Epalte Klinta, Grjadovojs Aleksandrs, Bērziņa Guna
Department of Rehabilitation, Riga Stradiņš University, Riga, Latvia.
JMIR Rehabil Assist Technol. 2023 Apr 14;10:e44285. doi: 10.2196/44285.
There is a lack of resources for the provision of adequate rehabilitation after a stroke, thus creating a challenge to provide the necessary high-quality, patient-centered, and cost-efficient rehabilitation services at a time when they are needed the most. Tablet-based therapeutic programs present an alternative way to access rehabilitation services and show a new paradigm for providing therapeutic interventions following a stroke anytime and anywhere. The digital assistant Vigo is an artificial intelligence-based app that provides an opportunity for a new, more integrative way of carrying out a home-based rehabilitation program. Considering the complexity of the stroke recovery process, factors such as a suitable population, appropriate timing, setting, and the necessary patient-specialist support structure need to be thoroughly researched. There is a lack of qualitative research exploring the perspectives of professionals working in neurorehabilitation of the content and usability of the digital tool for the recovery of patients after a stroke.
The aim of this study is to identify the requirements for a tablet-based home rehabilitation program for stroke recovery from the perspective of a specialist working in stroke rehabilitation.
The focus group study method was chosen to explore specialists' attitudes, experience, and expectations related to the use of the digital assistant Vigo as a home-based rehabilitation program for stroke recovery in domains of the app's functionality, compliance, usability, and content.
In total, 3 focus groups were conducted with a participant count of 5-6 per group and the duration of the discussion ranging from 70 to 80 minutes. In total, 17 health care professionals participated in the focus group discussions. The participants represented physiotherapists (n=7, 41.2%), occupational therapists (n=7, 41.2%), speech and language therapists (n=2, 11.8%), and physical medicine and rehabilitation physicians (n=1, 5.9%). Audio and video recordings of each discussion were created for further transcription and analysis. In total, 4 themes were identified: (1) the clinician's views on using Vigo as a home-based rehabilitation system, (2) patient-related circumstances facilitating and limiting the use of Vigo; (3) Vigo's functionality and use process (program creation, individual use, remote support); and (4) complementary and alternative Vigo use perspectives. The last 3 themes were divided further into 10 subthemes, and 2 subthemes had 2 sub-subthemes each.
Health care professionals expressed a positive attitude toward the usability of the Vigo app. It is important that the content and use of the app be coherent with the aim to avoid (1) misunderstanding its practical use and the need for integration in practice and (2) misusing the app. In all focus groups, the importance of close involvement of rehabilitation specialists in the process of app development and research was highlighted.
缺乏资源用于在中风后提供充分的康复治疗，因此在最需要高质量、以患者为中心且具有成本效益的康复服务时，提供这些服务成为一项挑战。基于平板电脑的治疗方案提供了一种获取康复服务的替代方式，并展示了一种在中风后随时随地提供治疗干预的新范式。数字助手Vigo是一款基于人工智能的应用程序，为开展家庭康复计划提供了一种新的、更综合的方式。考虑到中风恢复过程的复杂性，诸如合适的人群、恰当的时机、环境以及必要的患者 - 专家支持结构等因素需要进行深入研究。目前缺乏定性研究来探讨神经康复领域专业人员对该数字工具用于中风后患者康复的内容和可用性的看法。
本研究旨在从中风康复专科医生的角度确定基于平板电脑的中风恢复家庭康复计划的要求。
选择焦点小组研究方法，以探讨专家在应用程序功能、依从性、可用性和内容等方面，对使用数字助手Vigo作为中风恢复家庭康复计划的态度、经验和期望。
总共进行了3个焦点小组讨论，每组有5 - 6名参与者，讨论时长为70至80分钟。共有17名医疗保健专业人员参与了焦点小组讨论。参与者包括物理治疗师（n = 7，41.2%）、职业治疗师（n = 7，41.2%）、言语和语言治疗师（n = 2，11.8%）以及物理医学与康复医师（n = 1，5.9%）。为便于进一步转录和分析，对每次讨论进行了音频和视频录制。总共确定了4个主题：（1）临床医生对将Vigo用作家庭康复系统的看法；（2）促进和限制Vigo使用的与患者相关的情况；（3）Vigo的功能和使用过程（程序创建、个人使用、远程支持）；（4）Vigo使用的补充和替代观点。最后3个主题进一步细分为10个子主题，其中2个子主题各有2个次子主题。
医疗保健专业人员对Vigo应用程序的可用性持积极态度。重要的是，应用程序的内容和使用要与目标一致，以避免（1）误解其实际用途以及在实践中整合的必要性，（2）滥用该应用程序。在所有焦点小组中，都强调了康复专家密切参与应用程序开发和研究过程的重要性。
