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Aggarwal S, Tabassum H, Agarwal P, Grover A, Singh R. Beyond Barriers: Addressing Challenges and Opportunities of People with Disability During the Pandemic. Indian J Community Med 2024; 49:579-587. [PMID: 39291115 PMCID: PMC11404413 DOI: 10.4103/ijcm.ijcm_49_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/19/2024] [Indexed: 09/19/2024] Open
Abstract
People with disabilities often experience worse health outcomes than ordinary people because of multiple barriers to accessing healthcare. These inequalities are particularly exposed during the pandemic, indicating an urgent need to strengthen health systems, so that they are inclusive and responsive to the needs of these people during crises. These people are particularly affected by changes in routine services because of diversion of healthcare staff and facilities to respond to the pandemic, e.g., rehabilitation and medications. The combination of these factors substantially imparts negative impacts on their functioning and well-being. Health services research can help address the challenges of maintaining continuity of care during crises as well as addressing systematic inequalities in the health sector that marginalize people with disabilities even during noncrisis times. Therefore, research is needed to understand the health service design and to identify strategies to maximize active participation from this population.
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Affiliation(s)
- Sumit Aggarwal
- Department of Descriptive Research, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Heena Tabassum
- Non-Communicable Diseases, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Pragati Agarwal
- Department of Descriptive Research, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Ashoo Grover
- Department of Delivery Research, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Ravinder Singh
- Non-Communicable Diseases, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
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Ogedengbe TO, Kreidy C, Gürke N, Twahirwa BN, Boateng MA, Eslahi M, Khodayari F, Nemargut JP, Martiniello N, Wittich W. Feasibility of telerehabilitation to address the orientation and mobility needs of individuals with visual impairment: perspectives of current guide dog users. Disabil Rehabil 2024:1-11. [PMID: 38907578 DOI: 10.1080/09638288.2024.2368058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 06/11/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVE To assess guide dog users' perspectives on the feasibility of telerehabilitation for their O&M needs. METHOD An online survey gathered insights from 56 guide dog (GD) users (Mean age = 59, Mean GD used = 4, Mean duration of use = 22 years). Thirteen GD users further participated in interviews or focus groups to explore survey responses. Data were analyzed using content analysis. FINDINGS Most (40) were blind, and 16 had low vision, with intermediate (25) and advanced (25) communication technology proficiency. Most GD users (46) underwent residential training, and 10 received one-on-one visits. Qualitative analysis revealed acceptance of telerehabilitation services, citing accessibility as an advantage. However, GD users expressed concerns about safety, potential loss of behavioral observation, and social contact loss. Success depended on the type of technology, service type, and personal attributes. CONCLUSION While feasible, telerehabilitation services may not be universally suitable for all training stages. Flexibility and applicability in service design are necessary to accommodate individual preferences and experience levels.
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Affiliation(s)
- Tosin Omonye Ogedengbe
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
| | - Chantal Kreidy
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Québec, Canada
| | - Nora Gürke
- Vrije Universiteit Amsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam, Noord-Holland, Netherlands
| | | | - Mark A Boateng
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | - Mina Eslahi
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
| | | | - Joseph P Nemargut
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Québec, Canada
- Centre de Réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Natalina Martiniello
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Québec, Canada
- Centre de Réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Walter Wittich
- School of Optometry, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Québec, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Québec, Canada
- Centre de Réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montréal, Québec, Canada
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Chouliara N, Cameron T, Ballard-Ridley S, Fisher RJ, Kettlewell J, Kidd L, Luxton L, Pomeroy V, Stockley RC, Thomas S, Gordon AL. Investigating the Implementation of Community-Based Stroke Telerehabilitation in England; A Realist Synthesis Study Protocol. Healthcare (Basel) 2024; 12:1027. [PMID: 38786437 PMCID: PMC11120767 DOI: 10.3390/healthcare12101027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Telerehabilitation (TR) shows promise as a method of remote service delivery, yet there is little guidance to inform implementation in the context of the National Health Service (NHS) in England. This paper presents the protocol for a realist synthesis study aiming to investigate how TR can be implemented to support the provision of high-quality, equitable community-based stroke rehabilitation, and under what conditions. Using a realist approach, we will synthesise information from (1) an evidence review, (2) qualitative interviews with clinicians (n ≤ 30), and patient-family carer dyads (n ≤ 60) from three purposively selected community stroke rehabilitation services in England. Working groups including rehabilitation professionals, service-users and policy-makers will co-develop actionable recommendations. Insights from the review and the interviews will be synthesised to test and refine programme theories that explain how TR works and for whom in clinical practice, and draw key messages for service implementation. This protocol highlights the need to improve our understanding of TR implementation in the context of multidisciplinary, community-based stroke service provision. We suggest the use of a realist methodology and co-production to inform evidence-based recommendations that consider the needs and priorities of clinicians and people affected by stroke.
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Affiliation(s)
- Niki Chouliara
- School of Medicine, University of Nottingham, Nottingham NG7 2TU, UK; (T.C.); (J.K.); (S.T.); (A.L.G.)
- NIHR Applied Research Collaboration (ARC) East Midlands, Nottingham NG7 2TU, UK
| | - Trudi Cameron
- School of Medicine, University of Nottingham, Nottingham NG7 2TU, UK; (T.C.); (J.K.); (S.T.); (A.L.G.)
- NIHR Applied Research Collaboration (ARC) East Midlands, Nottingham NG7 2TU, UK
| | | | | | - Jade Kettlewell
- School of Medicine, University of Nottingham, Nottingham NG7 2TU, UK; (T.C.); (J.K.); (S.T.); (A.L.G.)
| | - Lisa Kidd
- Department of Nursing and Community Health, Glasgow Caledonian University, Glasgow G4 0BA, UK;
| | - Leanna Luxton
- Northampton General Hospital NHS Trust, Northampton NN1 5BD, UK;
| | - Valerie Pomeroy
- School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK;
| | - Rachel C. Stockley
- School of Nursing and Midwifery, University of Central Lancashire, Lancashire PR1 2HE, UK;
| | - Shirley Thomas
- School of Medicine, University of Nottingham, Nottingham NG7 2TU, UK; (T.C.); (J.K.); (S.T.); (A.L.G.)
| | - Adam L. Gordon
- School of Medicine, University of Nottingham, Nottingham NG7 2TU, UK; (T.C.); (J.K.); (S.T.); (A.L.G.)
- NIHR Applied Research Collaboration (ARC) East Midlands, Nottingham NG7 2TU, UK
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Partanen T, Seppänen-Järvelä R, Hiekkala S, Lindh J. Telerehabilitation in the Finnish Outpatient Rehabilitation Setting from the Perspective of the Socio-Technical Systems Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6519. [PMID: 37569057 PMCID: PMC10419293 DOI: 10.3390/ijerph20156519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/04/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND In the development of effective telerehabilitation (TR) interventions, understanding the various characteristics affecting its practice is essential. Remote connection creates a new technically shaped environment for therapy and, therefore, previous therapy methods do not work the same way as before. OBJECTIVE The objective of this survey was to describe the practice of TR through the socio-technical theory approach. METHODS The 629 respondents to the online questionnaire included music therapists, occupational therapists, speech and language therapists, physiotherapists, and neuropsychologists. The materials consisted of five open-ended questions. The analysis combined data-based and theory-based analysis. RESULTS In the data-based content analysis, we identified three main categories and eight generic categories, whereas in the theory-based, we categorised the main results according to the Fit Between Individuals, Tasks, Technology, and Environment (FITTE) framework dimensions. TR is everyday-life based, it requires shared participation, and the approach has to include coaching and collaboration with the client and their close associates. The everyday-life environment is one of the main dimensions that affect all the other dimensions. CONCLUSIONS TR can be seen as technology-mediated home-based rehabilitation, as it can integrate rehabilitation into the client's everyday life. In TR, therapy becomes multilateral and it creates a new kind of shared partnership into outpatient therapy.
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Affiliation(s)
- Tuija Partanen
- Kela Research, Social Insurance Institution of Finland, FI-00250 Helsinki, Finland;
- Faculty of Social Sciences, University of Lapland, FI-96101 Rovaniemi, Finland;
| | | | - Sinikka Hiekkala
- The Finnish Association of People with Physical Disabilities, FI-00280 Helsinki, Finland;
| | - Jari Lindh
- Faculty of Social Sciences, University of Lapland, FI-96101 Rovaniemi, Finland;
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Pol M, Qadeer A, van Hartingsveldt M, Choukou MA. Perspectives of Rehabilitation Professionals on Implementing a Validated Home Telerehabilitation Intervention for Older Adults in Geriatric Rehabilitation: Multisite Focus Group Study. JMIR Rehabil Assist Technol 2023; 10:e44498. [PMID: 37463040 PMCID: PMC10394599 DOI: 10.2196/44498] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/24/2023] [Accepted: 06/01/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Owing to demographic trends and increasing health care costs, quick discharge with geriatric rehabilitation at home is advised and recommended for older adults. Telerehabilitation has been identified as a promising tool to support rehabilitation at home. However, there is insufficient knowledge about how to implement a validated home telerehabilitation system in other contexts. One of the major challenges for rehabilitation professionals is transitioning to a blended work process in which human coaching is supplemented via digital care. OBJECTIVE The study aimed to gain an in-depth understanding of the factors that influence the implementation of an evidence-based sensor monitoring intervention (SMI) for older adults by analyzing the perspectives of rehabilitation professionals working in 2 different health ecosystems and mapping SMI barriers and facilitators. METHODS We adopted a qualitative study design to conduct 2 focus groups, 1 in person in the Netherlands during winter of 2017 and 1 on the web via Zoom (Zoom Video Communications; owing to the COVID-19 pandemic) in Canada during winter of 2022, to explore rehabilitation providers' perspectives about implementing SMI. Qualitative data obtained were analyzed using thematic analysis. Participants were a group of rehabilitation professionals in the Netherlands who have previously worked with the SMI and a group of rehabilitation professionals in the province of Manitoba (Canada) who have not previously worked with the SMI but who were introduced to the intervention through a 30-minute web-based presentation before the focus group. RESULTS The participants expressed different characteristics of the telerehabilitation intervention that contributed to making the intervention successful for at-home rehabilitation: focus on future participation goals, technology support provides the rehabilitation professionals with objective and additional insight into the daily functioning of the older adults at home, SMI can be used as a goal-setting tool, and SMI deepens their contact with older adults. The analysis showed facilitators of and barriers to the implementation of the telerehabilitation intervention. These included personal or client-related, therapist-related, and technology-related aspects. CONCLUSIONS Rehabilitation professionals believed that telerehabilitation could be suitable for monitoring and supporting older adults' rehabilitation at home. To better guide the implementation of telerehabilitation in the daily practice of rehabilitation professionals, the following steps are needed: ensuring that technology is feasible for communities with limited digital health literacy and cognitive impairments, developing instruction tools and guidelines, and training and coaching of rehabilitation professionals.
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Affiliation(s)
- Margriet Pol
- Amsterdam University of Applied Sciences, Research Group Occupational Therapy - Participation and Environment, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam, Netherlands
- Amsterdam University Medical center, location Vrije Universiteit Amsterdam, Department of Medicine for Older People, Amsterdam, Netherlands
- Amsterdam Public Health, Aging & Later Life, Amsterdam, Netherlands
| | - Amarzish Qadeer
- Bimedical Engineering graduate program, University of Manitoba, Winnipeg, MB, Canada
| | - Margo van Hartingsveldt
- Amsterdam University of Applied Sciences, Research Group Occupational Therapy - Participation and Environment, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam, Netherlands
| | - Mohamed-Amine Choukou
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Centre on Aging, University of Manitoba, Winnipeg, MB, Canada
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Buckingham S, Anil K, Demain S, Gunn H, Jones RB, Kent B, Logan A, Marsden J, Playford ED, Freeman J. Telerehabilitation for people with physical disabilities and movement impairment: development and evaluation of an online toolkit for practitioners and patients. Disabil Rehabil 2023; 45:1885-1892. [PMID: 35603803 DOI: 10.1080/09638288.2022.2074549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Telerehabilitation has increasingly been used since the COVID-19 pandemic but with limited guidance available on undertaking physical assessments using remote methods. We aimed to provide such guidance by developing a Telerehab Toolkit, an online information and training resource for practitioners, patients, and carers on telerehabilitation for people with physical disabilities and movement impairment. MATERIALS AND METHODS Development and evaluation of the toolkit were informed by the Knowledge to Action framework and took place iteratively in two phases-knowledge creation and action. Information was collated from various sources including literature review, online survey, service evaluation, and focus group discussions. The toolkit has been evaluated using think-aloud interviews, e-mail and social media feedback from users, and analytics data on user engagement with the website. RESULTS The Telerehab Toolkit focuses on remote physical assessments, and contains information on technology, digital skills, remote assessment tools, information governance, and safety for telerehabilitation. Resources include top tips from practitioners and patients, how-to guides, checklists, videos, and links to evidence. CONCLUSIONS The Telerehab Toolkit has been well-received by practitioners, healthcare students, patients, and carers, is being disseminated widely, and is freely available (www.plymouth.ac.uk/research/telerehab). IMPLICATIONS FOR REHABILITATIONTelerehabilitation has been increasingly used since the COVID-19 pandemic, but with limited guidance and training for practitioners on undertaking safe and effective remote physical assessments.The Telerehab Toolkit has been developed iteratively using the Knowledge to Action framework; it is a free online resource for practitioners and patients with specific guidance on telerehabilitation for physical disabilities and movement impairment.It is anticipated that the resource will help to improve the knowledge, skills, and confidence of the current and future rehabilitation workforce.
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Affiliation(s)
- Sarah Buckingham
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Krithika Anil
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Sara Demain
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Hilary Gunn
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | - Ray B Jones
- Centre for Health Technology, University of Plymouth, Plymouth, UK
- School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Bridie Kent
- School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Angela Logan
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
- Stroke Rehabilitation, Royal Devon and Exeter NHS Foundation Trust, William Wright House, Wonford Hospital, Exeter, UK
| | - Jonathan Marsden
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
| | | | - Jenny Freeman
- School of Health Professions, Peninsula Allied Health Centre, University of Plymouth, Plymouth, UK
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Özden F, Sarı Z. The effect of mobile application-based rehabilitation in patients with total knee arthroplasty: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 113:105058. [PMID: 37172329 DOI: 10.1016/j.archger.2023.105058] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 05/07/2023] [Accepted: 05/07/2023] [Indexed: 05/14/2023]
Abstract
OBJECTIVE Mobile applications have been used frequently in post-operative orthopedic rehabilitation in recent years. However, no systematic review has emphasized the importance of mobile applications in the rehabilitation process after total knee arthroplasty (TKA). This systematic review and meta-analysis aimed to evaluate the effectiveness of mobile application-based rehabilitation practices in patients with TKA. MATERIAL AND METHODS PubMed, Web-of-Science, Scopus, ScienceDirect and Cochrane databases were searched. The Physiotherapy Evidence Database (PEDro) and the Revised Cochrane risk-of-bias tool randomized trials 2 (RoB2) tools were used to demonstrate the methodological quality and risk of bias. RESULTS A total of 584 articles were screened. Finally, six papers were included in the systematic review. PEDro scores ranged from 4 to 7 (median: 5.5), indicating fair to good methodological quality. All studies were classified as "some concerns" in RoB2. Mobile application-based rehabilitation demonstrated better scores on pain, range of motion (ROM), objective and subjective function, satisfaction and compliance in general. Meta-analysis proved that mobile application-based telerehabilitation demonstrated better results on subjective function (ES:0.57, 95% CI: 0.11-1.02). CONCLUSION Compared to conventional rehabilitation, application-based telerehabilitation provides more effective results in function, pain and ROM. Furthermore, mobile application-based rehabilitation should also be considered regarding patient satisfaction and compliance.
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Affiliation(s)
- Fatih Özden
- Department of Health Care Services, Muğla Sıtkı Koçman University, Köyceğiz Vocational School of Health Services, Muğla, Turkey.
| | - Zübeyir Sarı
- Physiotherapy and Rehabilitation Department, Marmara University, Faculty of Health Sciences, İstanbul, Turkey
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van Ierssel J, O'Neil J, King J, Zemek R, Sveistrup H. Clinician Perspectives on Providing Concussion Assessment and Management via Telehealth: A Mixed-Methods Study. J Head Trauma Rehabil 2023; 38:E233-E243. [PMID: 36731011 DOI: 10.1097/htr.0000000000000827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To examine clinician perspectives regarding the use of telehealth for concussion assessment and management. SETTING A Pan-Canadian survey. PARTICIPANTS Twenty-five purposively sampled multidisciplinary clinician-researchers with concussion expertise (female, n = 21; physician, n = 11; and other health professional, n = 14). DESIGN Sequential mixed-method design: (1) electronic survey and (2) semistructured interviews with focus groups via videoconference. Qualitative descriptive design. MAIN OUTCOME MEASURES Survey : A 59-item questionnaire regarding the suitability of telehealth to perform recommended best practice components of concussion assessment and management. Focus groups : 10 open-ended questions explored survey results in more detail. RESULTS Clinicians strongly agreed that telehealth could be utilized to obtain a clinical history (96%), assess mental status (88%), and convey a diagnosis (83%) on initial assessment; to take a focused clinical history (80%); to monitor functional status (80%) on follow-up; and to manage symptoms using education on rest (92%), planning and pacing (92%), and sleep recommendations (91%); and to refer to a specialist (80%). Conversely, many clinicians believed telehealth was unsuitable to perform a complete neurologic examination (48%), cervical spine (38%) or vestibular assessment (61%), or to provide vestibular therapy (21%) or vision therapy (13%). Key benefits included convenience, provision of care, and patient-centered approach. General and concussion-specific challenges included technology, quality of care, patient and clinician characteristics, and logistics. Strategies to overcome identified challenges are presented. CONCLUSIONS From the perspective of experienced clinicians, telehealth is suited to manage symptomatic concussion patients presenting without red flags or following an initial in-person assessment, but may have limitations in ruling out serious pathology or providing return-to-sport clearance without an in-person physical examination.
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Affiliation(s)
- Jacqueline van Ierssel
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada (Drs van Ierssel and Zemek); School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada (Drs O'Neil, King, and Sveistrup); Bruyère Research Institute, Ottawa, Canada (Drs O'Neil and Sveistrup); and Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada (Dr Zemek)
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Leone E, Eddison N, Healy A, Royse C, Chockalingam N. Do UK Allied Health Professionals (AHPs) have sufficient guidelines and training to provide telehealth patient consultations? HUMAN RESOURCES FOR HEALTH 2022; 20:82. [PMID: 36471340 PMCID: PMC9721053 DOI: 10.1186/s12960-022-00778-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES The COVID-19 pandemic caused a rapid shift to remote consultations. United Kingdom (UK) NHS Allied Health Professional (AHP) services may have been unprepared for telehealth implementation. This study explored these services' organisational readiness regarding telehealth guidelines implementation and staff training. METHODS A cross-sectional online survey exploring available telehealth guidelines and staff training was distributed among UK AHPs and AHP service managers between May and June 2021. RESULTS 658 participants answered the survey (119 managers and 539 clinicians). Most services, in which telehealth was in place, had implemented telehealth guidelines (clinicians, 64%; managers, 82%), with most guidelines produced by the NHS staff who use them for their consultations. Most clinicians reported that guidelines had ambiguous areas (e.g., regarding protection from litigation and dealing with emergencies), whereas most managers reported the opposite opinion. Guidelines most frequently reported on appropriate telehealth technology and environment for staff and patients, while recommended consultation length and how to conduct telehealth with certain population groups were least reported. Clinicians lacked training in most telehealth aspects, while managers reported that staff training focused on telehealth software and hardware. For both clinicians and managers, training is needed on how to deal with emergencies during telehealth. CONCLUSIONS UK NHS AHP services are not fully equipped with clear and comprehensive guidelines and the skills to deliver telehealth. Vulnerable people are excluded from current guidelines, which may widen health inequalities and hinder the success of the NHS digital transformation. The absence of national guidelines highlights the need for uniform AHP telehealth guidelines.
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Affiliation(s)
- Enza Leone
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Leek Road, Stoke-on-Trent, ST4 2DF, United Kingdom
| | - Nicola Eddison
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Leek Road, Stoke-on-Trent, ST4 2DF, United Kingdom
- Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0QP, United Kingdom
| | - Aoife Healy
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Leek Road, Stoke-on-Trent, ST4 2DF, United Kingdom
| | - Carolyn Royse
- Dorset County Hospital NHS Foundation Trust, Dorchester, Dorset, DT1 2JY, United Kingdom
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Leek Road, Stoke-on-Trent, ST4 2DF, United Kingdom.
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Buckingham SA, Sein K, Anil K, Demain S, Gunn H, Jones RB, Kent B, Logan A, Marsden J, Playford ED, Freeman J. Telerehabilitation for physical disabilities and movement impairment: A service evaluation in South West England. J Eval Clin Pract 2022; 28:1084-1095. [PMID: 35437833 PMCID: PMC9790516 DOI: 10.1111/jep.13689] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 12/30/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES: Telerehabilitation was used to ensure continued provision of care during the COVID-19 pandemic, but there was a lack of guidance on how to use it safely and effectively for people with physical disabilities and movement impairment. In this service evaluation, we aimed to collate information on practitioner and patient experiences, challenges and facilitators, and examples of best practice to inform the development of an online toolkit and training package. METHODS Guided discussions were carried out with 44 practitioners, 7 patients and 2 carers from five health and social care organisations in South West England, and analysed thematically. RESULTS Practitioners and patients had positive experiences of telerehabilitation and were optimistic about its future use. Recognized benefits for people with physical disabilities included greater flexibility, reduced travel and fatigue, having appointments in a familiar environment and ease of involving family members. Challenges encountered were: technological (usability issues, access to technology and digital skills); difficulties seeing or hearing patients; the lack of 'hands-on' care; and safety concerns. Facilitators were supported by colleagues or digital champions, and family members or carers who could assist patients during their appointments. Key themes in best practice were: person-centred and tailored care; clear and open communication and observation and preparation and planning. Practitioners shared tips for remote physical assessments; for example, making use of patient-reported outcomes, and asking patients to wear bright and contrasting coloured clothing to make it easier to see movement. CONCLUSION Telerehabilitation holds promise in health and social care, but it is necessary to share good practice to ensure it is safe, effective and accessible. We collated information and recommendations that informed the content of the Telerehab Toolkit (https://www.plymouth.ac.uk/research/telerehab), a practical resource for practitioners, patients and carers, with a focus on remote assessment and management of physical disabilities and movement impairment.
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Affiliation(s)
- Sarah A. Buckingham
- Peninsula Allied Health Centre, School of Health ProfessionsUniversity of PlymouthPlymouthUK
| | - Kim Sein
- Peninsula Allied Health Centre, School of Health ProfessionsUniversity of PlymouthPlymouthUK
| | - Krithika Anil
- Peninsula Allied Health Centre, School of Health ProfessionsUniversity of PlymouthPlymouthUK
| | - Sara Demain
- Peninsula Allied Health Centre, School of Health ProfessionsUniversity of PlymouthPlymouthUK
- School of Health SciencesUniversity of SouthamptonSouthamptonUK
| | - Hilary Gunn
- Peninsula Allied Health Centre, School of Health ProfessionsUniversity of PlymouthPlymouthUK
| | - Ray B. Jones
- Centre for Health Technology, School of Nursing and MidwiferyUniversity of PlymouthPlymouthUK
| | - Bridie Kent
- School of Nursing and MidwiferyUniversity of PlymouthPlymouthUK
| | - Angela Logan
- Peninsula Allied Health Centre, School of Health ProfessionsUniversity of PlymouthPlymouthUK
- Stroke Rehabilitation, Royal Devon University Healthcare NHS Foundation Trust, William Wright House, Wonford HospitalExeterUK
| | - Jonathan Marsden
- Peninsula Allied Health Centre, School of Health ProfessionsUniversity of PlymouthPlymouthUK
| | - E D. Playford
- Warwick Medical SchoolUniversity of WarwickCoventryUK
| | - Jenny Freeman
- Peninsula Allied Health Centre, School of Health ProfessionsUniversity of PlymouthPlymouthUK
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