Hardianto Iridiastadi
Quality of (working) life has been considered as an important key indicator that describes ones wellbeing. In the medical sector, efforts have been done that can improve quality of life for people with limited mobility. These people have certain type of disability that limits their ability to move and work independently. According to Mitra et al. (2011), disability is a general term that describes disorders, limitations of activities, and the restricted ability to actively participate in personal and social activities. Disabilities should not be associated with only the patients, but should also be addressed within the contextual environments in which the patients engage in their activities. The number of disabled patients tends to increase, both internationally and nationally in Indonesia. Reports from the International Labor Organization (2014) indicated that millions of people worldwide suffer from disabilities. In developing countries, disabled patients tend to be associated with poverty, poor health, and low quality of working life. In Indonesia, disability accounts for at least 10% of the population (ILO, 2014). National data from Pusdatin (2010) indicated more than 11.5 million Indonesians suffer from disabilities. During the same year, a different statistics was reported by the Ministry of Manpower and Transmigration, in which seven million people were considered as disabled. Such statistics may not be representative of the current situation, considering that the Indonesian government does not have an accurate and reliable database. Nevertheless, the number of people with disabilities is perceived to be increasing, and poses an important issue to many stakeholders. More than three million people in Indonesia suffer from disabilities that are physical in nature (ILO, 2014). This limitation can be due to birth defect, or a negative consequence following an accident or surgery. Chronic health effects can also result in physical limitations in mobility. Stroke, for example, is a health condition that is prevalent in many countries (Hatchinski et al., 2011; Lloyd-Sherlock, 2009), including Indonesia (Handayani, 2013; Republika Online, 2014). In addition to resulting in death, stroke can also result in paralysis and degradation in cognitive abilities. This kind of health problem also has a wide array of negative socio-economic implications. People with physical disabilities tend to be associated with lower income, poverty, and lower quality of life (Mitra et al., 2011). Larger household spending (due to disability) is also a consequence faced by these individuals and their family. A number of health care equipment is available for the disabled (e.g., Kumar et al., 1997; Martins et al., 2014; Posugade et al., 2012). For specific activities, however, the disabled still needs other people’s help. This is true even for simple daily activities such as moving from bed to a wheelchair, or when going to the bathroom. Individuals with physical disabilities typically cannot move their body on their own effort, and should seek help for accomplishing the tasks. This dependence (on nurse or caregiver) is phenomenon that can be observed in many hospital as well as home settings. In this context, one of the serious issues faced by nurses and caregivers is the risk of musculoskeletal disorders when handling disabled patients. Nurses are also an occupation believed to have a high prevalence of lower back pain incidence (Bardak et al., 2012; Nelson et al., 2006). The risk could involve lower back pain (LBP), pain to the upper region of the shoulder, or injuries to the upper extremities. Karahan (2009) reported the prevalence of LBP among nurses and hospital staffs in the order of nearly 80%. The risk of injury arises during patient handling tasks, such as lifting, lowering, or positioning patients. Other risk factors involved include poor working postures, such as kneeling, bending, or squatting. It should be noted that mass of an adult patient plays a significant role in increasing the risk. In many home settings, space for maneuvering the patient is typically limited that poor working posture cannot be avoided. One of the solutions that can be adopted in lowering the risk of LBP include the use of mechanisms that aid the nurses and caregivers (Magnier et al., 2010). This technology allows nurses and caregivers to move, position, lift, and handle patients with much lower loading on the spine and other body parts. In many hospitals in Indonesia, such technology is neither widely known nor applicable. This technology is commonly utilized in advanced nations, but is somewhat very rare and costly for many Indonesians. The objective of this research is to design a prototype of a patient handling equipment (PHE), based on the engineering design that has been developed in the earlier research (2015-2016). This research will also: - Describe design specifications as requested by the user (nurses and caregivers). - Describe materials and the electro-mechanical system to be used - Describe the manufacturing process required, including the feasibility and economic considerations. - Evaluate the utility of PHE in medical/home settings. It is expected that the design can be economically manufactured, and can be made affordable and widely available for home and hospital settings. In the long run, this study can contribute to the safety of patient with disability, while in same time, lessens the risk of injury among nurses and caregivers.