Telerehabilitation for People With Physical Disabilities and Movement Impairment: A Survey of United Kingdom Practitioners.
Telerehabilitation for People With Physical Disabilities and Movement Impairment: A Survey of United Kingdom Practitioners.
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DOI：
10.2196/30516
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发表时间：
2022-01-03
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远程康复是面对面康复的一种可行且可能有效的替代方案。然而，对对身体残疾和运动障碍人士进行远程评估的从业人员的具体指导、培训和支持是有限的。这项针对英国健康和社会保健从业人员的调查的目的是探索经验，评估培训需求，并整理关于身体残疾和运动障碍远程康复最佳实践的想法。目的是利用研究结果为远程康复使用的实用工具包和培训包提供信息。英国康复从业者受邀于 2020 年 11 月至 12 月完成在线调查问卷。利用机会和滚雪球抽样的方式从专业和教育网络、特殊兴趣团体以及社交媒体招募参与者。使用描述性统计分析封闭式问卷项目。使用 NVivo 的定性归纳分析用于开放式响应。共有 247 名受访者，其中 177 名（72%）是物理治疗师和职业治疗师。大多数（n=207，84%）使用了基于视频的咨询（通常由电话和电子邮件支持），并且自 COVID-19 大流行以来，这种方法的使用频率有所增加。从业者总体上对远程康复持积极态度，并认识到为患者带来的好处，包括降低感染风险、便利性和灵活性，以及减少旅行和疲劳。常见的障碍是技术相关（例如，互联网连接）、实用（例如，相机定位困难）、患者相关（例如，健康状况）、从业者相关（例如，缺乏技术技能）和组织（例如，缺乏技术访问权限）。家庭成员或护理人员的支持是成功远程咨询的主要促进因素。在使用视频咨询的 207 名受访者中，103 名（50%）使用这种方法评估了身体损伤，107 名（52%）评估了身体功能，121 名（59%）使用了患者报告的结果测量。尽管从业者普遍对提供视频咨询充满信心，但他们在进行远程身体评估方面感觉不太熟练，并对有效性、可靠性和安全性表示担忧。 247 名受访者中，只有 46 名 (19%) 接受过远程康复或视频咨询培训，有些人觉得自己“在黑暗中摸索”。从业者希望获得有关适合远程使用的身体评估工具、何时使用基于视频的咨询或替代方法、治理问题、数字平台以及为自己和患者提供数字技能培训路标的培训和指导。为了应对 COVID-19 大流行，从业者迅速对身体残疾和运动障碍人士采取了远程康复治疗。然而，还存在技术、实践和组织方面的障碍需要克服，并且显然需要改进远程身体评估的指导和培训。这项调查的结果将为当前和未来远程康复人员开发资源工具包和培训包提供信息。
Telerehabilitation is a feasible and potentially effective alternative to face-to-face rehabilitation. However, specific guidance, training, and support for practitioners who undertake remote assessments in people with physical disabilities and movement impairment are limited. The aims of this survey of United Kingdom–based health and social care practitioners were to explore experiences, assess training needs, and collate ideas on best practices in telerehabilitation for physical disabilities and movement impairment. The aim will be to use the findings to inform a practical tool kit and training package for telerehabilitation use. UK rehabilitation practitioners were invited to complete an online questionnaire from November to December 2020. Opportunity and snowball sampling were used to recruit participants from professional and educational networks, special interest groups, and via social media. Closed questionnaire items were analyzed using descriptive statistics. Qualitative inductive analysis using NVivo was used for open responses. There were 247 respondents, of which 177 (72%) were physiotherapists and occupational therapists. Most (n=207, 84%) had used video-based consultations (typically supported by telephone and email), and the use of this method had increased in frequency since the COVID-19 pandemic. Practitioners perceived telerehabilitation positively overall and recognized benefits for patients including a reduced infection risk, convenience and flexibility, and reduced travel and fatigue. Common obstacles were technology related (eg, internet connection), practical (eg, difficulty positioning the camera), patient related (eg, health status), practitioner related (eg, lack of technical skills), and organizational (eg, lack of access to technology). Support from family members or carers was a major facilitator for successful remote consultations. Of the 207 respondents who had used video-based consultations, 103 (50%) had assessed physical impairments using this method, 107 (52%) had assessed physical function, and 121 (59%) had used patient-reported outcome measures. Although practitioners generally felt confident in delivering video-based consultations, they felt less proficient in undertaking remote physical assessments, expressing concerns about validity, reliability, and safety. Only 46 of the 247 (19%) respondents had received any training in telerehabilitation or video consultations, and some felt they were “feeling their way in the dark.” Practitioners desired training and guidance on physical assessment tools suitable for remote use, when to use video-based consultations or alternative methods, governance issues, digital platforms, and signposting to digital skills training for themselves and their patients. In response to the COVID-19 pandemic, practitioners rapidly adopted telerehabilitation for people with physical disabilities and movement impairment. However, there are technical, practical, and organizational obstacles to overcome, and a clear need for improved guidance and training in remote physical assessments. The findings of this survey will inform the development of a tool kit of resources and a training package for the current and future workforce in telerehabilitation.