Exploring patient experiences and perspectives of a heart failure telerehabilitation program: A mixed methods approach

Hwang, Rita; Mandrusiak, Allison; Morris, Norman; Peters, Robyn; Korczyk, Dariusz; Bruning, Jared; Russell, Trevor

doi:10.1016/j.hrtlng.2017.03.004

Cited by 52 publications

(110 citation statements)

References 29 publications

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“…Participants in our heart failure telerehabilitation program described overall positive experiences and perceptions related to the program, including high visual clarity and ease of use for the monitoring equipment (Hwang et al, 2017b). In line with previous work, our participants preferred to complement telerehabilitation with in-person visits (Pfaeffli Dale et al, 2015).…”

Section: Patient Experiences and Perspectives Related To Telerehabilisupporting

confidence: 70%

Providing Heart Failure Rehabilitation in the Home via Telerehabilitation

Hwang

Bruning

Mandrusiak

et al. 2016

Heart, Lung and Circulation

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Exercise is effective for patients with chronic heart failure (CHF). Despite this, many patients are unable to access traditional exercise-based rehabilitation programs for various reasons, such as transport difficulties and program availability. Telerehabilitation, in which telecommunication technologies are used to provide rehabilitation at a distance, is an alternative approach which may overcome some of these barriers.The current literature suggests that telerehabilitation is effective in patients with cardiopulmonary diseases. However the majority of studies focus on phone-based interventions, so there is a need for more studies on the use of video-based telerehabilitation programs. Video-based telerehabilitation is a new approach which enables patients to exercise in the comfort of their homes, whilst maintaining synchronous audiovisual communication. This approach enables the clinician to watch patients performing the exercises and to provide real-time feedback and modification as required, as well as facilitate the development of rapport between the clinician and patients, and peer support amongst patients. Video-based telerehabilitation also presents a potential way to conduct remote assessment of functional exercise capacity.This thesis aimed to explore a new service delivery model for providing heart failure exercise-based rehabilitation programs. The thesis commences with a systematic review of telerehabilitation in patients with cardiopulmonary diseases (Study 1, Paper 1). The next study aimed to determine the suitability of the timed up and go test (TUGT) as an outcome measurement in heart failure rehabilitation programs (Study 2, Paper 2). In addition, the validity and reliability of telerehabilitation assessments of functional tests including the TUGT were examined in patients with CHF (Study 3, Paper 3). A randomised controlled trial determined the feasibility and effectiveness of a home-based heart failure telerehabilitation program compared with a traditional centre-based program (Study 4, Paper 4). A mixed methods study was also conducted to determine patient experiences and perspectives related to a heart failure telerehabilitation program (Study 5, Paper 5).Based on the systematic review of 11 studies, telerehabilitation appears to be a promising alternative to traditional centre-based programs in patients with cardiopulmonary diseases. In particular, telerehabilitation has been shown to improve exercise capacity and quality of life in these patient groups and has higher adherence rates compared with traditional centre-based programs.iii However, suitable outcome measures that can be administered via telerehabilitation are required. A possible outcome measure is the TUGT, which is a quick and easy-to-administer functional test.However prior to using the TUGT as an outcome measure in telerehabilitation studies, it was first important to validate its use in both face-to-face and telerehabilitation environments. The TUGT demonstrated excellent test-retest reliability in patients with C...

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Section: Patient Experiences and Perspectives Related To Telerehabilisupporting

confidence: 70%

Providing Heart Failure Rehabilitation in the Home via Telerehabilitation

Hwang

Bruning

Mandrusiak

et al. 2016

Heart, Lung and Circulation

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“…From these articles seven (7) were excluded. [8][9][10][11] So, the material of the present study is based on nineteen (19) articles [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. The methodology of the review is summarized in picture 1.…”

Section: Methodsmentioning

confidence: 99%

“…From this extensive review, outcomes concerning heart failure patients under telemonitoring or telephone communication support program are encouraging. Structured communication is associated with reduced readmissions in hospitals, improvedquality of life and self-care behavior 16,18,20,[22][23]25,27. The reason is that both the collection of data and the evaluation of patients' clinical status can reveal disorders before the deregulation in heart failure and the hospitalization of patients.34 However, the provision of modern digital media, as patients have clearly noticed, should not reduce the ability for an interpersonal communication, since devices may not act as a direct tool substitute of direct communication which has many advantages, such as the expression of the emotions (active listening…”

mentioning

confidence: 99%

Educational interventions for patients with heart failure: a systematic review of randomized controlled trials

et al. 2019

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Background: Patient education is an important intervention for the management of heart failure; however, in practice patient education varies considerably. The purpose is to systematically review educational interventions that have been implemented for heart failure patients and assess their effectiveness.Method and Material: Randomized controlled trials from 2008 to 2018 in MEDLINE were reviewed using the following search terms: nursing teaching, education, intervention, patients with heart failure, hospital. From the Randomized controlled trials 26 abstracts were reviewed.Results: A total of 2484 patients were included in the 19 studies that met the inclusion criteria. Commonly, the initial educational intervention was a one-on-one didactic session conducted by nurses supplemented by written materials and multimedia approaches. One study referred to a theoretical model as a framework for their educational intervention. Studies used a variety of outcome measures to evaluate their effectiveness. Of the studies reviewed, 17 demonstrated a significant effect from their intervention in at least one of their outcome measures.Conclusions: Despite improvements in knowledge, we have variable results in outcomes and this is very likely related to the heterogeneity of the studies included in this review. It was difficult to establish the most effective educational strategy as the educational interventions varied considerably in delivery methods and duration as well as the outcome measures that were used for the evaluation. A patient-centered multidisciplinary approach based on educational theory and evaluated appropriately may assist to develop an evidence base for patient education.

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“…[24][25][26] Some studies have pointed out the effectiveness of these methods; [27,28] however the last systematic reviews and meta-analyzes highlight the limited evidence, mainly due to the lack of high quality research studies. [29,30] In general terms, telerehabilitation methods have been reported as positive experiences by patients [31], and can represent an important way to reduce associated healthcare costs [29]. Nonetheless, in this case the reasons for implementing telerehabilitation are not economic, but of necessity to avoid the spread of the virus, due to the general house confinement of the entire Spanish population.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Pulmonary Telerehabilitation Protocol in patients affected by COVID-19, confined in their homes: Study Protocol for a Randomized Control Trial

González-Gerez

Bernal‐Utrera

Anarte‐Lazo

et al. 2020

Preprint

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Abstract Background: In December 2019, 27 cases of pneumonia, of unknown cause, were identified in the province of Hubei (China). The WHO declared the situation as a Public Health emergency of International Concern and it was finally declared a global pandemic on March 11, 2020. Spanish Government obliges the entire population to remain confined to their homes, with exception of essential basic services, to stop the spread of COVID-19. Home isolation implies a notable physical deconditioning. Telerehabilitation methods have reported positive experiences and we propose to study in affected patients of COVID-19, due to the general house confinement of the entire Spanish population. Methods: Patients will be recruited in the regions of Andalusia, Murcia and Valencia (Spain). Patients will remain confined to their homes, and there they will carry out their assigned exercise program, which will be controlled telematically. Evaluators will attend to carry out all measurements at the beginning, during, and end of the study, telematically controlled. The patients will be randomly divided into three groups, two of them will perform a home exercise program (breathing exercises or non-specific exercises for muscle toning) and the third group will perform sedentary activities, using mental activation techniques, and will act as a sham group. We will evaluate respiratory variables and other variables of physical state through physical tests, effort and perceived fatigue. The data will be statistically analyzed, and the hypotheses will be tested between the groups, using the SPSS software, v.20, considering a 95% confidence interval. Discussion: We will analyze the results, in terms of level of fatigue and perceived exertion, physical health, and maintenance of respiratory activity of two types of exercise programs, toning and respiratory, applied in patients affected by COVID19 during the period of home confinement. We intend to investigate a field not previously studied, such as the repercussion of carrying out a toning and respiratory exercise program in these patients, in historical circumstances that no one had previously observed in Spain, since the general population has never been forced to remain confined in their homes, due to a pandemic infection, by coronavirus (COVID19). Observing the effects that these two home exercise programs could produce in patients infected with COVID19, we will try to better analyze and understand the mechanisms that are associated with worsening of breathing in this type of patient.

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Exploring patient experiences and perspectives of a heart failure telerehabilitation program: A mixed methods approach

Cited by 52 publications

References 29 publications

Providing Heart Failure Rehabilitation in the Home via Telerehabilitation

Providing Heart Failure Rehabilitation in the Home via Telerehabilitation

Educational interventions for patients with heart failure: a systematic review of randomized controlled trials

Therapeutic Pulmonary Telerehabilitation Protocol in patients affected by COVID-19, confined in their homes: Study Protocol for a Randomized Control Trial

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