Dzierzewski, Ph.D., Karen Josephson, M.P.H., B. Josea Kramer, Ph.D.

Disability and Health Journal, Vol. 8, Issue 1, p86–92
Published online: June 30 2014



Evidence suggests that medical equipment often fails to accommodate the needs of individuals with disabling conditions. Few studies have focused on the accessibility of home medical devices such as positive airway pressure (PAP), which is a type of home medical equipment prescribed for long-term therapy.


The purpose of this study was to explore in detail the types of difficulties experienced by patients with physical/sensory impairments who use PAP devices, as an initial step in designing a questionnaire to survey users about this topic.


In this descriptive study, in-depth interviews were conducted with 19 participants (9 patients with physical/sensory impairment and 10 health care providers). Interviews were coded and analyzed for major topics.


Participants detailed the numerous ways in which current PAP devices fail to meet the needs of individuals with physical/sensory impairments (e.g., tremor, poor depth perception, paresis), by requiring patients to perform manually difficult tasks, such as inserting PAP parts through small apertures, attaching parts using a twisting motion, and lifting arms overhead to apply PAP headgear. These demands contributed to patients’ frustration with and reduced usage of the home medical device.


Our findings suggest that home medical devices such as PAP may not be currently designed to meet the needs of some users with physical/sensory impairments. Additional studies are needed to measure the prevalence and impact of impairment-related barriers on PAP adherence for this common medical equipment.