Listening to the patients: using participatory design in the development of a cardiac telerehabilitation web portal

Katrine Joensson, Camilla Melholt, John Hansen, Soeren Leth, Helle Spindler, Mathias Vassard Olsen, Birthe Dinesen

Abstract

Background: Cardiovascular disease is the leading cause of all deaths worldwide. Cardiac rehabilitation is an effective approach for preventing secondary complications, but it remains a complex intervention because of the need for lifestyle changes. One solution is to employ interactive telerehabilitation or eHealth web portals. However, these have not been implemented as intended by developers. The aim of this study was to evaluate the design and usability of a cardiac telerehabilitation web portal, called the ‘HeartPortal’, for use among heart failure (HF) patients.

Methods: The HeartPortal was designed using participatory design (PD). The design process involved HF patients, their relatives, healthcare professionals (HCP), healthcare company specialists and researchers. Self-determination theory (SDT) was used to enable the design to elicit intrinsic motivation within the patients. With eHealth literacy skills in mind, the goal of the HeartPortal was to successfully target the end-users. The PD process and data collection techniques included cultural probes, workshops, participant-observation, questionnaires, and problem-solving tasks.

Results: The PD process helped us design an interactive web portal, the HeartPortal. Based on participants’ feedback, the design incorporated features such as being able to make notes and to communicate with HCP, view data from self-tracking devices in a graphic form, and to obtain information on rehabilitation in the form of text, audio, and video. More than half of those testing the HeartPortal found that it was easy to navigate, and most of the users stated that it had an excellent structure and that using it could possibly improve their condition.

Conclusions: Overall, the HeartPortal was found to be logical and easy to navigate and will now be tested in a clinical trial within the Future Patient Telerehabilitation Program.

The full article is available here.

Video communication as a tool for psychosocial support for people recovering from severe mental disorder: social workers’ experiences

Claus Ugilt Oestergaard, Birthe Dinesen

Abstract

Background: This paper focuses on a Danish social tele-rehabilitation project, which uses video technologies to support mentally ill citizens in their recovery process in their homes. The aim of the study is to explore how social workers experience using video communication as part of a tele-social-rehabilitation program aimed at citizens discharged from a psychiatric hospital and lives in their own home with mental disorders recovering from a mental illness.

Methods: The research strategy in this study is the case study method. Data collection techniques for the case study were based on triangulation of several data sources, such as analysis of relevant documents, participant observation and qualitative interviews with clients and with social workers assisting citizens in their recovery process.

Results: The social workers stated that video technology gave them the opportunity to make changes in their working practices with the citizens. They also felt they were better able to meet the citizens’ need to improve their everyday lives. The social workers found that video technology was less intrusive than a physical visit to the citizen’s home. The technology helps to promote the client’s recovery process.

Conclusions: The social workers who used video technology in a tele-social-rehabilitation program experienced a community of practice, changes in their work routine and changes in the way they carried out social rehabilitation for clients in their recovery following discharge from mental hospital.

The full article is available here.

Vi har lige fået publiceret artikel om forskningsprotokol til projektet “Future Patient-telerehabilitering af hjertesvigtpatienter” i Journal of Medical Internet Research (JMIR) – se link:
www.researchprotocols.org/2019/9/e14517/

Developing a telerehabilitation programme for postoperative recovery from knee surgery:

Specifications and requirements

The development of the sensor-based telerehabilitation programme was carried out based on user needs. The programme includes a portable platform for the patient as well as a web-based platform for the healthcare professional, thus allowing for an individualised rehabilitation programme. Communication, training, reporting, and information services were provided for the patients. Moreover, the portability and usability of the programme were enhanced by utilising the system in offline mode as well. Application The programme is currently being tested in the North Denmark Region to assess the feasibility and acceptance of a telerehabilitation programme as an alternative solution to the self-training programme for patients who have been discharged from knee surgery. The preliminary results of our assessment showed a high level of acceptance among the users. Discussion In this study, a semi-online

Have a look at this link.

Ny artikel med resultater fra forskningsprojektet Teledialog er netop publiseret – se her.

Integration of Rehabilitation Activities Into Everyday Life Through Telerehabilitation: Qualitative Study of Cardiac Patients and Their Partners

By Dinesen et. al.

Abstract

Background: Implementation of cardiac rehabilitation has not been optimal, with patient participation rates below 50%. Factors that contribute to cardiac patients’ lack of participation in rehabilitation programs are patient motivation, logistical difficulties in getting to the rehabilitation facilities, lack of psychosocial elements, and individualization of activities in the rehabilitation programs. Telerehabilitation has been proposed as a new way to address the challenge of engaging and motivating cardiac patients and their partners to participate in rehabilitation.
Objective: The aim of this study was to explore the experiences of cardiac patients and their partners of participating in the Teledialog Telerehabilitation Program (TTP). The Teledialog program consisted of a digital rehabilitation plan, transmission of health data from patient’s home to hospital and health care center, and an interactive Web portal with information and training videos.

Methods: This case study used a theoretical approach combining the “community of practice” approach and self-determination theory. A triangulation of data collection techniques was used, including documents, participant observation (72 hours), and qualitative interviews with cardiac patients and their partners enrolled in the telerehabilitation group. A total of 14 cardiac patients, 12 patient spouses/partners, and 1 son participated in the study. The participants were interviewed at enrollment in the telerehabilitation program and after 12 weeks of participation in the program. Interview data were analyzed using NVivo 11.0.

Results: Patients and their partners found the Web portal ActiveHeart.dk and the electronic rehabilitation (e-rehabilitation) plan to be helpful tools for health education, coordinating rehabilitation goals, creating an overview of the data, and ensuring continuity in the rehabilitation process. The patients felt that the TTP treated them as individuals, gave them a sense of autonomy, and provided enhanced relatedness to health care professionals and partners and a sense of competence as active participants in their own rehabilitation process. Some patients missed being part of a community of practice with other cardiac patients and did not use the Web forum. Patients’ partners found that the telerehabilitation program gave them a sense of security and helped them balance their involvement as a partner to the patient and not push the patient too hard.

Conclusions: Cardiac patients and their partners found telerehabilitation technologies a useful digital toolbox in the rehabilitation process. Telerehabilitation motivated the patients to integrate rehabilitation activities into their work schedule and everyday life and made them feel like unique individuals. Participating in the Teledialog Telerehabilitation Program might not be a suitable strategy for all cardiac patients. Being a patient’s partner in the telerehabilitation program was associated with a heightened sense of security, navigation between active involvement in the rehabilitation process, being an equal partner, and not pushing the patient too hard.