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

Abstract

Background: Returning to work after traumatic injury can be problematic. We developed a vocational telerehabilitation (VR) intervention for trauma survivors, delivered by trained occupational therapists (OTs) and clinical psychologists (CPs), and explored factors affecting delivery and acceptability in a feasibility study. Methods: Surveys pre- (5 OTs, 2 CPs) and post-training (3 OTs, 1 CP); interviews pre- (5 OTs, 2 CPs) and post-intervention (4 trauma survivors, 4 OTs, 2 CPs). Mean survey scores for 14 theoretical domains identified telerehabilitation barriers (score ≤ 3.5) and facilitators (score ≥ 5). Interviews were transcribed and thematically analysed. Results: Surveys: pre-training, the only barrier was therapists’ intentions to use telerehabilitation (mean = 3.40 ± 0.23), post-training, 13/14 domains were facilitators. Interviews: barriers/facilitators included environmental context/resources (e.g., technology, patient engagement, privacy/disruptions, travel and access); beliefs about capabilities (e.g., building rapport, complex assessments, knowledge/confidence, third-party feedback and communication style); optimism (e.g., impossible assessments, novel working methods, perceived importance and patient/therapist reluctance) and social/professional role/identity (e.g., therapeutic methods). Training and experience of intervention delivery addressed some barriers and increased facilitators. The intervention was acceptable to trauma survivors and therapists. Conclusion: Despite training and experience in intervention delivery, some barriers remained. Providing some face-to-face delivery where necessary may address certain barriers, but strategies are required to address other barriers.

Global Impact of the COVID-19 Pandemic on Orthopedics and the Implications of Telemedicine: A Systematic Review of the Literature

“…Recently, more and more other studies discussed the implications of telemedicine in orthopedics from various aspects. [ 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ].…”

The patient acceptability of a remotely delivered pain management programme for people with persistent musculoskeletal pain: A qualitative evaluation

“…14,15 Consistent with our findings, a study of a telehealth vocational rehabilitation intervention also found that remote delivery reduced the burden for patients as they felt more comfortable receiving therapy at home and did not need to travel to access the programme. 16 Reduced travel demands and childcare requirements also contribute to the acceptability of virtual consultations in an orthopaedic setting. 17 In contrast, other participants in our study reported that childcare responsibilities were a distraction which could reduce the programme’s effectiveness.…”

A Tailored Occupational Therapist–Led Vocational Intervention for People With Stroke: Protocol for a Pilot Randomized Controlled Trial

“…Participants randomized to the experimental group will receive early vocational rehabilitation (the Work intervention) to address individualized goals set in relation to work and working in addition to usual clinical rehabilitation. The vocational intervention will be predominantly delivered face to face, but there is potential to deliver using telehealth [ 18 ]. Whether in-person or via telehealth, the intervention will be delivered on a one-to-one basis and be individually tailored to the participant in terms of content, dose, intensity, and duration according to participants’ needs and preferences (eg, whether the participant consents to employer liaison and workplace visits).…”