Harniess Phillip, Basu Anna Purna, Gibbs Deanna, Bezemer Jeff
Institute of Education, Faculty of Education and Society, University College London, London, UK.
Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Health Expect. 2025 Apr;28(2):e70215. doi: 10.1111/hex.70215.
This study explores the 'peripandemic' implementation of synchronous videoconference calls during COVID-19 for delivering physiotherapy early intervention services to families of infants with childhood-onset disability. The interactional experience of conducting early intervention through videoconference calls is under researched. We aimed to understand parents' and therapists' experiences of communication and learning within early intervention sessions for infants with cerebral palsy conducted via video conference calls.
Data were collected through interviews, video case studies and focus groups involving 15 parents and 16 therapists. We used qualitative analytical methods inspired by grounded theory and multimodality.
Undertaking early intervention sessions via synchronous videoconference calls creates complexities and disrupts communication norms between parent, therapist and infant. These audio-visual constraints have implications for developing shared understanding and learning. Resolving these challenges necessitated increased interactive work within the parent-therapist partnership. The onus placed on parents to have additional logistical roles in some circumstances created strain, which diverted attention from optimal learning.
The post-pandemic healthcare landscape pushes for digital innovation challenging traditional therapy models. Our contribution outlines that while videoconference calls may improve efficiency, they also add cognitive load and interaction challenges, which require modification to routine in-person session designs. We provide recommendations for adaptive implementation strategies for videoconference calls that will benefit from further iterative codesign cycles.
We partnered with parents through public and patient involvement. Parents (n = 9) who were previous NHS early intervention service users formed the Parent Advisory Group (PAG). These parent partners came from a variety of backgrounds and provided their unique perspectives to directly contribute and guide decision-making throughout the project. Their contribution influenced approach to recruitment and consent; the participant information and consent form development; topic guide development; considerations of the use of video in the project design and sense checking of analytical interpretations.
本研究探讨了在新冠肺炎疫情期间，通过同步视频会议进行“疫情期间及之后”的早期干预服务，为患有儿童期残疾的婴儿家庭提供物理治疗。通过视频会议进行早期干预的互动体验研究较少。我们旨在了解家长和治疗师在通过视频会议为脑瘫婴儿进行早期干预过程中的沟通和学习体验。
通过访谈、视频案例研究和焦点小组收集数据，涉及15名家长和16名治疗师。我们采用了受扎根理论和多模态启发的定性分析方法。
通过同步视频会议进行早期干预会产生复杂性，并扰乱家长、治疗师和婴儿之间的沟通规范。这些视听限制对达成共同理解和学习有影响。解决这些挑战需要家长-治疗师伙伴关系中增加互动工作。在某些情况下，家长承担额外后勤角色的责任造成了压力，从而分散了对最佳学习的注意力。
疫情后的医疗环境推动数字创新，挑战传统治疗模式。我们的研究表明，虽然视频会议可能提高效率，但也增加了认知负担和互动挑战，这需要对常规面对面治疗环节的设计进行调整。我们为视频会议的适应性实施策略提供了建议，这些策略将受益于进一步的迭代式协同设计周期。
我们通过公众和患者参与与家长建立了合作关系。曾使用过英国国家医疗服务体系早期干预服务的9名家长组成了家长咨询小组（PAG）。这些家长伙伴来自不同背景，提供了独特的观点，直接为整个项目做出贡献并指导决策。他们的贡献影响了招募和同意方式；参与者信息和同意书的制定；主题指南的制定；项目设计中视频使用的考虑以及分析解读的合理性检查。
