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通过远程医疗为脑卒中后中重度残疾患者共同设计康复资源。

Co-designing resources for rehabilitation via telehealth for people with moderate to severe disability post stroke.

机构信息

Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia; Physiotherapy, Western Health, St Albans, Australia; Australian Institute of Musculoskeletal Sciences, St Albans, Australia.

Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia; Physiotherapy, Western Health, St Albans, Australia; School of Health Sciences and Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Australia; Allied Health Strategy, Planning, Innovation, Research and Education Unit, Western Health, St Albans, Australia.

出版信息

Physiotherapy. 2024 Jun;123:109-117. doi: 10.1016/j.physio.2024.02.006. Epub 2024 Feb 24.

Abstract

OBJECTIVES

The COVID-19 pandemic necessitated rapid transition to telehealth. Telehealth presents challenges for rehabilitation of stroke survivors with moderate-to-severe physical disability, which traditionally relies on physical interactions. The objective was to co-design resources to support delivery of rehabilitation via telehealth for this cohort.

DESIGN

Four-stage integrated knowledge translation co-design approach. Stage 1: Research team comprising researchers, clinicians and stroke survivors defined the research question and approach. Stage 2: Workshops and interviews were conducted with knowledge users (participants) to identify essential elements of the program. Stage 3: Resources developed by the research team. Stage 4: Resources reviewed by knowledge users and adapted.

PARTICIPANTS

Twenty-one knowledge users (clinicians n = 11, stroke survivors n = 7, caregivers n = 3) RESULTS: All stakeholders emphasised the complexities of telehealth rehabilitation for stroke and the need for individualised programs. Shared decision-making was identified as critical. Potential risks and benefits of telehealth were acknowledged and strategies to ameliorate risks and deliver effective rehabilitation were identified. Four freely available online resources were co-designed; three resources to support clinicians with shared decision-making and risk management and a decision-aid to support stroke survivors and caregivers throughout the process. Over six months, 1129 users have viewed the webpage; clinician resources were downloaded 374 times and the decision-aid was downloaded 570 times.

CONCLUSIONS

The co-design process identified key elements for delivery of telehealth rehabilitation to stroke survivors with moderate-to-severe physical disability and led to development of resources to support development of an individualised telehealth rehabilitation plan. Future research should evaluate the effectiveness of these resources. CONTRIBUTION OF PAPER.

摘要

目的

新冠疫情大流行促使医疗保健迅速转向远程医疗。远程医疗为中度至重度身体残疾的中风幸存者的康复带来了挑战,因为传统上这种康复依赖于身体互动。本研究的目的是共同设计资源,以支持为这一人群通过远程医疗进行康复治疗。

设计

四阶段综合知识转化共同设计方法。第 1 阶段:由研究人员、临床医生和中风幸存者组成的研究团队定义了研究问题和方法。第 2 阶段:与知识用户(参与者)进行研讨会和访谈,以确定方案的基本要素。第 3 阶段:由研究团队开发资源。第 4 阶段:知识用户审查并调整资源。

参与者

21 名知识用户(临床医生 n=11,中风幸存者 n=7,照顾者 n=3)

结果

所有利益相关者都强调了中风远程医疗康复的复杂性,以及需要个体化的方案。共同决策被认为是至关重要的。远程医疗的潜在风险和益处得到了认可,并确定了减轻风险和提供有效康复的策略。共同设计了四个免费的在线资源;三个资源用于支持临床医生进行共同决策和风险管理,一个决策辅助工具用于支持中风幸存者和照顾者整个过程。在六个月的时间里,有 1129 名用户访问了网页;临床医生资源下载了 374 次,决策辅助工具下载了 570 次。

结论

共同设计过程确定了为中度至重度身体残疾的中风幸存者提供远程医疗康复的关键要素,并开发了支持制定个体化远程医疗康复计划的资源。未来的研究应该评估这些资源的有效性。

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