Determinants of Telerehabilitation Acceptance among Patients Attending Pulmonary Rehabilitation Programs in the United States.

BACKGROUND: Pulmonary rehabilitation (PR) is an interdisciplinary intervention designed to improve the physical status and the psychological condition of people with chronic respiratory diseases. To improve patients' participation in PR programs, telerehabilitation has been introduced. OBJECTIVE: This study aimed to identify factors that could influence the intention to use telerehabilitation among patients attending traditional PR programs. METHODS: This cross-sectional study recruited subjects attending the PR centers in the hospitals of the Indiana State University, United States of America, between January and May 2017. Data were collected using self-administered Tele-Pulmonary Rehabilitation Acceptance Scale (TPRAS). TPRAS had two subscales: perceived usefulness and perceived ease of use. Behavioral intention (BI) was the dependent variable, and all responses were dichotomized into positive and negative intention to use. Multiple logistic regressions were performed to assess the influence of variables on the intention to use telerehabilitation. RESULTS: A total of 134 respondents were included in this study, of which 61.2% indicated positive intention to use telerehabilitation. Perceived usefulness was a significant predictor of the positive intentions to use of telerehabilitation. Duration of respiratory disease was negatively associated with the use of telerehabilitation. CONCLUSION: Perceived usefulness was a significant predictor of using telerehabilitation. The findings of this study may be useful for health-care organizations in improving the adoption of telerehabilitation or in its implementation. Future telerehabilitation acceptance studies could explore the effects of additional factors including computer literacy and culture on the intention to use telerehabilitation.

Client buy-in: An essential consideration for graded motor imagery in hand therapy.

STUDY DESIGN: This is a cross-sectional survey research. INTRODUCTION: Current evidence provides efficacy of graded motor imagery (GMI) in chronic pain conditions but also reveals barriers to its implementation. PURPOSE OF THE STUDY: The purpose of this study was to describe current utilization of GMI in hand therapy practice. METHODS: Survey tool, informed by literature and Revised Neurophysiology of Pain Questionnaire (NPQ) was electronically distributed to members of the American Society of Hand Therapists. RESULTS: 132 therapists completed the survey. 65.2% reported they would always or very likely use GMI in clients with central sensitization, but no relationship between the likelihood of therapists using GMI to score achieved on the NPQ was found. Lack of patient buy-in, was the main barrier cited. "Sell it well" with pain neuroscience education the most cited strategy. DISCUSSION: GMI is frequently used in clients with central sensitization but requires client buy-in. CONCLUSIONS: Understanding and explaining pain mechanism is essential for implementing GMI.

Health Care Practitioners' Determinants of Telerehabilitation Acceptance.

BACKGROUND: Pulmonary rehabilitation is a multidisciplinary patient-tailored intervention that aims to improve the physical and psychological condition of people with chronic respiratory diseases. Providing pulmonary rehabilitation (PR) services to the growing population of patients is challenging due to shortages in health care practitioners and pulmonary rehabilitation programs. Telerehabilitation has the potential to address this shortage in practitioners and PR programs as well as improve patients' participation and adherence. This study's purpose was to identify and evaluate the influences of intention of health care practitioners to use telerehabilitation. METHODS: Data were collected through a self-administered Internet-based survey. RESULTS: Surveys were completed by 222 health care practitioners working in pulmonary rehabilitation with 79% having a positive intention to use telerehabilitation. Specifically, perceived usefulness was a significant individual predictor of positive intentions to use telerehabilitation. CONCLUSION: Perceived usefulness may be an important factor associated with health care providers' intent to use telerehabilitation for pulmonary rehabilitation.

Development and Validation of the Tele-Pulmonary Rehabilitation Acceptance Scale.

BACKGROUND: Using telehealth in pulmonary rehabilitation (telerehabilitation) is a new field of health-care practice. To successfully implement a telerehabilitation program, measures of acceptance of this new type of program need to be assessed among potential users. The purpose of this study was to develop a scale to measure acceptance of using telerehabilitation by health-care practitioners and patients. METHODS: Three objectives were met (a) constructing a modified scale of the technology acceptance model, (b) judging the items for content validity, and (c) judging the scale for face validity. Nine experts agreed to participate and evaluate item relevance to theoretical definitions of domains. To establish face validity, 7 health-care practitioners and 5 patients were interviewed to provide feedback about the scale's clarity and ease of reading. RESULTS: The final items were divided into 2 scales that reflected the health-care practitioner and patient responses. Each scale included 3 subscales: perceived usefulness, perceived ease of use, and behavioral intention. CONCLUSIONS: The 2 scales, each with 3 subscales, exhibited evidence of content validity and face validity. The 17-item telerehabilitation acceptance scale for health-care practitioners and the 13-item telerehabilitation acceptance scale among patients warrant further psychometric testing as valuable measures for pulmonary rehabilitation programs.

Role of Occupational Therapy in Case Management and Care Coordination for Clients With Complex Conditions.

Specific aspects of the profession of occupational therapy support a distinct value for its practitioners participating fully in the development of case management and care coordination systems. The expectation in the 21st century is that the U.S. health care system must be transformed from one that promotes volume of service to one that promotes value of care. Case management and care coordination will be critical components of that transformation. Occupational therapy's principles, education, practice, approach, and perspective offer much to benefit this increased attention to case management and care coordination. Occupational therapy practitioners should promote themselves and their profession as these system changes develop.

Computer workstation analysis: a case study of an occupational therapy intervention.

OBJECTIVE: This study was designed to determine the efficacy of the implementation of computer workstation recommendation by an occupational therapist and the satisfaction of employees with these recommendations. The original worksite analysis was performed to decrease pain symptoms and discomfort of employees whose work is at a computer. METHODS: Semi-structured interviews were conducted in the participants' work environments with a follow-up questionnaire used. All participant responses underwent a cross-case comparison analysis to identify themes. RESULTS: Six of the seven participants reported experiencing a reduction in their musculoskeletal pain symptoms after implementing the ergonomic recommendations made following the computer station worksite analysis by an occupational therapist. The changes led to increased comfort and productivity. CONCLUSIONS: Compliance of the workers following through with the recommendations contributed to the improvement in musculoskeletal pain and discomfort for employees. Using a worksite analysis to provide customized ergonomic recommendations for an individual's computer workstation resulted in decreased upper extremity musculoskeletal pain and increased productivity for these employees.

Musculoskeletal injuries associated with selected university staff and faculty in an office environment.

A research team with backgrounds in occupational therapy, rehabilitation, policy and rulemaking, and prevention programs affecting occupational health and safety designed, validated, and analyzed an ergonomics survey of university staff and faculty. The purpose of the study was to validate identified risk factors from the literature contributing to work-related musculoskeletal disorders (WRMDs) in an office setting within a university setting. The study was also designed to determine differences between faculty and staff in the university setting and their exposure to physical risk factors to WRMDs. The results suggest faculty have their keyboard in awkward positions more frequently than staff, and staff had more experience with mechanical stress than faculty. The researchers recommend parameters for the design of a university ergonomics program based on employee and education, management commitment, medical case management, problem job identification, and development of solutions.

Perception differences between groups of employees identifying the factors that influence a return to work after a work-related musculoskeletal injury.

Employee health and productivity losses as a result of work-related injury are estimated to be US dollars 1.2 trillion annually to US companies. This is approximately 14.3% of the gross domestic product [6,8,11,35]. Workers' compensation, medical care, and short and long-term disability are a part of these costs. Controlling or eliminating these costs is a problem for US employers [3,6,14,21,29]. The study discussed in this article examined the perceptions of manufacturing employees in identifying factors that influence a return to work after a work-related musculoskeletal injury. The classification of employees who participated in this study were safety professionals, supervisors and workers from the manufacturing industry in central Kentucky. The worker group consisted of material handlers, assembly line workers and quality control inspectors. The participants completed a developed survey instrument, the Return to Work Perception Survey. This survey instrument examined the perception of the participants on factors related to return to work: company policies and procedures, job satisfaction, worker relationships and work environment. The results indicated safety professionals and supervisors perceptions differ from workers on the variables of job satisfaction, worker relationships and work environment. Their perceptions did not differ on the variable relating to company policies and procedures. In addition, the safety professional and supervisor groups rated the items addressing job satisfaction higher than did the worker group. The worker group did not differ from one another on any of the factors. Implications of this study for manufacturing companies suggest (a). identifying those issues contributing to employee job satisfaction, (b). developing a plan for achieving increased job satisfaction and employee recognition at the workplace among all workers, and (c). consider allowing employees to develop new capacities and new learning, thus fostering motivation and job satisfaction [18,20].

Occupational-psychosocial perceptions influencing return to work and functional performance of injured workers.

Much has been done to identify psychosocial factors influencing risk of vocational injury and prolonged disability. The purpose of this paper is to enhance the ability of injured workers to return to their prior worker role through the identification of the influencing psychosocial perceptions. Psychosocial perceptions may assist in the identification of negative or counterproductive factors that hinder the rehabilitative process. Identifying perceptions are individual centered and focused on the views of injured workers as they proceed through the transition in life following injury. Occupational therapists play a key role in the rehabilitative process of injured workers through enhancing the person-job-environment fit [4].