Using telerehabilitation to support people with multiple sclerosis: A qualitative analysis of interactions, processes, and issues across three interventions

Abstract

Introduction: It is important to understand the interactions, processes, and issues that occur within telerehabilitation interventions to inform research and practice. The aim of this study was to identify the difficulties reported and intervention features that were captured as helpful in the notes written by occupational therapists during a telerehabilitation trial. Method: Administrative documentation in the form of 60 subjective, objective, assessment, and plan notes were collected. The trial examined the effectiveness of three teleconference-delivered interventions: physical activity alone, fatigue management with physical activity, and contact-control social support for people with multiple sclerosis. Results: Five themes emerged: desiring change, taking action, experiencing difficulty, infrastructure support, and relief and appreciation. Desiring change captured therapists' observations of clients' desire to manage symptoms and improve participation; it was most apparent at the beginning and supported clients' taking action as the interventions progressed. Therapists identified their own difficulties with group facilitation and time management and clients' difficulties with some intervention materials. Infrastructure support was reported to be helpful in minimizing some of these difficulties. In the end, the therapists expressed relief that the clients appeared to benefit from and appreciate the interventions. Conclusion: This study highlights the need for and importance of providing resources and training to support teleconferencedelivered interventions in clinical practice.

The Work Experience Survey: An on-the-job needs assessment tool to promote successful career outcomes for young adult central nervous system cancer survivors

“…Such an assessment should be comprehensive in nature, providing insights into what Strauser (2013) called for in his tripartite model of work adjustment that includes: a) disabilityrelated barriers to job performance (e.g., physical, cognitive, and psychological symptoms), b) environmental factors (e.g., co-worker attitudes, on-the-job accommodations, employer discrimination), and c) interactive influences of the disability and the environment. Rehabilitation professionals should also note that the data collected with the WES were gathered in telephone interviews with participants rather than in site visits, which speaks to the cost effectiveness of the WES (Fakolade et al, 2017).…”

Qualitative case studies of professional-level workers with traumatic brain injuries: A contextual approach to job accommodation and retention

“…Such an assessment should be comprehensive in nature, providing insights into what Strauser [27] called for in his tripartite model of work adjustment that includes: a) disability-related barriers to job performance (e.g., physical, cognitive, and psychological symptoms), b) environmental factors (e.g., co-worker attitudes, onthe-job accommodations, employer discrimination), and c) interactive influences of the disability and the environment. Rehabilitation professionals should also note that the data collected with the WES were gathered in telephone interviews with participants rather than in site visits, which speaks to the cost effectiveness of the WES [28].…”

Determining the use and value of social support in Telerehabiliation Interventions for individuals with Multiple Sclerosis: A narrative synthesis review

“…For instance, it can provide motivation of individuals with MS to adhere to an intervention [15]. Emotional and esteem support can give patients a sense of empowerment and increased con idence [16][17][18]. Particular techniques like health coaching and motivational interviewing can enhance adherence to rehabilitation interventions.…”

“…Despite frequent descriptions of the bene icial aspects of peer support for information exchange and empowerment in participants with MS in the literature [17,18], only one study facilitated peer support through an online forum. There is some research to suggest that emotional support is most effectively provided by similar others [44], as they can connect over shared experiences.…”