Telerehabilitation in the context of community stroke service provision; exploring the lived experiences of rehabilitation professionals in the UK

Abstract

Introduction: Research into technologies to deliver rehabilitation remotely (Telerehabilitation) is needed to develop guideline recommendations to support implementation. Rehabilitation professionals’ perspectives are key to inform the design and integration of telerehabilitation in routine care. This study explored clinicians' experiences of telerehabilitation in the context of community stroke service provision.

Method: Purposive sampling was used to recruit healthcare professionals involved in community stroke services in England, Wales and Scotland. We interviewed 57 multidisciplinary team (MDT) professionals and 4 stroke network leads. Using a realist approach, qualitative analysis explored contextual factors and processes driving implementation.

Results or details of the case: A variety of technologies and telerehabilitation models were used in routine care. Telerehabilitation was regarded as an important strategy to increase therapy provision in an efficient way. Perceived ease of use, safety and relative advantage were key factors influencing adoption. Conditions for sustained use included organisational readiness, availability of technical and administrative support and presence of digital champions. A coordinated MDT approach helped to ensure continuity and personalised care, especially where discipline-specific interventions were used. Respondents’ perceptions of their own digital health competence varied; therapists called for guidance and examples of successful implementation to support clinical decision making.

Conclusion: The study highlighted technological, attitudinal and organisational factors influencing the use of telerehabilitation, from the perspective of rehabilitation professionals. Investing in digital infrastructure and staff training, may promote therapists’ confidence in the value of telerehabilitation and their own ability to provide it safely and where appropriate.