N.A. Ricci1, T.D. Castro1, K.I. Molina2
1Universidade Cidade de São Paulo, Master's and Doctoral Programs in Physical Therapy, São Paulo, Brazil, 2Universidade Cidade de São Paulo, Undergraduate Course in Physical Therapy, São Paulo, Brazil
Background: The COVID pandemic imposed restrictions to face-to-face physiotherapy for older adults. In this scenario of social distance and quarantine, telerehabilitation emerged to provide the necessary care for them. Therefore, it is important to understand the motivations and to explore the experience of older adults in changing face-to-face sessions, to which they were familiar, to a new method, the telerehabilitation. With this knowledge, the physiotherapists can better offer telerehabilitation for this population.
Purpose: To describe the perception of older adults regarding the experience of changing the face-to-face home care sessions to telerehabilitation during the pandemic.
Methods: This is a qualitative descriptive phenomenological study. Purposive sampling was used to identify patients (older adults ≥ 60 years) that changed the home care physiotherapy to synchronous telerehabilitation because of the pandemic. Regularity was required in both type of methods (at least once a week for a minimum of one month). Semi-structured individual interviews were conducted via Blackboard CollaborateTM web conference, lasting approximately one hour. The audiovisual recordings were transcribed with the support of the research diary, and content analysis was conducted with MAXQDA 12®.
Results: The saturation was reached with eight patients, all of them female with 77.3±9.2 years old (min-max: 67-92 yrs) and high-level of education. Excepted from one patient that lives with her husband, all others lived alone. The main reason for doing physiotherapy was musculoskeletal pain (n= 4). Most patients use WhatsApp for telerehabilitation (n= 6) and do not need assistance for synchronous sessions (n= 5). Throughout the patients’ reports, it was clear the influence of the previous experience with face-to-face sessions on making telerehabilitation possible and effective. The patients’ interviews revealed three main themes. In the first theme “transitioning from home care to telerehabilitation” patients reported the paths between the time they had to stop face-to-face sessions (because of the imposed quarantine) throughout the acceptation of doing telerehabilitation. The reasons to accept telerehabilitation were the worsening on functional condition, and laziness or afraid to do exercises by themselves without orientation. In the second theme “the telerehabilitation sessions” the patients described mixed feelings regarding the use of technology; some were used to laptops/ mobile phones giving them confidence to telerehabilitation, while others were fearful to use technology and the support of the therapist was important to encourage them. The third theme was “comparison between methods” which showed more similarities, like sessions having the same purpose and perceived benefits; than dissimilarities, like not possible to use analgesic equipment and manual therapy. Although the telerehabilitation interaction was seeing as helpful in this difficult situation (pandemic), patients reported that they miss the social aspect of the home care visits.
Conclusion(s): The past experience with face-to-face physiotherapy was essential for the success of telerehabilitation. Patients views of telerehabilitation were positive, specially related to outcomes. However, the social interaction promoted by the home care sessions was considered an essential part of the treatment process.
Implications: Physiotherapists should outline telerehabilitation considering the barriers and facilitators pointed out by patients. This can ensure better adherence and motivation with the treatment process.
Funding, acknowledgements: This work was unfunded.
Keywords: telerehabilitation, home care, older adults
Topic: Older people
Did this work require ethics approval? Yes
Institution: Universidade Cidade de São Paulo
Committee: Research Ethics Committee UNICID
Ethics number: CAAE: 33255220.7.0000.0064 n. 4.103.879
All authors, affiliations and abstracts have been published as submitted.
