Adherence and factors affecting satisfaction in long-term telerehabilitation for patients with chronic obstructive pulmonary disease: a mixed methods study.
Adherence and factors affecting satisfaction in long-term telerehabilitation for patients with chronic obstructive pulmonary disease: a mixed methods study.
复制标题
DOI：
10.1186/s12911-016-0264-9
复制
发表时间：
2016-02-25
影响因子：
3.5
通讯作者：
Zanaboni P
中科院分区：
文献类型：
--
作者：
Hoaas H;Andreassen HK;Lien LA;Hjalmarsen A;Zanaboni P
远程医疗可增加慢性阻塞性肺疾病（COPD）患者获得肺康复的机会，从而加强长期运动维持。我们的目的是探讨慢性阻塞性肺病患者的长期远程康复的依从性和经验，以了解影响满意度和服务改进的潜力的因素。对10例COPD患者进行了为期两年的初步研究。干预措施包括在家中进行跑步机运动训练，以及远程监测和自我管理网页，并与物理治疗师每周进行视频会议。我们进行了四个独立的数据收集系列。遵守率是以网页注册频率来衡量的。通过两个半结构化的焦点小组和一个单独的开放式问卷调查，探讨了影响满意度和依从性的因素，以及服务改进的潜力。定性数据进行了分析系统的文本压缩。通过可用性调查问卷测量用户友好性。平均而言，参与者每周在网络日记中记录3.0份症状报告，每周1.7次培训。第二年的依从率下降。四个主要主题的因素影响满意度，坚持和潜在的改进的干预措施出现：（一）体验到的健康益处;（二）提高自我效能和独立性;和（三）情绪安全，由于定期会议和获得特殊能力;（四）保持动力。参与者普遍对远程康复干预的技术组成部分非常满意。COPD患者长期坚持远程康复治疗两年。满意度得到了经验丰富的健康益处，自我效能和情感安全的支持。保持积极性是一项挑战，可能会影响长期坚持。四个关键因素的潜在改善，在长期的远程康复：（一）坚持不同组成部分的远程康复干预是依赖于所提供的关注水平的卫生人员参与;（二）的潜力，规律性在于技术应加以利用，以避免复发后休假; ㈢通过定制个人咨询，以支持良好健康的体验，并实现个人目标和激励战略，可以提高动机;（iv）互动功能或游戏工具可提供同侪支持、同侪示范和增强动力。
Telemedicine may increase accessibility to pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD), thus enhancing long-term exercise maintenance. We aimed to explore COPD patients’ adherence and experiences in long-term telerehabilitation to understand factors affecting satisfaction and potential for service improvements. A two-year pilot study with 10 patients with COPD was conducted. The intervention included treadmill exercise training at home and a webpage for telemonitoring and self-management combined with weekly videoconferencing sessions with a physiotherapist. We conducted four separate series of data collection. Adherence was measured in terms of frequency of registrations on the webpage. Factors affecting satisfaction and adherence, together with potential for service improvements, were explored through two semi-structured focus groups and an individual open-ended questionnaire. Qualitative data were analysed by systematic text condensation. User friendliness was measured by the means of a usability questionnaire. On average, participants registered 3.0 symptom reports/week in a web-based diary and 1.7 training sessions/week. Adherence rate decreased during the second year. Four major themes regarding factors affecting satisfaction, adherence and potential improvements of the intervention emerged: (i) experienced health benefits; (ii) increased self-efficacy and independence; and (iii) emotional safety due to regular meetings and access to special competence; (iv) maintenance of motivation. Participants were generally highly satisfied with the technical components of the telerehabilitation intervention. Long-term adherence to telerehabilitation in COPD was maintained for a two-year period. Satisfaction was supported by experienced health benefits, self-efficacy, and emotional safety. Maintenance of motivation was a challenge and might have affected long-term adherence. Four key factors of potential improvements in long-term telerehabilitation were identified: (i) adherence to different components of the telerehabilitation intervention is dependent on the level of focus provided by the health personnel involved; (ii) the potential for regularity that lies within the technology should be exploited to avoid relapses after vacation; (iii) motivation might be increased by tailoring individual consultations to support experiences of good health and meet individual goals and motivational strategies; (iv) interactive functionalities or gaming tools might provide peer-support, peer-modelling and enhance motivation.