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职业伤害后远程康复后护理计划的障碍、促进因素和要求:与主要利益相关者的半结构化访谈。

Barriers, Facilitators, and Requirements for a Telerehabilitation Aftercare Program for Patients After Occupational Injuries: Semistructured Interviews With Key Stakeholders.

机构信息

Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

JMIR Form Res. 2024 Nov 8;8:e51865. doi: 10.2196/51865.

Abstract

BACKGROUND

Patients with occupational injuries often receive multidisciplinary rehabilitation for a rapid return to work. Rehabilitation aftercare programs give patients the opportunity to help patients apply the progress they have made during the rehabilitation to their everyday activities. Telerehabilitation aftercare programs can help reduce barriers, such as lack of time due to other commitments, because they can be used regardless of time or location. Careful identification of barriers, facilitators, and design requirements with key stakeholders is a critical step in developing a telerehabilitation aftercare program.

OBJECTIVE

This study aims to identify barriers, facilitators, and design requirements for a future telerehabilitation aftercare program for patients with occupational injuries from the perspective of the key stakeholders.

METHODS

We used a literature review and expert recommendations to identify key stakeholders. We conducted semistructured interviews in person and via real-time video calls with 27 key stakeholders to collect data. Interviews were transcribed verbatim, and thematic analysis was applied. We selected key stakeholder statements about facilitators and barriers and categorized them as individual, technical, environmental, and organizational facilitators and barriers. We identified expressions that captured aspects that the telerehabilitation aftercare program should fulfill and clustered them into attributes and overarching values. We translated the attributes into one or more requirements and grouped them into content, functional, service, user experience, and work context requirements.

RESULTS

The key stakeholders identified can be grouped into the following categories: patients, health care professionals, administrative personnel, and members of the telerehabilitation program design and development team. The most frequently reported facilitators of a future telerehabilitation aftercare program were time savings for patients, high motivation of the patients to participate in telerehabilitation aftercare program, high usability of the program, and regular in-person therapy meetings during the telerehabilitation aftercare program. The most frequently reported barriers were low digital affinity and skills of the patients and personnel, patients' lack of trust and acceptance of the telerehabilitation aftercare program, slow internet speed, program functionality problems (eg, application crashes or freezes), and inability of telerehabilitation to deliver certain elements of in-person rehabilitation aftercare such as monitoring exercise performance. In our study, the most common design requirements were reducing barriers and implementing facilitators. The 2 most frequently discussed overarching values were tailoring of telerehabilitation, such as a tailored exercise plan and tailored injury-related information, and social interaction, such as real-time psychotherapy and digital and in-person rehabilitation aftercare in a blended care approach.

CONCLUSIONS

Key stakeholders reported on facilitators, barriers, and design requirements that should be considered throughout the development process. Tailoring telerehabilitation content was the key value for stakeholders to ensure the program could meet the needs of patients with different types of occupational injuries.

摘要

背景

职业伤害患者通常需要接受多学科康复治疗,以快速重返工作岗位。康复后护理计划为患者提供了机会,帮助患者将康复期间取得的进展应用于日常生活活动中。远程康复后护理计划可以帮助减少障碍,例如因其他事务而缺乏时间,因为无论时间或地点如何,都可以使用该计划。与主要利益相关者仔细确定障碍、促进因素和设计要求是开发远程康复后护理计划的关键步骤。

目的

本研究旨在从主要利益相关者的角度确定职业伤害患者未来远程康复后护理计划的障碍、促进因素和设计要求。

方法

我们使用文献回顾和专家建议来确定主要利益相关者。我们通过面对面和实时视频通话与 27 名主要利益相关者进行了半结构式访谈,以收集数据。访谈记录被逐字转录,并应用了主题分析。我们选择了主要利益相关者关于促进因素和障碍的陈述,并将其归类为个人、技术、环境和组织促进因素和障碍。我们捕捉到远程康复后护理计划应满足的方面的表达,并将其聚类为属性和总体价值。我们将属性转换为一个或多个要求,并将其分组为内容、功能、服务、用户体验和工作环境要求。

结果

确定的主要利益相关者可以分为以下几类:患者、医疗保健专业人员、行政人员以及远程康复计划设计和开发团队的成员。未来远程康复后护理计划最常被报道的促进因素是为患者节省时间、患者高度参与远程康复后护理计划的动机、计划的高可用性以及在远程康复后护理计划期间定期进行面对面治疗会议。最常被报道的障碍是患者和人员的数字亲和力和技能低、患者对远程康复后护理计划的信任和接受度低、互联网速度慢、计划功能问题(例如,应用程序崩溃或冻结)以及远程康复无法提供某些面对面康复后护理内容,例如监测运动表现。在我们的研究中,最常见的设计要求是减少障碍和实施促进因素。讨论最多的两个总体价值是远程康复的定制,例如定制的锻炼计划和定制的与损伤相关的信息,以及社交互动,例如实时心理治疗以及数字和面对面的康复后护理在混合保健方法中的结合。

结论

主要利益相关者报告了在整个开发过程中应考虑的促进因素、障碍和设计要求。定制远程康复内容是利益相关者的关键价值,以确保该计划能够满足不同类型职业伤害患者的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8673/11584548/01f0fdabbaca/formative_v8i1e51865_fig1.jpg

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