Patient Satisfaction with In-Home Telerehabilitation After Total Knee Arthroplasty: Results from a Randomized Controlled Trial
Patient Satisfaction with In-Home Telerehabilitation After Total Knee Arthroplasty: Results from a Randomized Controlled Trial
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DOI：
10.1089/tmj.2016.0060
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发表时间：
2017-02-01
影响因子：
4.7
通讯作者：
Dimentberg, Ronald
中科院分区：
文献类型：
--
作者：
Moffet, Helene;Tousignant, Michel;Dimentberg, Ronald
背景和介绍：全膝关节置换术（TKA）后的远程康复得到了此类干预有效性的有力证据和成本效益观点的支持。TKA术后患者对家庭远程康复的满意度尚未在大规模临床试验中得到彻底检查。本研究旨在比较TKA术后接受家庭远程康复（TELE）的患者与接受常规面对面家访（STD）康复的患者的满意度。其次，确定任何临床或个人变量是否与满意度水平相关。材料与方法：本研究为多中心随机对照试验，205例患者随机分为两组。两组的康复干预是相同的，只有提供服务的方法不同（远程康复或家访）。在基线（TKA前）、出院时以及出院后2个月和4个月（E4）使用功能结局对参与者进行评估。在E4时，使用经验证的医疗保健满意度问卷（HCSQ）测量患者满意度。结果：所有参与者的特征在基线时相似。两组的满意度没有差异，都很高（超过85%）。它既不相关的个人特征，也没有改善功能水平从术前到E4。满意度，而发现与步行和爬楼梯的表现。结论：这些结果，结合临床有效性和成本效益的证据表明，在同一样本的患者，强烈支持使用远程康复，以改善获得康复服务和TKA后的服务提供效率。
Background and Introduction: Telerehabilitation after total knee arthroplasty (TKA) is supported by strong evidence on the effectiveness of such intervention and from a cost-benefit point of view. Satisfaction of patients toward in-home telerehabilitation after TKA has not yet been examined thoroughly in large-scale clinical trials. This study aims to compare satisfaction level of patients following in-home telerehabilitation (TELE) after TKA to one of the patients following a usual face-to-face home visit (STD) rehabilitation. Secondarily, to determine if any clinical or personal variables were associated to the level of satisfaction. Materials and Methods: This study was embedded in a multicenter randomized controlled trial with 205 patients randomized into two groups. Rehabilitation intervention was the same for both groups; only approach for service delivery differed (telerehabilitation or home visits). Participants were assessed at baseline (before TKA), at hospital discharge, and at 2 and 4 months postdischarge (E4) using functional outcomes. Patient satisfaction was measured using the validated Health Care Satisfaction Questionnaire (HCSQ) at E4. Results: Characteristics of all participants were similar at baseline. Satisfaction level of both groups did not differ and was very high (over 85%). It was neither correlated to personal characteristics nor to improvements of functional level from preoperative to E4. Satisfaction was rather found associated to walking and stair-climbing performances. Conclusions: These results, in conjunction with evidences of clinical effectiveness and cost benefits demonstrated in the same sample of patients, strongly support the use of telerehabilitation to improve access to rehabilitation services and efficiency of service delivery after TKA.