Perspectives of stakeholders on implementing a validated home telerehabilitation intervention for older adults in geriatric rehabilitation: a multi-site qualitative study (Preprint)

Abstract

Due to the demographic trends and increasing healthcare 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 on how to implement a validated home telerehabilitation system in other contexts. One of the major challenges for health professionals is transitioning to a blended work process in which human coaching is supplemented by digital care.

This study aims to depict the factors that influence the implementation of an evidence-based sensor monitoring intervention for older adults (SMI) from the perspectives of health professionals working in two different health ecosystems: 1) professionals in the Netherlands who have previously worked with the sensor monitoring intervention, and, 2) professionals in the province of Manitoba (Canada) who have not previously worked with the sensor monitoring intervention by mapping of the barriers and facilitators of using the intervention

We adopted a qualitative study design to conduct two focus groups, one in-person in the Netherlands and one online via Zoom (due to covid-19) in Canada, to explore stakeholders’ perspectives on implementing SMI. Qualitative data obtained were analyzed using thematic analysis.

The participants expressed different characteristics of the telerehabilitation intervention that contributed to making the intervention successful for the at-home rehabilitation: 1) Focus on future participation goals; 2) The technology support provides the professionals with objective and additional insight into the daily functioning of the older adults at home; 3) The SMI can be used as a goal-setting tool; 4) The SMI deepens their contact with older adults. The analysis showed facilitators and barriers to the implementation of the telerehabilitation intervention. These included i. personal/client related, ii. therapist related, and iii. technology related.

Health professionals believed 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 health professionals the following steps are needed: 1) ensuring technology is feasible for communities with limited digital health literacy, and cognitive impairments; 2) developing instruction tools and guidelines and 3) training and coaching of professionals.

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