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Maximizing telerehabilitation for patients with visual loss after stroke : interview and focus group study with stroke survivors, carers, and Occupational Therapists.

Dunne, Stephen and Close, Helen and Richards, Nicola and Ellison, Amanda and Lane, Alison R. (2020) 'Maximizing telerehabilitation for patients with visual loss after stroke : interview and focus group study with stroke survivors, carers, and Occupational Therapists.', Journal of medical Internet research., 22 (10). e19604.

Abstract

Background: Visual field defects are a common consequence of stroke, and entraining compensatory eye-movement strategies has been identified as the most promising rehabilitation option. There has been a move towards compensatory telerehabilitation options such as the Durham Reading and Exploration (DREX) training app which significantly improves visual exploration, reading, and self-reported quality of life. Objective: This study details an iterative process of liaising with stroke survivors, carers, and healthcare professionals to identify barriers and facilitators to using such tools, alongside elements of good practice in telerehebalitation, with a focus on how the DREX package can be maximised. Methods: Survey data from 75 stroke survivors informed 12 semi-structured engagement activities (seven focus groups and five interviews) with 32 stroke survivors, 10 carers, and 24 occupational therapists. Results: Thematic analysis identified key themes within the data. Themes identified problems associated with post-stroke healthcare from both patient and occupational therapists’ perspective that need to be addressed to improve uptake of this rehabilitation tool and telerehabilitation options generally. This included identifying what additional materials or assistance were required to boost the impact of training packages generally. The acute rehabilitation setting was an identified barrier, with perceptions of technology considered to be a barrier by some but a facilitator by others. In addition to which four key features of telerehabilitation were identified: additional materials, the importance of goal-setting, repetition, and feedback. Conclusions: The data was utilised to try and overcome some barriers to the DREX training and are further discussed in terms of considerations for e-therapies more generally moving forward.

Item Type:Article
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Status:Peer-reviewed
Publisher Web site:https://doi.org/10.2196/19604
Publisher statement:© Stephen Dunne, Helen Close, Nicola Richards, Amanda Ellison, Alison R Lane. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.10.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
Date accepted:29 July 2020
Date deposited:23 October 2020
Date of first online publication:23 October 2020
Date first made open access:23 October 2020

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