Choong Elena America, Schladen Manon Maitland, Alles Yvonne Beth
School of Business, Technology, and Health Care Administration, Capella University, Minneapolis, MN, United States.
Department of Biomedical Engineering, The Catholic University of America, Washington, DC, United States.
Front Psychol. 2022 Nov 30;13:1030741. doi: 10.3389/fpsyg.2022.1030741. eCollection 2022.
In response to the throttling of children's therapy programs precipitated by COVID-19 shutdowns, interest in the use of telehealth has increased among service providers at both the clinical and administrative levels. TelePT promises to be particularly appropriate in devising programs of on-going, therapeutic exercise interventions for children with neuromotor disorders. From the lay perspective, physical/physiotherapy (PT) which is seemingly characterized by the "hands-on," and corrective approach to managing impairments, makes it a counter-intuitive candidate for delivery over telehealth. Over the past decades, however, PT as a discipline has increasingly adhered to a relationship-driven, family-centered model of intervention. This model is "hands-off," figuratively if not always literally, and hence is not necessarily disconsonant with delivery mediated by telehealth technology. The current study explores in-depth the experiences and reflections of seven practicing therapists, on the impact of telehealth, telePT on the operationalization of relationship-based, family-centered methods into therapy. Interpretative phenomenological analysis was selected as the analytic method for understanding participants' experience providing services using both distance and standard face-to-face practice modalities. Results identified eight principal themes emerging from participants' descriptions of their experience of delivering therapy over telePT. Four of these themes correspond to the tenets of relationship-driven, family-centered care identified across four frameworks applied to pediatric rehabilitation. The remaining four themes focus on the particularities of the telePT modality and its viability in clinical practice. The ability telePT afforded to "see into the child's environment" emerged arguably as the greatest value of the modality in patient care. It revealed to therapists so much that they did not know about their patients' progress and, more strikingly, had not realized they did not know. TelePT provides a unique window into the child's functioning in the hours he is not in therapy. Given its potential in parent-therapist relationship building, assuring the ecological validity of therapy programs, and the empowerment of families who seek it, telePT is likely to be part of the future of PT and one driver of its evolution as a profession. There is a compelling case to retain telePT modalities offering them alongside in-person formats for convenience, safety, and service quality enhancement.
针对因新冠疫情封锁导致儿童治疗项目受限的情况，临床和行政层面的服务提供者对远程医疗的兴趣都有所增加。远程物理治疗有望特别适用于为患有神经运动障碍的儿童设计持续的治疗性运动干预项目。从外行的角度来看，物理治疗（PT）似乎以“亲力亲为”以及针对损伤的矫正方法为特点，这使得它成为通过远程医疗提供服务的反直觉选择。然而，在过去几十年里，PT作为一门学科越来越坚持以关系为驱动、以家庭为中心的干预模式。这种模式在形象上（如果不是总是字面意义上）是“不直接接触”的，因此不一定与远程医疗技术介导的服务提供方式不一致。本研究深入探讨了七位执业治疗师对远程医疗、远程物理治疗对将基于关系、以家庭为中心的方法应用于治疗的影响的经验和反思。选择解释性现象学分析作为分析方法，以了解参与者使用远程和标准面对面实践模式提供服务的体验。结果确定了八个主要主题，这些主题来自参与者对通过远程物理治疗提供治疗的体验描述。其中四个主题与应用于儿科康复的四个框架中确定的以关系为驱动、以家庭为中心的护理原则相对应。其余四个主题关注远程物理治疗模式的特殊性及其在临床实践中的可行性。远程物理治疗能够“洞察儿童的环境”，这一点可以说是该模式在患者护理中最大的价值。它让治疗师了解到他们对患者进展情况所知甚少，更惊人的是，他们还没有意识到自己不知道。远程物理治疗为儿童在非治疗时间的功能提供了一个独特的窗口。鉴于其在建立家长与治疗师关系、确保治疗项目的生态效度以及增强寻求治疗的家庭的能力方面的潜力，远程物理治疗很可能成为物理治疗未来的一部分，并成为其作为一门专业发展的一个驱动力。保留远程物理治疗模式并将其与面对面形式一起提供，以方便、安全和提高服务质量，这是一个令人信服的理由。
