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多发性硬化症患者的远程通讯和康复:使用意愿和途径。一项横断面研究。

Telecommunication and rehabilitation for patients with multiple sclerosis: access and willingness to use. A cross-sectional study.

机构信息

Service of Physical Medicine and Rehabilitation, Clinic University of Saint-Luc, Brussels, Belgium.

Neuromusculoskeletal lab (NMSK), Institut of Experimental Clinical Research, Department of Health Sciences, Catholic University of Louvain, Brussels, Belgium.

出版信息

Eur J Phys Rehabil Med. 2020 Aug;56(4):403-411. doi: 10.23736/S1973-9087.20.06061-X. Epub 2020 Apr 15.

Abstract

BACKGROUND

Telerehabilitation is a promising approach for patients with multiple sclerosis (MS), but uncertainties regarding patients' access and preferences remain.

AIM

To investigate the access to telecommunication technologies and rehabilitation services of patients with MS, and their willingness to use these technologies for rehabilitation.

DESIGN

Cross-sectional survey.

SETTING

Outpatient neurological facility.

POPULATION

Patients with MS.

METHODS

Patients with MS attending consultations in the Neurology department were asked to fill in a paper questionnaire. This anonymous z was designed to gain information about needs and access to rehabilitation and telecommunication technologies, as well as interests and perspectives of telerehabilitation among these patients. Descriptive statistics, Chi-squared tests and logistic regressions were used to describe the sample and survey answers.

RESULTS

Two hundred patients completed the questionnaire. Mean age was 44.41(±12.52) years. Seventy-one percent were women, and 49% were unemployed. Ninety-one percent of the patients regularly used internet and 73% used apps. Most patients were interested in using telecommunication technologies to receive a program of physical exercises (62%), for information and personalized advice about physical activity and MS (69%), and to communicate with caregivers (75%). Patients with EDSS>4 were less interested than patients with EDSS≤4 in communicating with the caregivers via apps (33% vs. 52%,Δ19%[CI-36%;-2%],P=0.04) but expressed greater interest in receiving information and personal advice about physical activity and MS via the internet (70% vs. 51%,Δ19%[CI+2%;+36%],P=0.03). One third of the patients was not interested in receiving telerehabilitation interventions (32%), notably patients with EDSS>4 and non-workers.

CONCLUSIONS

Patients with MS are mainly interested in using telecommunication technologies for rehabilitation services, and most of these patients have access to the required technology. Being mildly disabled and having a professional activity are associated with a greater interest in telerehabilitation. In contrary, patients with moderate-to-severe disability and non-workers have reportedly less access and ease in using the required technologies.

CLINICAL REHABILITATION IMPACT

Telerehabilitation is feasible and wished by patients with MS, specifically in patients with low EDSS scores and workers. Given the strong need for rehabilitation in more disabled patients, the barriers to its access, the lower access and ease of use of telecommunication technologies, a special effort is needed to facilitate their use in these patients.

摘要

背景

远程康复对于多发性硬化症(MS)患者来说是一种很有前景的方法,但患者对其的接受程度和偏好仍存在不确定性。

目的

调查 MS 患者对远程通信技术和康复服务的使用情况,以及他们对使用这些技术进行康复的意愿。

设计

横断面调查。

地点

神经科门诊。

人群

MS 患者。

方法

在神经科就诊的 MS 患者被要求填写纸质问卷。该匿名问卷旨在了解康复和远程通信技术的需求和使用情况,以及这些患者对远程康复的兴趣和看法。使用描述性统计、卡方检验和逻辑回归来描述样本和调查结果。

结果

200 名患者完成了问卷。平均年龄为 44.41(±12.52)岁。71%为女性,49%为失业人员。91%的患者经常使用互联网,73%的患者使用应用程序。大多数患者对使用远程通信技术来接收体育锻炼计划(62%)、获取关于体育活动和 MS 的信息和个性化建议(69%)以及与护理人员进行沟通(75%)感兴趣。EDSS>4 的患者比 EDSS≤4 的患者对通过应用程序与护理人员进行沟通的兴趣较低(33%比 52%,差异 19%[CI-36%;-2%],P=0.04),但对通过互联网获取关于体育活动和 MS 的信息和个性化建议的兴趣更高(70%比 51%,差异 19%[CI+2%;+36%],P=0.03)。三分之一的患者对接受远程康复干预不感兴趣(32%),尤其是 EDSS>4 和非就业人员。

结论

MS 患者主要对使用远程通信技术进行康复服务感兴趣,且大多数患者都能获得所需的技术。轻度残疾和有职业活动的患者对远程康复的兴趣更大。相反,中重度残疾和非就业人员报告称,他们在使用所需技术方面的便利性和机会较少。

临床康复影响

远程康复对 MS 患者是可行且受欢迎的,特别是对 EDSS 评分较低和有工作的患者。鉴于残疾程度较高的患者对康复的强烈需求,以及他们在获取康复服务方面存在障碍,远程通信技术的使用便利性和机会较少,因此需要特别努力促进这些患者使用这些技术。

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