Factors Affecting the Delivery and Acceptability of the ROWTATE Telehealth Vocational Rehabilitation Intervention for Traumatic Injury Survivors: A Mixed-Methods Study

Kettlewell, Jade; Lindley, Rebecca; Radford, Kate; Patel, Priya; Bridger, Kay; Kellezi, Blerina; Timmons, Stephen; Andrews, Isabel; Fallon, Stephen; Lannin, Natasha; Holmes, Jain; Kendrick, Denise

Abstract

Background: Returning to work after traumatic injury can be problematic. We developed a vocational telerehabilitation (VR) intervention for trauma survivors, delivered by trained occupational therapists (OTs) and clinical psychologists (CPs), and explored factors affecting delivery and acceptability in a feasibility study. Methods: Surveys pre-(5 OTs, 2 CPs) and post-training (3 OTs, 1 CP); interviews pre-(5 OTs, 2 CPs) and post-intervention (4 trauma survivors, 4 OTs, 2 CPs). Mean survey scores for 14 theoretical domains identified telerehabilitation barriers (score ≤ 3.5) and facilitators (score ≥ 5). Interviews were transcribed and thematically analysed. Results: Surveys: pre-training, the only barrier was therapists’ intentions to use telerehabilitation (mean = 3.40 ± 0.23), post-training, 13/14 domains were facilitators. Interviews: barriers/facilitators included environmental context/resources (e.g., technology, patient engagement, privacy/disruptions, travel and access); beliefs about capabilities (e.g., building rapport, complex assessments, knowledge/confidence, third-party feedback and communication style); optimism (e.g., impossible assessments, novel working methods, perceived importance and patient/therapist reluctance) and social/professional role/identity (e.g., therapeutic methods). Training and experience of intervention delivery addressed some barriers and increased facilitators. The intervention was acceptable to trauma survivors and therapists. Conclusion: Despite training and experience in intervention delivery, some barriers remained. Providing some face-to-face delivery where necessary may address certain barriers, but strategies are required to address other barriers.

• Journal Article Type: Article
• Acceptance Date: Sep 14, 2021
• Online Publication Date: Sep 16, 2021
• Publication Date: Sep 1, 2021
• Deposit Date: Sep 14, 2021
• Publicly Available Date: Sep 22, 2021
• Journal: International Journal of Environmental Research and Public Health
• Print ISSN: 1661-7827
• Electronic ISSN: 1660-4601
• Publisher: MDPI AG
• Peer Reviewed: Peer Reviewed
• Volume: 18
• Issue: 18
• Article Number: 9744
• DOI: https://doi.org/10.3390/ijerph18189744
• Keywords: Health, Toxicology and Mutagenesis; Public Health, Environmental and Occupational Health
• Public URL: https://nottingham-repository.worktribe.com/output/6239275
• Publisher URL: https://www.mdpi.com/1660-4601/18/18/9744
• Additional Information: Authors on behalf of the ROWTATE Team