Abstract
Objective
To explore the perceived barriers and facilitators of tele-rehabilitation (TR) by
stroke patients, caregivers and rehabilitation therapists in an Asian setting.
Design
Qualitative study involving semi-structured in-depth interviews and focus group discussions.
Setting
General community.
Participants
Participants (N=37) including stroke patients, their caregivers, and tele-therapists
selected by purposive sampling.
Interventions
Singapore Tele-technology Aided Rehabilitation in Stroke trial.
Main Outcome Measures
Perceived barriers and facilitators for TR uptake, as reported by patients, their
caregivers, and tele-therapists.
Results
Thematic analysis was used to inductively identify the 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 setup–related
difficulties and limited scope of exercises; barriers identified by tele-therapists
were patient assessments, interface problems and limited scope of exercises; and common
to both were connectivity barriers. Patient characteristics like age, stroke severity,
caregiver support, and cultural influence modified patient perceptions and choice
of rehabilitation.
Conclusions
Patient attributes and context are significant determinants in adoption and compliance
of stroke patients to technology driven interventions like TR. Policy recommendations
from our work are inclusion of introductory videos in TR programs, provision of technical
support to older patients, longer FaceTime sessions as re-enforcement for severely
disabled stroke patients, and training of tele-therapists in assessment methods suitable
for virtual platforms.
Keywords
List of abbreviations:
DR (day rehabilitation), RCT (randomized controlled trial), TR (tele-rehabilitation)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: June 11, 2018
Footnotes
Supported by the Singapore Millennium Foundation (Grant Number: R – 608 -000 – 048 - 592) and Saw Swee Hock School of Public Health Tele-Health InnOvation Research (THOR) Program Grant (Grant Number: R – 608 – 000 – 120 - 733).
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
