title: Home tele-rehabilitation for rheumatic patients: impact and satisfaction of care analysis.
abstract: Introduction In this paper, we evaluated patients' perspectives on the use of a system for home tele-rehabilitation, designed for subjects with low computer literacy suffering hand impairment due to rheumatic diseases. Methods After a clinical trial assessing device effectiveness, the Psychosocial Impact of Assistive Devices Scale (PIADS), Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) and Individually Prioritised Problem Assessment (IPPA) questionnaires were administered to evaluate the system's impact on each patient's life, and the results were correlated with clinical indices. Patients were asked to continue self-administered rehabilitation with common objects. One year later, a semi-structured telephone interview gathered data on their experience. Results The system received a positive QUEST score (4.5 ± 0.3) and a modest PIADS score (0.84 ± 0.8) due to the small impact on adaptability and self-esteem. The IPPA (3.7 ± 3.4) revealed improvement in the ability to perform tasks considered important, which was significantly correlated ( r = 0.60; p < 0.02) with the clinical Health Assessment Questionnaire (HAQ) index improvement. The interviews revealed a positive engagement effect, enhanced by the need to develop skills to be able to use the device (technological challenge) and by the perception of more attention by the medical staff. This may explain the significant dropout rate (80%) from the post-trial rehabilitation of the patients who used the device. Discussion The system was largely accepted by the patients. The results suggest that the need for information on their rehabilitation progress and the technological challenge deserves further study to make patients more autonomous in cases of continuous rehabilitation.
authors.affiliation: 1 DIEE - Department of Electrical and Electronic Engineering, University of Cagliari, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Pani
authors.affiliation: 2 Rheumatology Unit, Department of Medical Sciences, University and AOU of Cagliari, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Piga
authors.affiliation: 1 DIEE - Department of Electrical and Electronic Engineering, University of Cagliari, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Barabino
authors.affiliation: 1 DIEE - Department of Electrical and Electronic Engineering, University of Cagliari, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Crabolu
authors.forename: S
authors.initials: S
authors.lastname: Uras
authors.affiliation: 2 Rheumatology Unit, Department of Medical Sciences, University and AOU of Cagliari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mathieu
authors.affiliation: 1 DIEE - Department of Electrical and Electronic Engineering, University of Cagliari, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Raffo
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012216:Rheumatic Diseases / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D000069350:Telerehabilitation / Q000295:instrumentation / Q000379:methods*
keywords: Tele-rehabilitation; follow-up; rheumatic diseases; tele-monitoring; user evaluation