Barriers and enablers of COPD telerehabilitation – a frontline staff perspective
Authors Damhus CS, Emme C, Hansen H
Received 7 March 2018
Accepted for publication 2 June 2018
Published 17 August 2018 Volume 2018:13 Pages 2473—2482
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Charles Downs
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Christina Sadolin Damhus,1 Christina Emme,2 Henrik Hansen1
1Research Unit of Chronic Diseases and Telemedicine – Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark; 2Department of Quality and Education, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
Background: Telerehabilitation (TR) aimed at patients with COPD has shown promising effects on symptoms, physical function, and quality of life, but little research has been conducted to understand the impact of implementation on frontline health professionals. Therefore, the aim of this study was to examine the barriers and enablers of health professionals to online exercise-based TR in patients with COPD, to support a successful implementation process.
Methods: Semistructured individual and focus group interviews were conducted with 25 health professionals working with conventional COPD rehabilitation or TR. Interviews were audiotaped and transcribed verbatim. Investigator triangulation was applied during data generation. The Theoretical Domains Framework directed the interview guide and was used as a coding framework in the analysis.
Results: We identified six predominant domains essential in understanding the enablers and barriers of TR from a staff perspective: 1) skills, 2) professional role and identity, 3) beliefs about capabilities, 4) beliefs about consequences, 5) environmental context and resources, and 6) social influences. We found that health professionals held both enablers and barriers important for the implementation process of TR. TR introduces new work tasks and new ways for the health professionals to communicate and exercise with the patients, which influence their professional role and self-perceived capability.
Conclusion: Specific attention toward involvement of the health professionals in the decision process combined with sufficient education and skill training is highly essential to support a successful implementation of TR in clinical practice.
Keywords: telecare, health professionals, theoretical domains framework, qualitative research, implementation process
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