L. Fernandes1, R.F. Oliveira1, F.R. Fagundes1, R.J. Soares2, B. Saragiotto1
1Universidade Cidade de São Paulo, Physiotherapy, São Paulo, Brazil, 2Universidade de Taubaté, Physiotherapy, Taubaté, Brazil
Background: Regulations for the use of telehealth and telerehabilitation were developed worldwide as an emergency response to the significant drop in outpatient consultations and for allowing continuation of care after COVID-19 outbreak. In high income countries, those technologies were already merged to healthcare system functioning and required specific adjustments regarding insurance coverage. In low- and middle- income countries, telehealth and telerehabilitation were not a reality for most professionals and population. Rapid introduction left no time for discussion on implementation outcomes.
Purpose: The aim of this study was to investigate acceptability of telerehabilitation initiatives in COVID-19 pandemic context by Brazilian physical therapists and their preferences and needs in telerehabilitation.
Methods: We conducted an observational cross-sectional study with an online survey. Physical therapists were contacted through social media and professional discussion groups (eg, whatsapp groups). The online survey consisted of 13 multiple choice items, 7 focusing on acceptability domains, and 6 focusing on preferences and needs. It remained available for a period of 1 month, concomitantly to the initial spread of COVID-19 disease in Brazil and the national regulation of telerehabilitation. Descriptive analysis of data was conducted using the SPSS software. A correlational analysis was conducted among years of experience and the items referring to acceptability.
Results: A total of 707 responses were registered. Clinicians’ profile included both sexes (28% males and 72% females) predominantly holding a post-graduation degree. Half of respondents self-reported confident on delivering their services through internet. Same proportion showed disbelief on telerehabilitation effectiveness. Large part of respondents endorsed telerehabilitation should cost less than face-to-face encounters. Brazilian physical therapists agreed telerehabilitation should contain educational, self-management strategies and exercises information. Clinicians have shown preference for synchronous communication with patients, especially by videoconference, and have demonstrated concerns towards the initial assessment being done remotely. There was no correlation between years of experience and acceptability to telerehabilitation.
Conclusion(s): Lack of preparation might interplay a decisive role on clinicians’ acceptability of telerehabilitation. The provision of robust regulations, guidelines and training can support clinicians on the uptake of telerehabilitation.
Implications: Clinicians’ acceptability to telerehabilitation is key to its adequate implementation. Researchers, funders and Policy-makers must understand context and acceptability to improve the sustainable adoption and implementation of effective, generalizable, evidence-based telerehabilitation and telehealth interventions.
Funding, acknowledgements: The present study was funded by the São Paulo Research Foundation (FAPESP/ process number 2020/06314-0).
Keywords: Telerehabilitation, acceptability, implementation research
Topic: Research methodology, knowledge translation & implementation science
Did this work require ethics approval? Yes
Institution: Universidade Cidade de São Paulo
Committee: Ethical Committee of Universidade Cidade de São Paulo
Ethics number: CAAE: 30119120.3.0000.0064
All authors, affiliations and abstracts have been published as submitted.
