'Well if the Kids Can Do It, I Can Do It': A Qualitative Study of the Experiences of Users of Telerehabilitation Delivered by a Hospital Home Rehabilitation Team

Claire Morris, Wendy Shulver, Maggie Killington, Maria Crotty

    Research output: Contribution to conferencePaperpeer-review

    Abstract

    Background and Rationale: Health services across the
    globe are being driven to consider alternative options for rehabilitation
    due to an ageing population with increased incidence and
    prevalence of debilitating disease [1, 2]. In Australia, rural and
    remote dwelling patients can benefit greatly from a reduction in
    travel and the improved access [3] provided by telerehabilitation.
    Technology can be used for videoconferencing, exercise prescription,
    chronic disease management, information dissemination,
    peer group support and activity monitoring. Rehabilitation services
    are beginning to integrate the use of technology into usual practice
    but whilst there is a growing body of evidence about the efficacy
    of telerehabilitation, implementation has been slow [2, 4, 5].
    It is unclear whether the use of technologies and reduced face-toface
    contact are acceptable to elderly patients undergoing rehabilitation
    as there have been few in-depth explorations of patient
    experiences of telerehabilitation, with most studies focusing on
    satisfaction surveys [6].
    Methods: Sixty-one elderly community dwelling adults, 32
    (53%) of whom had had a recent stroke, participated in a pilot of
    an individualised home telerehabilitation programme which used
    a combination of face-to-face and video consults with clinicians.
    The program used ‘off-the-shelf’ technologies including iPads for
    videoconferencing and the use of therapeutic apps for exercise and
    homework, and electronic FitBitR devices to encourage activity
    [7]. A qualitative study was then conducted with thirteen participants,
    three spouses and one carer via interview [8].
    Results: Thematic analysis revealed five emergent themes: 1)
    Telerehabilitation is convenient; 2) Telerehabilitation promotes
    motivation and self-awareness; 3) Telerehabilitation allows positive
    therapeutic relationships; 4) Mastering technologies used by
    younger relatives is a valued aspect of telerehabilitation; and 5)
    Telerehabilitation does not replace traditional face-to-face rehabilitation
    therapies.
    Conclusion: Telerehabilitation allows engagement of both
    patient and carer with the treating team. The telerehabilitation programme
    promoted self-management approaches particularly practice.
    However the expectation that responsive technology support
    is available may mean that health services will need to consider
    ways of providing 7 day a week IT support or partner with private
    telecommunication companies to implement. Current funding
    models and reluctance of health services to fund telerehabilitation
    using mobile devices, in particular, remain hurdles to full implementation.

    Conference

    ConferenceOral presentation at the Annual Conference of the Asia Pacific Stroke Conference (APSO) Combined with Stroke Society of Australasia.
    Period14/07/16 → …

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