Improving patients experience in a neuro-rehabilitation unit using tablet computers

Abstract

Rationale, aims and objectives: Patients in stroke rehabilitation units spend considerable time unengaged in therapeutic or meaningful activity, feeling bored with suboptimal engagement in rehabilitation. Systematic reviews have shown that novel interventions such as interactive video gaming result in improved motor function and cognitive performance. The objective of this study was to evaluate the feasibility of introducing “tablet computers - iPads” in hospital rehabilitation programmes and their impact on patients’ boredom and overall satisfaction. In addition, acceptance and familiarity of the multidisciplinary members of the neuro-rehabilitation team with iPads were explored.Methods: A £10,000 fund was secured from Health Education England, UK to buy 10 iPads. A loan scheme was implemented to regulate iPad use. Information technology and governance issues were agreed with the hospital trust to ensure safety, accountability and confidentiality. Members of the multidisciplinary team offered training and education to patients on iPad use. Questionnaires were used before iPad use to assess patients and staff views on iPads. After iPad use patients and staff completed another questionnaire and were interviewed about which specific applications were used, boredom levels before and after use, and overall satisfaction.Results: Nine patients (7 males) used the iPads (8 strokes and 1 traumatic brain injury), with an average age of 59 (19-79) years. Staff used several applications in physiotherapy and speech therapy and found some applications such as memory games and puzzles particularly helpful. In addition to therapeutic uses, patients used iPads for internet searches, e-mail, Facebook, Skype and games. Eighty-nine percent of patients were satisfied with the iPad experience and 100% reported less boredom or between better and the same boredom compared to baseline.Conclusions: iPad use is feasible and beneficial to patients and welcomed by staff in neuro-rehabilitation units.

iPad Use in Stroke Neuro-Rehabilitation

“…Utilising tablet computers therefore has the potential to reduce social isolation and might prove to be cost-effective by reducing length of hospital stay and servicesdependency. Feedback from rehabilitation therapists in our recent service evaluation study indicated enhanced patients' participation and engagement in therapy sessions with the use of tablet computers [31]. Therapists also reported reduced levels of patients' abandonment of therapy sessions.…”

“…In addition to improving functional recovery, several qualitative data demonstrates high acceptance and satisfaction of iPad-based rehabilitation programmes by stroke survivors [27][28][29][30][31]50]. Qualitative data presented by White et al (2014) from 12 stroke survivors investigated stroke survivors' acceptability of iPad-based rehabilitation in the first 3 months of recovery [30].…”

“…Feedback from physiotherapists in our recent service evaluation study highlighted the benefit of iPads in recording stroke patients walking and transferring which were later used as learning and re-training tool [31]. Moreover, Kizony et al (2016) examined the effectiveness of iPad-based application ("Tap-it") on post-stroke hand dexterity impairment [29].…”

Patient experience using digital therapy “Vigo” for stroke patient recovery: a qualitative descriptive study

“…Main priority for applications designed for the stroke patient population is the simplicity of use, technical support and foolproof content [36]. Our data shows that at a patient level use of tablet technologies is acceptable and feasible as long as they are easy to use and beneficial at an individual level [37]. Users of the application had positive feedback on the layout of the interface and Chatbot design.…”

“…Some participants acknowledged that the Chatbot design helps to create a feeling of real conversation and someone supporting them. Reduced feeling of loneliness and abondominet increases engagement and reduces feelings of isolation and boredom [37]. Another factor that increases engagement is patents ability to monitor their progress and have access to educational information [38].…”