Factors associated with willingness to use eRehabilitation after stroke: A cross-sectional study among patients, informal caregivers and healthcare professionals

Abstract

The use of digital eRehabilitation after stroke (e.g. in serious games, e-consultation and education) is increasing. However, the use of eRehabilitation in daily practice is limited. As a first step in increasing the use of eRehabilitation in stroke care, this study examined which factors influence the willingness of stroke patients, informal caregivers and healthcare professionals to use eRehabilitation. Beliefs about the benefits of eRehabilitation were found to have the largest positive impact on willingness to use eRehabilitation. These benefits included reduced travel time, increased adherence to therapy or motivation, and better health outcomes. The willingness to use eRehabilitation is limited by a lack of knowledge about how to use eRehabilitation. Objective: Despite the increasing availability of eRehabilitation, its use remains limited. The aim of this study was to assess factors associated with willingness to use eRehabilitation. Design: Cross-sectional survey. Subjects: Stroke patients, informal caregivers, health care professionals. Methods: The survey included personal characteristics, willingness to use eRehabilitation (yes/no) and barriers/facilitators influencing this willingness (4-point scale). Barriers/facilitators were merged into factors. The association between these factors and willingness to use eRehabilitation was assessed using logistic regression analyses. Results: Overall, 125 patients, 43 informal caregivers and 105 healthcare professionals participated in the study. Willingness to use eRehabilitation was positively influenced by perceived patient benefits (e.g. reduced travel time, increased motivation, better outcomes), among patients (odds ratio (OR) 2.68; 95% confidence interval (95% CI) 1.34-5.33), informal caregivers (OR 8.98; 95% CI 1.70-47.33) and healthcare professionals (OR 6.25; 95% CI 1.17-10.48). Insufficient knowledge decreased willingness to use eRehabilitation among patients (OR 0.36, 95% CI 0.17-0.74). Limitations of the study include low response rates and possible response bias. Conclusion: Differences were found between patients/informal caregivers and healthcare professionals. However, for both groups, perceived benefits of the use of eRehabilitation facilitated willingness to use eRehabilitation. Further research is needed to determine the benefits of such programs, and inform all users about the potential benefits, and how to use eRehabilitation.

Differences in factors influencing the use of eRehabilitation after stroke; a cross-sectional comparison between Brazilian and Dutch healthcare professionals

“…The questionnaire (Additional file 1) was specifically developed for an overarching research project to identify factors influencing the use of eRehabilitation. Results of a study concerning only Dutch responses were published elsewhere [20].…”

“…This included lack of confidence with hardware or software [15,16], fear of losing social face-to-face contact [17,18] and lack of meaningful reimbursement [7,19]. In order to make eRehabilitation feasible, programs need to be tailored to the patients' needs and sufficient support of a helpdesk for ICT is a prerequisite [20]. Studies performed in western countries concluded that eRehabilitation programs are generally considered feasible [5], however, in low-and middle income countries, future trails on the feasibility are needed [13].…”

Effect of a comprehensive eRehabilitation intervention alongside conventional stroke rehabilitation on disability and health-related quality of life: A pre–post comparison

“…A tailored strategy, based on barriers and facilitators identified in preceding studies ( 10 , 24 ) was used to implement the intervention. Implementation included, among others, structured integration in the healthcare process, providing education and information to healthcare professionals, people with stroke and their caregivers, and providing a helpdesk/support for all users.…”

Differences in factors influencing the use of eRehabilitation after stroke; a cross-sectional comparison between Brazilian and Dutch healthcare professionals

“…This included lack of confidence with hardware or software (18,19), fear of losing social face-to-face contact (12,20) and lack of meaningful reimbursement (7,21). In order to make eRehabilitation feasible, programs need to be tailored to the patients' needs and sufficient support of a helpdesk for ICT is a prerequisite (22). Studies performed in western countries concluded that eRehabilitation programs are generally considered feasible (5), however, in low-and middle income countries, future trails on the feasibility are needed (15).…”