INTRODUCTION

With the launch of the iPhone in 2007, the mobile technology industry has seen phenomenal and ground-breaking growth [1]. Mobile technology devices, which offer the convenience of technology in the pockets of users, have been widely adopted and pervasively used [2-4], to the extent that both in high and low income countries, the mobile phone is the most quickly adopted technology in the history of the world [5]. Further, mobile devices are the most commonly carried assistive technology devices for People with Disabilities (PwD) [6] .

The mobile industry includes smartphones, tablets, innovative mobile networks, interfaces, smartspeakers, and Apps. Mobile devices offer several unique advantages like: 1) personalization; 2) interactivity; 3) intuitiveness; 4) timeliness; 5) powerful computational ability; and 6) context specificity [6,7]. Most functions on mobile devices are managed by apps, which are specialized software, often downloadable for low or no cost, that assist the user in performing a variety of functions [8,9].

To the best of our knowledge, thus far no research has specifically examined the impact of ICT on Instrumental Activities of Daily Living (IADL) for Persons with Disabilities (PwD). The limited research that exists: (1) analyzes the impact of ICT on particular aspects of functional limitations for specific populations with disabilities; (2) investigates the impact of ICT broadly on society and its future [3,6,7,9-12); and (3) focuses on the impact of specific ICT devices or their use on particular environments or on unique functional aspects like productivity, innovation and organizational performance in the context of ICT [13].

In light of the profound impact of ICT and the dearth of research on the impact of ICT on IADLs, our first objective was to assess the nature and extent of ICT on how IADLs are completed by both people with and without disabilities. Thus, this article examines primary IADL domains, in terms of traditional and ICT-enabled ways of completing them. The second objective was to assess the future implications of this ICT paradigm shift.    

METHODS

A literature review was conducted to conceptually identify common IADL tasks that all people, with or without disabilities, use ICT to complete. Our review was completed searching the Embase, PubMed/MEDLINE, Scopus, and the Cumulative Index of Nursing and Allied Health Literature (CINHAL) databases. Studies identified were: (a) written in English, (b) peer-reviewed articles, conference proceedings, or book chapters with full text available for review, and (c) completed with ICT. No date restrictions were applied to this literature search. As we searched, we built a table (Table 1) of the different keywords and their associated MESH headings to provide a summary of all the terms used in our search strategy.

RESULTS

The total number of articles retained after removing duplicate articles was 381. One-hundred, four articles were selected based on their titles. Total number of articles screened for further evaluation after reading abstracts were 80.

ICT-Enabled IADL Domains:

Based on our search, 10 primary IADL domains were analyzed in depth. The domains analyzed were the management of: (1) transportation; (2) finances; (3) health practices; (4) meal preparation; (5) shopping; (6) communication; (7) household activities; (8) safety, security and emergency activities; (9) education and employment; and (10) leisure. The IADL domains we identified are included among those domains listed by the American Occupational Therapy Association, in the 3rd Edition Occupational Therapy Practice Framework [14]. The OTPF has several additional domains such as caring for others, caring for pets, child rearing, sleeping, and spirituality. For our research, we selected the 10 IADL domains that were completed with the use of ICT. Then, we analyzed each of our IADL domains in terms of the traditional versus ICT enabled ways of completing them.  

The following table provides a summary of key differences between the traditional and ICT-enabled methods of completing IADLs and associated advantages and limitations

Discussion

The impact of ICT has led to the development of a “new normal” that promotes an environment of independence, personal preferences and choice. The impact has been so profound that it has also led to changes in infrastructure, policies and practices [15]. As the new era of ICT evolves, so must practices and concepts used to guide rehabilitation.   

The advantages offered by ICT outweigh the disadvantages, especially for PwD. Due to the unprecedented impact of ICT, the global community is not only becoming increasingly more dependent on the ICT infrastructure, but also, the whole philosophy of social attitudes and daily functioning are continually changing to conform to an IT-based lifestyle [16]. The emergence of concepts like Electronic Health (eHealth), Electronic Commerce (eCommerce), etc., have resulted from the dramatic impact of ICT on changing lifestyle and infrastructure for some time. We would be prudent to recognize this impending change in the field of rehabilitation and assistive technology, and take pre-emptive steps to enable enhanced outcomes and promote optimal potential. Creation of the concept of Electronic Instrumental Activities of Daily Living (eIADLs) would be a first step in marking this paradigm shift, and would foster further advances for understanding the mechanisms underlying the ICT-based life style related outcome measurement in rehabilitation science.

The ICT and ICT-enabled paradigm shift heralds a new specialty for rehabilitation professionals who assist persons with newly acquired and chronic disabilities. Rehabilitation professionals will need to broaden their assessment procedures for matching PwD with the correct smart technology, while ensuring the best support service availability for the client. This will required rehabilitation and assistive technology professionals to widen their knowledge of electronic assistive devices like smartphones, smart speakers, Apps, internet availability, associated costs of these ICT, etc., to provide a greater range of options for their clients. Faculty in Rehabilitation associated departments will need to have faculty qualified to teach the use of ICT to students. Rehabilitation professionals will also need to be involved in development of these devices and their features that specifically help PwD. Last, faculty and professionals alike will need to advocate for health policies that recognize that smart and ICT technologies, like smart phones and internet access, are essential and cost savers by keeping PwD and persons aging in place, remaining independent in their ability to complete their IADLs.

CONCLUSION

The presence of ICT has substantially impacted the way we do IADLs. Indeed, the impact is so profound, that it marks a paradigm shift in the way we assess and measure everyday functioning. It is therefore prudent to embrace this change, and redefine IADLs to match the new normal of eIADLs. This would not only enable enhanced rehabilitation outcomes, but also, adoption and implementation of more effective interventions. The analysis in this paper further justifies the need for research studies to assess and validate this change.