JMIR Publications

ABSTRACT

Background:

Implementation of cardiac rehabilitation has not been optimal, with patient participation rates below 50%. Among the factors that contribute to cardiac patients’ lack of participation in rehabilitation activities programs are patients’ motivation, logistical difficulties in getting to the rehabilitation facilities, lack of psychosocial elements and individualization of activities in the rehabilitation programs. Telerehabilitation has been proposed as a new way to addressing the challenge of engaging and motivating cardiac patients and their partners to participate in rehabilitation.

Objective:

The aim of this study is to explore how cardiac patients and their partners experienced participating in the Teledialog Telerehabilitation Program. The telerehabilitation program consisted of a digital rehabilitation plan including transmission of health data and an interactive web portal with training videos.

Methods:

The case study was the overall method. The theoretical approach combined ‘community of practice’ and Self-determination theory. A triangulation of data collection techniques was used, including documents, participant observation (72 hours) and qualitative interviews with cardiac patients and their partners enrolled in the telerehabilitation group. A total of 14 cardiac patients, 12 partners and one son participated in the study. The participants were interviewed at enrollment into the telerehabilitation program and after 12 weeks of participation in the program. Data were analyzed using NVivo 11.0.

Results:

Patients and their partners found the web portal ActiveHeart.dk and the e-rehabilitation plan to be helpful tools for education, coordinating rehabilitation goals, creating an overview of the data and ensuring continuity in the rehabilitation process. The patients felt that the TTP gave them a feeling of being treated as individuals, a sense of autonomy, enhanced relatedness to healthcare professionals and partners, and a sense of competence as active participants in their own rehabilitation process. Some patients missed being part of a community of practice with other cardiac patients. Patients’ partners found that the telerehabilitation program gave them a sense of security, and helped them balance their involvement as equal partner with the patient and not pushing their partner too fast forward.

Conclusions:

Cardiac patients and their partners experienced telerehabilitation technologies as useful tools for education, coordinating their rehabilitation goals and creating an overview of data in the rehabilitation process. The patients felt that the telerehabilitation gave them a feeling of individualization, autonomy and relatedness to healthcare professionals and partners. Participating in the telerehabilitation program motivated the patients to integrate rehabilitation activities into their work schedule and everyday life. Telerehabilitation might not be a suitable strategy for all cardiac patients. Being a patient’s partner in a telerehabilitation program was associated with a heightened sense of security about the process, and navigating between involvement in the process, being an equal partner and not pushing the patient too fast forward. Clinical Trial: ClinicalTrials.gov NCT01752192; http://clinicaltrials.gov/ct2/show/NCT01752192 (Archived by WebCite at http://www.webcitation.org/6yR3tdEpb)