Abstract
BackgroundOccupational therapists working in hospitals are usually involved in discharge planning to assess patients’ safety and autonomy upon returning home. However, their assessment is usually done at the hospital due to organizational and financial constraints. The lack of visual data about the patients’ home may thus reduce the appropriateness and applicability of the support recommended upon discharge. Although various technological tools such as mobile devices (mobile health) are promising methods for home-based distance assessment, their application in hospital settings may raise several feasibility issues. To our knowledge, their usefulness and added value compared to standard procedure have not been addressed yet in previous studies. Moreover, several feasibility issues need to be explored.ObjectiveThis paper aims to (1) document the clinical feasibility of using an electronic tablet to assess the patient's home environment by mobile videoconferencing and (2) explore the added value of using mobile videoconferencing, compared to the standard procedure.MethodsA feasibility and comparative study using a mixed-methods (convergent) design is currently undergoing. Six occupational therapists will assess the home environment of their patients in the hospital setting: they will first perform a semistructured interview (a) and then use mobile videoconferencing (b) to compare “a versus a+b.” Interviews with occupational therapists and patients and their caregivers will further explore the advantages and disadvantages of mobile videoconferencing. Two valid tools are used (the Canadian Measure of Occupational Performance and the telehealth responsivity questionnaire). Direct and indirect time is also collected.ResultsThe project was funded in the spring of 2016 and authorized by the ethics committee in February 2017. Enrollment started in April 2017. Five triads (n=4 occupational therapists, n=5 clients, n=5 caregivers) have been recruited until now. The experiment is expected to be completed by April 2019 and analysis of the results by June 2019.ConclusionsMobile videoconferencing may be a familiar and easy solution for visualizing environmental barriers in the home by caregivers and clinicians, thus providing a promising and inexpensive option to promote a safe return home upon hospital discharge, but clinical feasibility and obstacles to the use of mobile videoconferencing must be understood.International Registered Report Identifier (IRRID)DERR1-10.2196/11674
Highlights
Occupational therapists working in hospitals are usually involved in discharge planning by making recommendations—such as environmental adaptations, assistive technologies, home care services—in order to promote a safe return home
Qualitative and quantitative data are collected at the same time. These data are merge in the analysis and interpretation of the results [18].The occupational therapist assesses the patient’s home environment from an acute care setting prior to being discharged (a) first by conducting an interview and (b) by using mobile videoconferencing, with the aim to compare a versus a+b
The analysis highlights how respondents' perceptions differ from one to another and how the problems identified and the recommendations made based on the interview (a) are different from those made with the combination with mobile videoconferencing (a+b)
Summary
Occupational therapists working in hospitals are usually involved in discharge planning by making recommendations—such as environmental adaptations, assistive technologies, home care services—in order to promote a safe return home. To ensure the applicability and appropriateness of these recommendations, they must consider the functional capabilities of their patients, and the environmental conditions in which they will evolve once they return home It is often essential for occupational therapists to know the number of stairs to access the home, the kitchen layout and hygiene, the availability of support surfaces in their bathroom, the distance to be covered to get to the toilet, and the thresholds around the house. Various technological tools such as mobile devices (mobile health) are promising methods for home-based distance assessment, their application in hospital settings may raise several feasibility issues To our knowledge, their usefulness and added value compared to standard procedure have not been addressed yet in previous studies.
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