Acceptance of tele-rehabilitation by stroke patients: perceived barriers and facilitators

Publication date: Available online 11 June 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Shilpa Tyagi, Daniel SY. Lim, Wilbert HH. Ho, Yun Qing Koh, Vincent Cai, Gerald CH. Koh, Helena Legido-Quigley
ObjectiveTo explore the perceived barriers and facilitators of tele-rehabilitation by stroke patients, caregivers and rehabilitation therapists in an Asian setting.DesignQualitative study involving semi-structured in-depth interviews and focus group discussions.SettingGeneral communityParticipants37 participants including stroke patients, their caregivers and tele-therapists selected by purposive sampling.InterventionsSTARS trial.Main outcome Measure(s)Perceived barriers and facilitators for tele-rehabilitation uptake, as reported by patients, their caregivers and tele-therapists.ResultsThematic analysis was used to inductively identify following themes: facilitators identified by patients were affordability and accessibility; by tele-therapists, was filling a service gap and common to both was unexpected benefits such as detection of uncontrolled hypertension. Barriers identified by patients were equipment set-up related difficulties and limited scope of exercises, by tele-therapists were patient assessments, interface problems and limited scope of exercises and common to both was connectivity barriers. Patient characteristics like age, stroke severity, caregiver support and cultural influence modified patient perceptions and choice of rehabilitation.ConclusionsPatient attributes and context are significant determinants in adoption and compliance of stroke patients to technology driven interventions like tele-rehabilitation. Policy recommendations from our work are inclusion of introductory videos in tele-rehabilitation program, provision of technical support to older patients, longer facetime sessions as re-enforcement for severely disabled stroke patients and training of tele-therapists in assessments methods suitable for virtual platform.



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