Factors that influence the provision of home-based rehabilitation services for people needing rehabilitation: a qualitative evidence synthesis
Articolo
Data di Pubblicazione:
2023
Citazione:
Factors that influence the provision of home-based rehabilitation services for people needing rehabilitation: a qualitative evidence synthesis / M. Velez, L.H. Lugo-Agudelo, D.F. Patiño Lugo, C. Glenton, A.M. Posada, L.F. Mesa Franco, S. Negrini, C. Kiekens, M.A. Spir Brunal, A.B. Roberg, K.M. Cruz Sarmiento. - In: COCHRANE DATABASE OF SYSTEMATIC REVIEWS. - ISSN 1469-493X. - 2023:2(2023 Feb 10), pp. 1-210. [10.1002/14651858.CD014823]
Abstract:
Background To increase people's access to rehabilitation services, particularly in the context of the COVID-19 pandemic, we need to explore how the delivery of these services can be adapted. This includes the use of home-based rehabilitation and telerehabilitation. Home-based rehabilitation services may become frequently used options in the recovery process of patients, not only as a solution to accessibility barriers, but as a complement to the usual in-person inpatient rehabilitation provision. Telerehabilitation is also becoming more viable as the usability and availability of communication technologies improve. Objectives To identify factors that influence the organisation and delivery of in-person home-based rehabilitation and home-based telerehabilitation for people needing rehabilitation. Search methods We searched PubMed, Global Health, the VHL Regional Portal, Epistemonikos, Health Systems Evidence, and EBM Reviews as well as preprints, regional repositories, and rehabilitation organisations websites for eligible studies, from database inception to search date in June 2022. Selection criteria We included studies that used qualitative methods for data collection and analysis; and that explored patients, caregivers, healthcare providers and other stakeholders' experiences, perceptions and behaviours about the provision of in-person home-based rehabilitation and home-based telerehabilitation services responding to patients' needs in diGerent phases of their health conditions.Data collection and analysis We used a purposive sampling approach and applied maximum variation sampling in a four-step sampling frame. We conducted a framework thematic analysis using the CFIR (Consolidated Framework for Implementation Research) framework as our starting point. We assessed our confidence in the findings using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. Main results We included 223 studies in the review and sampled 53 of these for our analysis. Forty-five studies were conducted in high-income countries, and eight in low-and middle-income countries. Twenty studies addressed in-person home-based rehabilitation, 28 studies addressed home-based telerehabilitation services, and five studies addressed both modes of delivery. The studies mainly explored the perspectives of healthcare providers, patients with a range of diGerent health conditions, and their informal caregivers and family members. Based on our GRADE-CERQual assessments, we had high confidence in eight of the findings, and moderate confidence in five, indicating that it is highly likely or likely respectively that these findings are a reasonable representation of the phenomenon of interest. There were two findings with low confidence. High and moderate confidence findings Home-based rehabilitation services delivered in-person or through telerehabilitation Patients experience home-based services as convenient and less disruptive of their everyday activities. Patients and providers also suggest that these services can encourage patients' self-management and can make them feel empowered about the rehabilitation process. But patients, family members, and providers describe privacy and confidentiality issues when services are provided at home. These include the increased privacy of being able to exercise at home but also the loss of privacy when one's home life is visible to others. Patients and providers also describe other factors that can aGect the success of home-based rehabilitation services.These include support from providers and family members, good communication with providers, the requirements made of patients and their surroundings, and the transition from hospital to home-based services. Telerehabilitation specifically Pati
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
M. Velez, L.H. Lugo-Agudelo, D.F. Patiño Lugo, C. Glenton, A.M. Posada, L.F. Mesa Franco, S. Negrini, C. Kiekens, M.A. Spir Brunal, A.B. Roberg, K.M. Cruz Sarmiento
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