Faculty of Health, Nutrition and Sports, The Hague University for Applied Sciences, The Hague, The Netherlands.
Sophia Rehabilitation Centre, The Hague, The Netherlands.
Implement Sci. 2018 Oct 29;13(1):133. doi: 10.1186/s13012-018-0827-5.
The uptake of eRehabilitation programs in stroke care is insufficient, despite the growing availability. The aim of this study was to explore which factors influence the uptake of eRehabilitation in stroke rehabilitation, among stroke patients, informal caregivers, and healthcare professionals.
A qualitative focus group study with eight focus groups (6-8 participants per group) was conducted: six with stroke patients/informal caregivers and two with healthcare professionals involved in stroke rehabilitation (rehabilitation physicians, physical therapists, occupational therapists, psychologists, managers). Focus group interviews were audiotaped, transcribed in full, and analyzed by direct content analysis using the implementation model of Grol.
Thirty-two patients, 15 informal caregivers, and 13 healthcare professionals were included. A total of 14 influencing factors were found, grouped to 5 of the 6 levels of the implementation model of Grol (Innovation, Organizational context, Individual patient, Individual professional, and Economic and political context). Most quotes of patients, informal caregivers, and healthcare professionals were classified to factors at the level of the Innovation (e.g., content, attractiveness, and feasibility of eRehabilitation programs). In addition, for patients, relatively many quotes were classified to factors at the level of the individual patient (e.g., patients characteristics as fatigue and the inability to understand ICT-devices), and for healthcare professionals at the level of the organizational context (e.g., having sufficient time and the fit with existing processes of care).
Although there was a considerable overlap in reported factors between patients/informal caregivers and healthcare professionals when it concerns eRehabilitation as innovation, its seems that patients/informal caregivers give more emphasis to factors related to the individual patient, whereas healthcare professionals emphasize the importance of factors related to the organizational context. This difference should be considered when developing an implementation strategy for patients and healthcare professionals separately.
尽管电子康复项目在中风护理中的可用性不断增加,但患者、照护者和医疗保健专业人员对其的接受程度仍然不足。本研究旨在探讨影响中风康复患者、照护者和医疗保健专业人员接受电子康复的因素。
采用定性焦点小组研究,共进行了 8 个焦点小组(每组 6-8 名参与者):6 个小组由中风患者/照护者组成,2 个小组由参与中风康复的医疗保健专业人员组成(康复医师、物理治疗师、职业治疗师、心理学家、管理人员)。对焦点小组访谈进行录音、完整转录,并使用 Grol 的实施模型进行直接内容分析。
共纳入 32 名患者、15 名照护者和 13 名医疗保健专业人员。共发现 14 个影响因素,分为 Grol 实施模型的 5 个层次(创新、组织背景、个体患者、个体专业人员和经济政治背景)。患者、照护者和医疗保健专业人员的大多数引言都被归类为创新层面的因素(例如,电子康复计划的内容、吸引力和可行性)。此外,对于患者,相对较多的引言被归类为患者个体层面的因素(例如,疲劳和无法理解 ICT 设备等患者特征),而对于医疗保健专业人员,则更多地归类为组织背景层面的因素(例如,是否有足够的时间以及是否符合现有护理流程)。
尽管患者/照护者和医疗保健专业人员在报告电子康复相关因素时存在较大重叠,但患者/照护者似乎更强调与个体患者相关的因素,而医疗保健专业人员则强调与组织背景相关的因素。在分别为患者和医疗保健专业人员制定实施策略时,应考虑到这种差异。