Differences in factors influencing the use of eRehabilitation after stroke; a cross-sectional comparison between Brazilian and Dutch healthcare professionals

Thea P M Vliet Vlieland,Berber Brouns,Lucia W Braga,Lígia M N Souza,Ingrid L C Gil,Arend J De Kloet,Jorit J L Meesters,Leti Van Bodegom-Vos

doi:10.1186/s12913-020-05339-7

Abstract

BackgroundTo improve the use of eRehabilitation after stroke, the identification of barriers and facilitators influencing this use in different healthcare contexts around the world is needed. Therefore, this study aims to investigate differences and similarities in factors influencing the use of eRehabilitation after stroke among Brazilian Healthcare Professionals (BHP) and Dutch Healthcare Professionals (DHP).MethodA cross-sectional survey study including 88 statements about factors related to the use of eRehabilitation (4-point Likert scale; 1–4; unimportant-important/disagree-agree). The survey was conducted among BHP and DHP (physical therapists, rehabilitating physicians and psychologists). Descriptive statistics were used to analyse differences and similarities in factors influencing the use of eRehabilitation.Resultsninety-nine (response rate 30%) BHP and 105 (response rate 37%) DHP participated. Differences were found in the top-10 most influencing statements between BHP and DHP BHP rated the following factors as most important: sufficient support from the organisation (e.g. the rehabilitation centre) concerning resources and time, and potential benefits of the use of eRehabilitation for the patient. DHP rated the feasibility of the use of eRehabilitation for the patient (e.g. a helpdesk and good instructions) as most important for effective uptake. Top-10 least important statements were mostly similar; both BHP and DHP rated problems caused by stroke (e.g. aphasia or cognitive problems) or problems with resources (e.g. hardware and software) as least important for the uptake of eRehabilitation.ConclusionThe results indicate that the use of eRehabilitation after stroke by BHP and DHP is influenced by different factors. A tailored implementation strategy for both countries needs to be developed.

Highlights

To improve the use of eRehabilitation after stroke, the identification of barriers and facilitators influencing this use in different healthcare contexts around the world is needed
The results indicate that the use of eRehabilitation after stroke by Brazilian Healthcare Professionals (BHP) and Dutch Healthcare Professionals (DHP) is influenced by different factors
In the top-10 most influencing factors, four statements were found for both BHP and of DHP, and twelve statements were found in the top-10 of only one group

Summary

Introduction

To improve the use of eRehabilitation after stroke, the identification of barriers and facilitators influencing this use in different healthcare contexts around the world is needed. The rapid growth of digital health technology [1] provides efficient strategies for delivering rehabilitation while maintaining or improving effectiveness [2]. It may offer a solution for the increasing need for care, especially in stroke rehabilitation, where incidence, survival rates and healthcare costs are growing [3]. ERehabilitation can be seen as an alternative way of providing all aspects of rehabilitation therapy, including intervention, maintenance activities, consultation, education, and training to clients at a remote location [4], and can included telerehabilitation (e.g. the provision of rehabilitation services to patients at a remote location using ICT), tablet-based therapy, and the use of commercially available devices like the Nintendo Wii [2, 4, 5, 8,9,10,11].

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