This study aimed to understand physiotherapists and occupational therapists’ preferences of digital rehabilitation device attributes, including how preferences differ across cultures and what other factors influence clinician preferences.
Choice experiments (best-worst scaling) are a common methodology used in health research to determine stakeholder preferences. Rehabilitation physiotherapists and occupational therapists were recruited across Australia and Brazil. Participants completed a survey including 10 best-worst questions, which asked them to select the ‘most important’ and ‘least important’ attribute from subsets of 31 device attributes. Results were analysed using multinomial models by country and latent class. Attribute preference scores (PS) were scaled to 0-100 (least to most important).
A total of 122 Brazilian clinicians and 104 Australian clinicians completed the survey. Most respondents were physiotherapists (83%), and approximately half worked with neurological populations (50%) within the private or self-employed sector (51%). Most respondents had experience using rehabilitation devices (87%), perceived rehabilitation devices to be useful (average Likert scale 7.9/10, SD 1.6) and reported a moderate level of confidence with using devices (average Likert scale 6.9/10, SD 2.2). Clinicians unanimously prioritised attributes: patient outcomes (PS 100.0), patient engagement (PS 93.9), usability (PS 81.3), research evidence (PS 80.4) and risk (PS 75.7). There was evidence of preference heterogeneity across countries and work sectors. In Australia and public/not-for-profit settings, clinicians favoured device attributes which facilitate increasing therapy dosage (PS 67.1–79.2) and patient independent practice (PS 66.4–66.8). Meanwhile, in Brazil and private/self-employed/other settings, clinicians prioritised attributes which reflect using devices as informative tools in therapy: clinical data (PS 53.3–67.6), feedback (PS 57.7–76.3) and clinical assessment (PS 50.1–65.6).
Rehabilitation physiotherapists and occupational therapists prioritise patient-related and practical device attributes above technical attributes. Contextual factors influenced clinician preferences rather than individual clinician characteristics (e.g., age or role in rehabilitation). To facilitate clinician buy-in and device adoption, future research should establish the effectiveness of digital devices for improving patient outcomes and provide practical guidance for device implementation within rehabilitation settings.
When designing and implementing devices in rehabilitation, culturally and socioeconomically diverse stakeholders should be consulted to account for variations across cultures and settings. Findings from this study, including a list of 31 device attributes ranked from most to least important, are useful to inform device selection and implementation in clinical practice, as well as future device design and research.
Technology
Cross-cultural comparison
