Service provider perceptions of telerehabilitation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: A qualitative study

Cottrell, Michelle; Hill, Anne J.; O’Leary, Shaun; Raymer, Maree; Russell, Trevor

doi:10.1016/j.msksp.2017.07.008

Cited by 82 publications

(89 citation statements)

References 23 publications

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“…Stakeholder perceptions and experiences of tele-WS assessment are remarkably similar to findings observed in other aspects of tele-health delivery, where remote health professionals and service users were more eager adopters of technology and specialists (urban) health professionals more hesitant [59,60] [61]. Service users regularly comment on improvement of access to specialist care and reduction in time and cost of IP services [62].…”

Section: Stakeholders Viewssupporting

confidence: 63%

“…Although most health professionals have sufficient aptitude to adopt telehealth technologies (supported by findings in this scoping review and elsewhere [60] learning to use new technologies takes time. Recognition of learning needs and time in workload management and IT support availability during transition to telehealth deliver are also likely to be important components in successful implementation.…”

Section: Stakeholders Viewsmentioning

confidence: 58%

“…Mechanisms of attitude development are unclear but it appears that the clinical context has a role in shaping these, for example, overall exposure to technology, and the degree of system flexibility to allow experimentation with technology and the incentivising of experimentation [37,60]. Despite this, shifting of attitudes appears to be difficult, with trusted peer adopters being a strong influencer [59] [61], suggesting that positive case examples and mentorship within and across services from peer health professionals will be vital in successfully implementing tele-WS assessment In future research of tele-WS assessment, evaluation of health professionals' attitude to telehealth generally would be useful in interpreting findings in the use and effectiveness of tele-WS assessment.…”

Section: Stakeholders Viewsmentioning

confidence: 99%

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Telehealth delivery of remote assessment of wheelchair and seating needs for adults and children: A scoping review (Preprint)

Graham¹,

Boland²,

Grainger³

et al. 2018

Preprint

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Background: Assessment of the wheelchair and seating needs of people with complex disabilities requires health professionals to have advanced training and experience, creating difficulties in accessing such specialist services for wheelchair users living outside of metropolitan areas. Use of telehealth technologies to enable remote assessment has been suggested as one way to improve accessibility to specialist assessment and reduce the cost of services, however no synthesis of this research is currently available to guide practice or research development.Objective: This scoping review synthesizes research to date on the effects and processes of telehealth enabled wheelchair and seating assessment and the perceptions of wheelchair users and healthcare providers of this mode of service delivery. Methods:A systematic search and scoping review of peer-reviewed publications and theses was undertaken. Five databases were searched including CINAHL, Embase, Medline, Psychinfo and Scopus followed by hand searching of reference lists and forward citations.Data extraction and synthesis was organised around each research objective. Results:From an initial identification of 1801 publications, 9 studies published in 13 documents met the inclusion criteria. Study quality and study design varied considerably. The effect of telehealth compared to in-person assessment was insignificant in all studies that compared effectiveness (n=2) in relation to wheelchair-user and assessor rated variables.Telehealth assessment improved accessibility for some wheelchair users (n=1). However the process of telehealth that was applied to wheelchair assessment was inadequately described in all studies. Qualitative studies (n= 2) revealed that wheelchair-users appraised telehealth wheelchair assessment more positively than assessors. Non-specialist, assisting assessors appraised telehealth assessment more positively than specialist assessors. It appeared that each stakeholder group appraised telehealth based on different criteria including accessibility, professional supportiveness and technical accuracy. No studies examined funder views.Conclusions: Preliminary research suggests telehealth wheelchair assessment may be as effective as in-person assessment. Furthermore, this approach is viewed favorably by wheelchair users and non-specialist assessors, while expert assessors have some hesitations.The literature to date has not provided adequate descriptions of the process undertaken during 3 remote wheelchair assessment. The process of remote wheelchair assessment requires clarification to further understandings of how telehealth can be used for greatest effect in this area.

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Section: Stakeholders Viewssupporting

confidence: 63%

Section: Stakeholders Viewsmentioning

confidence: 58%

Section: Stakeholders Viewsmentioning

confidence: 99%

See 1 more Smart Citation

Telehealth delivery of remote assessment of wheelchair and seating needs for adults and children: A scoping review (Preprint)

Graham¹,

Boland²,

Grainger³

et al. 2018

Preprint

View full text Add to dashboard Cite

show abstract

“…The participant survey was developed for the specific purpose of this study, with individual items derived from two main sources. The first source included themes identified by the research team in a previously published study (Cottrell, Hill, O’Leary, Raymer, & Russell, 2017b). These themes suggested that whilst there would most likely be an improvement in patients’ access to appropriate healthcare, telerehabilitation would have significant limitations, including safety and privacy, as well as achieving clinician-patient rapport, when compared to standard face-to-face care.…”

Section: Methodsmentioning

confidence: 99%

Clinicians' Perspectives of a Novel Home-based Multidisciplinary Telehealth Service for Patients with Chronic Spinal Pain

Cottrell¹,

Hill²,

O’Leary³

et al. 2018

Int J Telerehab

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Chronic spinal pain conditions can often be successfully managed by a non-surgical, multidisciplinary approach, however many individuals are unable to access such specialised services within their local community. A possible solution may be the delivery of care via telerehabilitation. This study aimed to evaluate clinicians’ perspectives on providing clinical care via telerehabilitation during the early implementation of a novel spinal telerehabilitation service. Eight clinicians’ were recruited, completing surveys at four separate time points. Confidence in providing treatment via telerehabilitation significantly improved with time (χ2(3)=16.22, p=0.001). Clinicians became significantly more accepting of telerehabilitation being a time- (χ2(3)=11.237, p=0.011), and cost-effective (χ2(3)=9.466, p=0.024) platform in which they could deliver care. Overall satisfaction was high, with technology becoming easier to use (p=0.026) and ability to establish rapport significantly improved with experience (p=0.043). Understanding clinicians’ perspectives throughout the early implementation phase of a new telerehabilitation service is a critical component in determining long-term sustainability.

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“…However, interest in , and evidence to support , remotely delivered health care (i.e., telerehabilitation) for chronic musculoskeletal conditions is growing. Given that physical touch and nonverbal cues (e.g., gestures, head nodding, and eye contact) play an important role in communication between physical therapists and their patients , the delivery of care via telerehabilitation has been regarded as possibly having a negative impact on the therapeutic alliance . Although there is qualitative evidence that both physical therapists and patients with OA who have received, or delivered, care via telephone and Skype video‐conferencing believe that they are able to develop strong relationships, no previous studies have quantitively investigated the therapeutic alliance between physical therapists and patients with OA consulting via telerehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Alliance Between Physical Therapists and Patients With Knee Osteoarthritis Consulting Via Telephone: A Longitudinal Study

Lawford

Bennell

Campbell

et al. 2020

Arthritis Care & Research

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Objective. To explore therapeutic alliance between physical therapists and patients with knee osteoarthritis during telephone consultations. Specifically, to describe and compare physical therapist and patient ratings, to determine whether alliance changes over time, and to evaluate whether individual characteristics are associated with alliance.Methods. We performed a secondary analysis of 84 patients in the intervention arm of a randomized controlled trial who completed 5-10 consultations with 1 of 8 physical therapists via telephone over 26 weeks, involving education, advice, and prescription of a strengthening and physical activity program. Therapeutic alliance was measured after the second (week 4) and final consultations (week 26), using the Working Alliance Inventory-Short Form.Results. Patient and physical therapist ratings of the alliance were high. At week 4, patients rated the overall alliance, and all 3 subscales, higher than therapists. At 26 weeks, patients rated the Task subscale higher than therapists. Patient ratings for the Goal subscale decreased over time, while physical therapist ratings for total alliance and the Bond subscale increased. For patients, the variables of living with others, consulting with a therapist with no previous experience delivering care remotely, having more telephone consultations, and having a higher self-efficacy were associated with greater alliance ratings. Therapists were more likely to perceive a stronger alliance if they had less clinical experience and when treating patients who were younger and had higher self-efficacy.Conclusion. Physical therapist perceptions of the therapeutic alliance tended to be lower than those of patients early in treatment, but differences were small and of unclear clinical significance. Some subgroups of patients rated the alliance more strongly than others.

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Service provider perceptions of telerehabilitation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: A qualitative study

Cited by 82 publications

References 23 publications

Telehealth delivery of remote assessment of wheelchair and seating needs for adults and children: A scoping review (Preprint)

Telehealth delivery of remote assessment of wheelchair and seating needs for adults and children: A scoping review (Preprint)

Clinicians' Perspectives of a Novel Home-based Multidisciplinary Telehealth Service for Patients with Chronic Spinal Pain

Therapeutic Alliance Between Physical Therapists and Patients With Knee Osteoarthritis Consulting Via Telephone: A Longitudinal Study

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