Family Caregivers' Experiences with Tele-Rehabilitation for Older Adults with Hip Fracture

Patrocinio Ariza-Vega, Rafael Prieto-Moreno, Herminia Castillo-Pérez, Virginia Martínez-Ruiz, Dulce Romero-Ayuso, Maureen C Ashe, Patrocinio Ariza-Vega, Rafael Prieto-Moreno, Herminia Castillo-Pérez, Virginia Martínez-Ruiz, Dulce Romero-Ayuso, Maureen C Ashe

Abstract

Background: There is a knowledge gap for implementing tele-rehabilitation (telerehab) after hip fracture. We recently conducted a clinical trial (ClinicalTrials.gov Identifier: NCT02968589) to test a novel online family caregiver-supported rehabilitation program for older adults with hip fracture, called @ctivehip. In this qualitative substudy, our objective was to use semi-structured interviews to explore family caregivers experience with the telerehab program.

Methods: Twenty-one family caregivers were interviewed between three and six months after the older adults completed @ctivehip. One occupational therapist with research and clinical experience, but not involved in the main trial, conducted and transcribed the interviews. We conducted a multi-step content analysis, and two authors completed one coding cycle and two recoding cycles.

Results: Family caregivers who enrolled in @ctivehip were satisfied with the program, stated it was manageable to use, and perceived benefits for older adults' functional recovery after hip fracture. They also suggested improvements for the program content, such as more variety with exercises, and increased monitoring by health professionals.

Conclusions: This work extends existing literature and generates research hypotheses for future studies to test telerehab content and program implementation.

Keywords: family caregiver; hip fracture; information and communication technology; older people; tele-rehabilitation.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Interview guide.
Figure 1
Figure 1
Flowchart for caregivers recruitment.
Figure 2
Figure 2
Caregivers experience with the telerehab program.

References

    1. Dyer S.M., Crotty M., Fairhall N., Magaziner J., Beaupre L.A., Cameron I.D., Sherrington C. A critical review of the long-term disability outcomes following hip fracture. BMC Geriatr. 2016;16:158. doi: 10.1186/s12877-016-0332-0.
    1. Orive M., Aguirre U., García-Gutiérrez S., Las Hayas C., Bilbao A., González N., Zabala J., Navarro G., Quintana J.M. Changes in health-related quality of life and activities of daily living after hip fracture because of a fall in elderly patients: A prospective cohort study. Int. J. Clin. Pract. 2015;69:491–500. doi: 10.1111/ijcp.12527.
    1. Perracini M.R., Kristensen M.T., Cunningham C., Sherrington C. Physiotherapy following fragility fractures. Injury. 2018;49:1413–1417. doi: 10.1016/j.injury.2018.06.026.
    1. Rocha S.A., de Avila M.A.G., Bocchi S.C.M. The influence of informal caregivers on the rehabilitation of the elderly in the postoperative period of proximal femoral fracture. Rev. Gauch. Enferm. 2016;37:e51069.
    1. Ariza-Vega P., Ortiz-Piña M., Kristensen M.T., Castellote-Caballero Y., Jiménez-Moleón J.J. High perceived caregiver burden for relatives of patients following hip fracture surgery. Disabil. Rehabil. 2019;41:311–318. doi: 10.1080/09638288.2017.1390612.
    1. Martín-Martín L.M., Valenza-Demet G., Ariza-Vega P., Valenza C., Castellote-Caballero Y., Jiménez-Moleón J.J. Effectiveness of an occupational therapy intervention in reducing emotional distress in informal caregivers of hip fracture patients: A randomized controlled trial. Clin. Rehabil. 2014;28:772–783. doi: 10.1177/0269215513519343.
    1. Siddiqui M.Q.A., Sim L., Koh J., Fook-Chong S., Tan C., Howe T. Sen Stress levels amongst caregivers of patients with osteoporotic hip fractures - A prospective cohort study. Ann. Acad. Med. Singapore. 2010;39:38–42.
    1. Auais M., French S.D., Beaupre L., Giangregorio L., Magaziner J. Identifying research priorities around psycho-cognitive and social factors for recovery from hip fractures: An international decision-making process. Injury. 2018;49:1466–1472. doi: 10.1016/j.injury.2018.04.017.
    1. McDonough C.M., Harris-Hayes M., Kristensen M.T., Overgaard J.A., Herring T.B., Kenny A.M., Mangione K.K. Physical Therapy Management of Older Adults With Hip Fracture. J. Orthop. Sport. Phys. Ther. 2021;51:CPG1–CPG81. doi: 10.2519/jospt.2021.0301.
    1. Saletti-Cuesta L., Tutton E., Langstaff D., Willett K. Understanding informal carers’ experiences of caring for older people with a hip fracture: A systematic review of qualitative studies. Disabil. Rehabil. 2018;40:740–750. doi: 10.1080/09638288.2016.1262467.
    1. Peretti A., Amenta F., Tayebati S.K., Nittari G., Mahdi S.S. Telerehabilitation: Review of the State-of-the-Art and Areas of Application. JMIR Rehabil. Assist. Technol. 2017;4:e7. doi: 10.2196/rehab.7511.
    1. Wang K.C., Xiao R., Cheung Z.B., Barbera J.P., Forsh D.A. Early mortality after hip fracture surgery in COVID-19 patients: A systematic review and meta-analysis. J. Orthop. 2020;22:584–591. doi: 10.1016/j.jor.2020.11.012.
    1. Bodilsen A.C., Pedersen M.M., Petersen J., Beyer N., Andersen O., Smith L.L., Kehlet H., Bandholm T. Acute hospitalization of the older patient: Changes in muscle strength and functional performance during hospitalization and 30 days after discharge. Am. J. Phys. Med. Rehabil. 2013;92:789–796. doi: 10.1097/PHM.0b013e31828cd2b6.
    1. Petersen W., Karpinski K., Backhaus L., Bierke S., Häner M. A systematic review about telemedicine in orthopedics. Arch. Orthop. Trauma Surg. 2021;141:1731–1739. doi: 10.1007/s00402-021-03788-1.
    1. Wang Q., Lee R.L.T., Hunter S., Chan S.W.C. The effectiveness of internet-based telerehabilitation among patients after total joint arthroplasty: A systematic review and meta-analysis of randomised controlled trials. J. Telemed. Telecare. 2021:1357633X2098029. doi: 10.1177/1357633X20980291.
    1. Pastora-Bernal J.M., Martín-Valero R., Barón-López F.J., Estebanez-Pérez M.J. Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review. J. Med. Internet Res. 2017;19:e142. doi: 10.2196/jmir.6836.
    1. Ashe M.C., Ekegren C.L., Chudyk A.M., Fleig L., Gill T.K., Langford D., Martin-Martin L., Ariza-Vega P. Telerehabilitation for community-dwelling middle-aged and older adults after musculoskeletal trauma: A systematic review. AIMS Med. Sci. 2018;5:316–336. doi: 10.3934/medsci.2018.4.316.
    1. Asif M., Cadel L., Kuluski K., Everall A.C., Guilcher S.J.T. Patient and caregiver experiences on care transitions for adults with a hip fracture: A scoping review. Disabil. Rehabil. 2020;42:3549–3558. doi: 10.1080/09638288.2019.1595181.
    1. Wolff J.L., Freedman V.A., Mulcahy J.F., Kasper J.D. Family Caregivers’ Experiences With Health Care Workers in the Care of Older Adults With Activity Limitations. JAMA Netw. open. 2020;3:e1919866. doi: 10.1001/jamanetworkopen.2019.19866.
    1. Ortiz-Piña M., Molina-Garcia P., Femia P., Ashe M.C., Martín-Martín L., Salazar-Graván S., Salas-Fariña Z., Prieto-Moreno R., Castellote-Caballero Y., Estevez-Lopez F., et al. Effects of Tele-Rehabilitation Compared with Home-Based in-Person Rehabilitation for Older Adult’s Function after Hip Fracture. Int. J. Environ. Res. Public Health. 2021;18:5493. doi: 10.3390/ijerph18105493.
    1. Ortiz-Piña M., Salas-Fariña Z., Mora-Traverso M., Martín-Martín L., Galiano-Castillo N., García-Montes I., Cantarero-Villanueva I., Fernández-Lao C., Arroyo-Morales M., Mesa-Ruíz A., et al. A home-based tele-rehabilitation protocol for patients with hip fracture called @ctivehip. Res. Nurs. Health. 2019;42:29–38. doi: 10.1002/nur.21922.
    1. Ariza-Vega P., Castillo-Pérez H., Ortiz-Piña M., Ziden L., Palomino-Vidal J., Ashe M.C. The Journey of Recovery: Caregivers’ Perspectives From a Hip Fracture Telerehabilitation Clinical Trial. Phys. Ther. 2021;101 doi: 10.1093/ptj/pzaa220.
    1. Thorne S., Kirkham S.R., O’Flynn-Magee K. The Analytic Challenge in Interpretive Description. Int. J. Qual. Methods. 2004;3:1–11. doi: 10.1177/160940690400300101.
    1. Graneheim U.H., Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Educ. Today. 2004;24:105–112. doi: 10.1016/j.nedt.2003.10.001.
    1. Saldaña J. The Coding Manual for Qualitative Researchers. 3rd ed. SAGE Publications Ltd.; London, UK: 2015.
    1. Shenton A.K. Strategies for ensuring trustworthiness in qualitative research projects. Educ. Inf. 2004;22:63–75. doi: 10.3233/EFI-2004-22201.
    1. Denzin N. Sociological Methods: A Sourcebook. Aldine Transaction; Piscataway, NJ, USA: 2006.
    1. Takeda H., Kamogawa J., Sakayama K., Kamada K., Tanaka S., Yamamoto H. Evaluation of clinical prognosis and activities of daily living using functional independence measure in patients with hip fractures. J. Orthop. Sci. Off. J. Japanese Orthop. Assoc. 2006;11:584–591. doi: 10.1007/s00776-006-1073-2.
    1. Giosa J.L., Stolee P., Dupuis S.L., Mock S.E., Santi S.M. An examination of family caregiver experiences during care transitions of older adults. Can. J. Aging. 2014;33:137–153. doi: 10.1017/S0714980814000026.
    1. Liu H.-Y., Yang C.-T., Cheng H.-S., Wu C.-C., Chen C.-Y., Shyu Y.-I.L. Family caregivers’ mental health is associated with postoperative recovery of elderly patients with hip fracture: A sample in Taiwan. J. Psychosom. Res. 2015;78:452–458. doi: 10.1016/j.jpsychores.2015.02.002.
    1. Nelson M., Russell T., Crossley K., Bourke M., McPhail S. Cost-effectiveness of telerehabilitation versus traditional care after total hip replacement: A trial-based economic evaluation. J. Telemed. Telecare. 2021;27:359–366. doi: 10.1177/1357633X19869796.
    1. Holden R.J., Karsh B.T. The technology acceptance model: Its past and its future in health care. J. Biomed. Inform. 2010;43:159–172. doi: 10.1016/j.jbi.2009.07.002.
    1. Nahm E.S., Resnick B., Plummer L., Park B.K. Use of discussion boards in an online hip fracture resource center for caregivers. Orthop. Nurs. 2013;32:89–95. doi: 10.1097/NOR.0b013e318289fa22.
    1. Glenny C., Stolee P., Sheiban L., Jaglal S. Communicating during care transitions for older hip fracture patients: Family caregiver and health care provider’s perspectives. Int. J. Integr. Care. 2013;13 doi: 10.5334/ijic.1076.
    1. Michie S., Richardson M., Johnston M., Abraham C., Francis J., Hardeman W., Eccles M.P., Cane J., Wood C.E. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behavior change interventions. Ann. Behav. Med. 2013;46:81–95. doi: 10.1007/s12160-013-9486-6.
    1. Bedra M., Finkelstein J. Feasibility of post-acute hip fracture telerehabilitation in older adults. Stud. Health Technol. Inform. 2015;210:469–473. doi: 10.3233/978-1-61499-512-8-469.
    1. Yadav L., Gill T.K., Taylor A., De Young J., Chehade M.J. Identifying Opportunities, and Motivation to Enhance Capabilities, Influencing the Development of a Personalized Digital Health Hub Model of Care for Hip Fractures: Mixed Methods Exploratory Study. J. Med. Internet Res. 2021;23:e26886. doi: 10.2196/26886.
    1. Michie S., van Stralen M.M., West R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement. Sci. 2011;6:42. doi: 10.1186/1748-5908-6-42.
    1. Kalron A., Tawil H., Peleg-Shani S., Vatine J.J. Effect of telerehabilitation on mobility in people after hip surgery: A pilot feasibility study. Int. J. Rehabil. Res. 2018;41:244–250. doi: 10.1097/MRR.0000000000000296.
    1. Tappen R.M., Whitehead D., Folden S.L., Hall R. Effect of a Video Intervention on Functional Recovery Following Hip Replacement and Hip Fracture Repair. Rehabil. Nurs. 2003;28:148–153. doi: 10.1002/j.2048-7940.2003.tb02048.x.
    1. Ammenwerth E. Technology Acceptance Models in Health Informatics: TAM and UTAUT. Stud. Health Technol. Inform. 2019;263:64–71. doi: 10.3233/SHTI190111.
    1. Mehta S.J., Hume E., Troxel A.B., Reitz C., Norton L., Lacko H., McDonald C., Freeman J., Marcus N., Volpp K.G., et al. Effect of Remote Monitoring on Discharge to Home, Return to Activity, and Rehospitalization After Hip and Knee Arthroplasty: A Randomized Clinical Trial. JAMA Netw. open. 2020;3:e2028328. doi: 10.1001/jamanetworkopen.2020.28328.
    1. Elliott J., Forbes D., Chesworth B.M., Ceci C., Stolee P. Information sharing with rural family caregivers during care transitions of hip fracture patients. Int. J. Integr. Care. 2014:14. doi: 10.5334/ijic.1195.
    1. Ashe M. Fracture Recovery for Seniors at Home: A Hip Fracture Recovery Guide for Patients & Families. 2015. [(accessed on 8 December 2021)]. Available online: .
    1. Langford D.P., Fleig L., Brown K.C., Cho N.J., Frost M., Ledoyen M., Lehn J., Panagiotopoulos K., Sharpe N., Ashe M.C. Back to the future – Feasibility of recruitment and retention to patient education and telephone follow-up after hip fracture: A pilot randomized controlled trial. Patient Prefer. Adherence. 2015;9:1343–1351. doi: 10.2147/PPA.S86922.

Source: PubMed

3
Abonneren