ABSTRACT
BACKGROUND: Cardiovascular disease is the leading cause of all deaths worldwide. Cardiac rehabilitation is an effective approach for preventing secondary complications, but it remains a complex intervention because of the need for lifestyle changes. One solution is to employ interactive telerehabilitation or eHealth web portals. However, these have not been implemented as intended by developers. The aim of this study was to evaluate the design and usability of a cardiac telerehabilitation web portal, called the 'HeartPortal', for use among heart failure (HF) patients. METHODS: The HeartPortal was designed using participatory design (PD). The design process involved HF patients, their relatives, healthcare professionals (HCP), healthcare company specialists and researchers. Self-determination theory (SDT) was used to enable the design to elicit intrinsic motivation within the patients. With eHealth literacy skills in mind, the goal of the HeartPortal was to successfully target the end-users. The PD process and data collection techniques included cultural probes, workshops, participant-observation, questionnaires, and problem-solving tasks. RESULTS: The PD process helped us design an interactive web portal, the HeartPortal. Based on participants' feedback, the design incorporated features such as being able to make notes and to communicate with HCP, view data from self-tracking devices in a graphic form, and to obtain information on rehabilitation in the form of text, audio, and video. More than half of those testing the HeartPortal found that it was easy to navigate, and most of the users stated that it had an excellent structure and that using it could possibly improve their condition. CONCLUSIONS: Overall, the HeartPortal was found to be logical and easy to navigate and will now be tested in a clinical trial within the Future Patient Telerehabilitation Program.
ABSTRACT
Telerehabilitation (TR) has gained attention as a promising rehabilitation format. Our study examined how patients responded to TR and whether it provided adequate support for their lifestyle changes and self-care efforts when compared to conventional rehabilitation (CR). Cardiac patients (n = 136) were randomly assigned to a TR or CR group. The TR group was provided with relevant health care technology for a period of three months, and both groups filled in questionnaires on their motivation for lifestyle changes and self-care psychological distress, and quality of life at 0, 3, 6, and 12 months. Patients in both groups were found to be equally motivated for lifestyle changes and self-care (p < 0.05) and they experienced similar levels of psychological distress and quality of life. TR is comparable to conventional rehabilitation in motivating patients, preventing psychological distress and improving quality of life. Although we observed an initial increase in autonomous motivation in the telerehabilitation group, this positive difference in motivation does not last over time. As such, neither rehabilitation format seems able to ensure long-term motivation. Therefore, TR may serve as a viable replacement for conventional rehabilitation when considered relevant. Further research is needed to enhance long-term motivation, and maybe telerehabilitation can help to achieve this.
Subject(s)
Heart Diseases/rehabilitation , Motivation , Telerehabilitation , Female , Humans , Male , Middle Aged , Quality of Life , Self Care , Stress, Psychological , Surveys and Questionnaires , Time FactorsABSTRACT
OBJECTIVE: The aims of this study are two-fold: 1) To explore how cardiac patients experience their use of a telerehabilitation tool for recuperation from surgery, and 2) To study how the patients' use of the interactive 'Active Heart' web portal affected their eHealth literacy skills. METHODS: The 'Active Heart' telerehabilitation web portal offers patients and their relatives information and exercises for recovery from cardiac surgery. 109 cardiac patients were using the Active Heart web portal for a duration of three months. RESULTS: 49 patients completed questionnaires that were administered both before and after their use of the portal, resulting in a 45% response rate. Respondents had a mean age of 60.64⯱â¯10.75 years, and 82% of the respondents were males. The respondents had a positive impression of Active Heart, reporting that it was easy to access, user-friendly, and written in an understandable language. The patients' eHealth literacy skills increased during the trial period. CONCLUSION: Use of a cardiac telerehabilitation web portal can be beneficial for patient education and can increase cardiac patients' eHealth literacy skills. PRACTICE IMPLICATIONS: Online telerehabilitation portals may be used as a tool in patient education and cardiac rehabilitation.
