Exploring future possibilities of using information and communication technology in multidisciplinary rehabilitation after stroke – a grounded theory study

Abstract

Background: Using Information and Communication Technology (ICT) could increase the intensity of rehabilitation, the level of patient activity and participation in everyday life after stroke and is in line with having a person-centred approach. Aim: To explore how healthcare professionals use and could potentially use ICT to enable a person-centred rehabilitation process after stroke. Methods: Six individual and two focus group interviews were conducted with a group of healthcare professionals working within rehabilitation after stroke. A grounded theory approach was used to collect and analyze the data. Results: The professionals described their current use of ICT as well as their vision of how ICT could be incorporated as a tool in rehabilitation for sharing in four categories: (1) Sharing of information, (2) Collaborating from a distance, (3) Having transparency in the documentation and (4) Supporting patients' use of ICT. Conclusion: Professionals state that using ICT solutions in rehabilitation after stroke could increase sharing between professionals and their patients and increase patient participation in the rehabilitation process. Significance: This study highlights the importance of developing ICT that healthcare professionals could use along with a person-centred approach. The results will be used to develop an ICT-supported multidisciplinary intervention for rehabilitation after stroke.

Physiotherapists’ and occupational therapists’ perspectives on information and communication technology in stroke rehabilitation

“…They perceived ICT integration as important in the early stroke screening, as many urgently need to be able to handle at least their mobile phone again in order to resume previous tasks, feel a sense of security and independence, and to compensate for remaining deficits. These results are in line with previous studies showing that stroke survivors, significant others and health professionals are interested in integrating ICT solutions in the rehabilitation process [4,16,23,28,29,47] because they can support stroke survivors' opportunities to engage in social activities [4,29,48], to give stroke survivors and significant others a greater feeling of independence [4,22,29], and, not least, to improve their quality of life [10,11].…”

“…Studies have also shown that health professionals have an important role in promoting successful integration of ICT in the rehabilitation process, as stroke survivors and significant others need to receive relevant introduction to and support on the use of these technologies, including how to handle ICT that acts unexpectedly and for example, needs to be updated [4,13,23,29,49,50]. Thus, therapists in this study pointed out that in order for ICT to be used among stroke survivors it must be easy and simple to handle with attention to cognitive impairments, which is in line with findings from other studies [36,51,52].…”

“…ICT, such as mobile phones, computers and tablets are becoming more frequently owned and used among the public, including among older people. ICT devices are also being increasingly used to support stroke rehabilitation and studies have shown that stroke survivors, their significant others, and health professionals are interested in integrating ICT into stroke rehabilitation [13,[21][22][23][24], given that ICT has the potential to accommodate many unmet needs expressed by stroke survivors and significant others. Among the unmet needs, dissatisfaction with the information level during the inpatient stay [22,25], and a lack of adaptation to changing information needs over time [4,25] have been reported.…”

“…Furthermore, there is a lack of qualitative literature identifying physiotherapists' (PTs) and occupational therapists' (OTs) perspectives on the use of ICT in stroke rehabilitation [21,37], including their perspectives on how ICT can support the rehabilitation process and be beneficial for both the stroke survivor, significant others, and health professionals involved in stroke rehabilitation. However, a recent qualitative study has shown that health professionals perceive ICT integration in the rehabilitation process to potentially increase sharing and communication between health professionals and patients, thus facilitating transparency during the rehabilitation process [23]. Recommended areas for future research include continuing to identify gaps along the continuum of the rehabilitation process and to develop new person-centred ICT-supported solutions to fill these gaps and support the rehabilitation process [22] simultaneously involving end-users in all phases of the developments to maximize the usability and usefulness of the ICT-solutions [36,38].…”

“…The involvement of end users is a key element of the project. Therefore, several qualitative studies have been performed to explore the experiences of using ICT in everyday life and in rehabilitation after stroke -from the perspectives of stroke survivors, significant others and health professionals in different health care contexts [4,16,23,29]. This present study was carried out to explore the perspectives of OTs and PTs within rehabilitation after stroke in a Danish health care context.…”