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远程康复服务的可接受性:创伤性脑损伤患者及其照护者的体验和观点。

Acceptability of telehealth-delivered rehabilitation: Experiences and perspectives of people with traumatic brain injury and their carers.

机构信息

The University of Sydney, Faculty of Medicine and Health, Australia.

The University of Technology Sydney, Graduate School of Health, Australia.

出版信息

J Telemed Telecare. 2022 Feb;28(2):122-134. doi: 10.1177/1357633X20923824. Epub 2020 May 28.

Abstract

INTRODUCTION

Communication skills training for people with traumatic brain injury (TBI) and their carers is recommended best practice. Delivery via telehealth could improve access to this training. This paper focuses on the acceptability of telehealth delivery of communication skills training.

METHODS

A mixed-methods investigation of acceptability of telehealth to people with TBI and their carers was incorporated into a clinical trial. Thirty-six people with TBI (23 metropolitan and 13 regional) and their carers were recruited. Metropolitan participants were randomly allocated to telehealth or in-person intervention at a 1:3 ratio. Regional participants were allocated to telehealth. Telehealth and in-person participants were compared on retention, time to complete the programme, home practice completion and therapeutic alliance ratings. Participants completed semi-structured interviews regarding their views on telehealth, which were analysed using thematic analysis.

RESULTS

There were no significant differences between telehealth and in-person participants in retention rate, time to complete the programme, degree of home practice completion or therapeutic alliance ratings. Three themes were identified: 'telehealth delivery opens a window for access to rehabilitation in the context of my daily life', 'in-person delivery offers rehabilitation based on natural human interaction' and 'weighing telehealth against in-person delivery'.

DISCUSSION

Participants found telehealth delivery acceptable, as indicated by the similarity between groups in the quantitative process measures, and as reported in interviews. Some reported a preference for in-person delivery if there had been a choice of delivery mode. Participants described characteristics of the two delivery modes which were relevant to their attitudes towards telehealth.

摘要

简介

创伤性脑损伤 (TBI) 患者及其照顾者的沟通技巧培训被推荐为最佳实践。通过远程医疗提供这种培训可以提高获得这种培训的机会。本文重点关注远程医疗提供沟通技巧培训的可接受性。

方法

一项针对 TBI 患者及其照顾者对远程医疗可接受性的混合方法调查被纳入一项临床试验。招募了 36 名 TBI 患者(23 名来自大都市地区,13 名来自地区)及其照顾者。大都市地区的参与者被随机分配到远程医疗或面对面干预组,比例为 1:3。地区参与者被分配到远程医疗组。对远程医疗和面对面参与者进行了保留率、完成计划的时间、家庭练习完成情况和治疗联盟评分的比较。参与者就他们对远程医疗的看法完成了半结构化访谈,访谈内容采用主题分析进行分析。

结果

远程医疗和面对面参与者在保留率、完成计划的时间、家庭练习完成程度或治疗联盟评分方面没有显著差异。确定了三个主题:“远程医疗的提供在我的日常生活背景下为获得康复提供了机会”、“面对面的提供基于自然的人际互动提供了康复”和“权衡远程医疗和面对面的提供”。

讨论

参与者发现远程医疗的提供是可以接受的,这从定量过程测量中两组之间的相似性以及访谈中的报告中可以看出。如果有选择的话,一些参与者报告更喜欢面对面的提供。参与者描述了两种提供模式的特点,这些特点与他们对远程医疗的态度有关。

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