Accepted for/Published in: JMIR Formative Research
Date Submitted: Feb 14, 2022
Date Accepted: May 16, 2022
Patient and health professional perspectives on participations in a feasibility study on exercise-based cardiac telerehabilitation after transcatheter aortic valve implantation: A qualitative study.
ABSTRACT
Background:
Aortic valve stenosis affects almost half of people at 85 years of age and older, and the recommended surgical treatment for older patients is transcatheter aortic valve implantation (TAVI). Despite strong evidence for its advantages, a low attendance rate in cardiac rehabilitation is seen among patients after TAVI. Cardiac telerehabilitation (CTR) has proven comparable with center-based rehabilitation; still, no study has investigated CTR targeting patients after TAVI. Based on participatory design, an exercise-based CTR program (TeleTAVI) was developed that included one online session with a cardiac nurse, a tablet containing an informative website, an activity tracker, and supervised home-based exercise sessions that follow the national recommendations for cardiac rehabilitation.
Objective:
This study aimed to explore patients’ and health professionals’ experiences using health technologies and being part of the exercise-based CTR program TeleTAVI.
Methods:
This study is a part of a feasibility study and will only report patients’ and health professionals‘ experiences of being a part of TeleTAVI. Eleven qualitative interviews were conducted with a semi-structured interview guide (seven patients and four health professionals). Patient interviews were conducted after eight weeks of participation in TeleTAVI, and interviews with health professionals were conducted after the end of the program. The analysis was carried out as inductive content analysis to create a condensed meaning presented as themes.
Results:
Reticence toward using the website was evident with reduced curiosity to explore it, and reduced benefit from using the activity tracker was seen, as the patients’ technical competencies were challenged. This was also found when using the tablet for online training sessions leading to the patients feeling worried before the training, as they anticipated technical problems. Disadvantages of the TeleTAVI program were technical problems and the inability to use hands-on guidance with the patients. Still, both physiotherapists and patients reported a feeling of improvement in patients’ physical fitness. The home training created a feeling of safety, supported adherence, and made individualization possible, which the patients valued. A good relationship and continuity in the contact with the health professionals seemed very important for the patients and affected their positive attitude toward the program.
Conclusions:
The home-based nature of the TeleTAVI program seems to hold the opportunity to support individualization, autonomy, independence, and adherence to physical training, in addition to improvement in physical capability in older patients. Despite technological challenges, basing the relationship between the health professional and patients on continuity may be beneficial for patients. Prehabilitation may also be considered, as it may create familiarity toward technology and adherence of the training. Clinical Trial: Local Trial Registration no: 2020-054
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.