Acceptability of telehealth-delivered rehabilitation: Experiences and perspectives of people with traumatic brain injury and their carers

Abstract

Introduction Communication skills training for people with traumatic brain injury (TBI) and their carers is recommended best practice. Delivery via telehealth could improve access to this training. This paper focuses on the acceptability of telehealth delivery of communication skills training. Methods A mixed-methods investigation of acceptability of telehealth to people with TBI and their carers was incorporated into a clinical trial. Thirty-six people with TBI (23 metropolitan and 13 regional) and their carers were recruited. Metropolitan participants were randomly allocated to telehealth or in-person intervention at a 1:3 ratio. Regional participants were allocated to telehealth. Telehealth and in-person participants were compared on retention, time to complete the programme, home practice completion and therapeutic alliance ratings. Participants completed semi-structured interviews regarding their views on telehealth, which were analysed using thematic analysis. Results There were no significant differences between telehealth and in-person participants in retention rate, time to complete the programme, degree of home practice completion or therapeutic alliance ratings. Three themes were identified: ‘telehealth delivery opens a window for access to rehabilitation in the context of my daily life’, ‘in-person delivery offers rehabilitation based on natural human interaction’ and ‘weighing telehealth against in-person delivery’. Discussion Participants found telehealth delivery acceptable, as indicated by the similarity between groups in the quantitative process measures, and as reported in interviews. Some reported a preference for in-person delivery if there had been a choice of delivery mode. Participants described characteristics of the two delivery modes which were relevant to their attitudes towards telehealth.

Factors Affecting the Delivery and Acceptability of the ROWTATE Telehealth Vocational Rehabilitation Intervention for Traumatic Injury Survivors: A Mixed-Methods Study

“…This difference may reflect the need to understand the work environment and functioning at work as part of our VR intervention. Our pre-intervention findings relating to privacy and disruptions are also consistent with those of other studies [ 38 , 39 ], including therapists’ concerns regarding communication with patients and building rapport [ 31 , 32 , 39 , 40 , 41 ].…”

“…Barriers to telerehabilitation have been identified in the broader literature, including technical problems [ 10 , 18 , 23 , 24 , 25 , 26 ], patient difficulty in using the necessary technology [ 27 , 28 ], difficulty conducting physical examinations [ 10 , 12 , 15 , 29 ] or psychosocial components [ 30 ], communication problems [ 31 , 32 ] and provider resistance to adopt telerehabilitation [ 27 , 29 ]. Some studies have found that patients prefer telerehabilitation to face-to-face rehabilitation, with others suggesting that patients have no preference for either mode [ 31 , 32 , 33 ].…”

COVID-19 and Psychosocial Support Services: Experiences of People Living with Enduring Mental Health Conditions

“…Our study indicated that familiarity with technology and tele-support was important to people’s experiences. This is supported by research in allied health, which has suggested that the acceptability of telehealth services increases with experience and exposure (Hines et al, 2019 ; Hines et al, 2015 ; Rietdijk et al, 2020 ). While difficult in the midst of pandemic restrictions, taking time to introduce service users to tele-support as an option is likely to increase their comfort with the medium.…”

Implementation of Web-Based Psychosocial Interventions for Adults With Acquired Brain Injury and Their Caregivers: Systematic Review

“…Adopters included in this review included 5723 adults with ABI (5424, 95% intervention recipients and 299, 5% controls), 1920 formal and informal caregivers (1729, 90% recipients and 191, 10% controls), and 50 staff (4, 8% healthy recipients, such as volunteers, who trialed the intervention; 13, 26% administrative staff in 1 study [ 49 ]; and at least 33, 66% clinicians delivering interventions, as Anderson et al [ 69 ] did not specify how many clinicians were consulted). Reviewed interventions typically targeted only the person with ABI (44/60, 73%); however, some included both an informal carer and the person with ABI (7/60, 12%), informal carers only (6/60, 10%), or either formal or informal carers together with a person with ABI (2/60, 3%) [ 70 , 71 ]. None of the interventions targeted only formal caregivers (ie, clinicians or support workers), but Lee et al [ 72 ] (1/60, 2%) targeted both speech-language pathology students and people with ABI.…”