title: Older adults' experiences of internet-based vestibular rehabilitation for dizziness: A longitudinal study.
abstract: OBJECTIVE
  Factors influencing engagement with self-managed rehabilitation are not well understood, but evidence suggests they may change over time. Despite increasing digitalisation of self-managed interventions, little is known about the role of internet-based interventions in patients' experiences of self-directed rehabilitation. This longitudinal qualitative study investigated individuals' ongoing experiences of internet-guided, self-managed rehabilitation within the context of rehabilitation for dizziness.
  
  
  METHODS
  Eighteen adults aged fifty and over who experienced dizziness used the 'Balance Retraining' internet intervention for six weeks. Participants took part in semi-structured telephone interviews at two-week intervals to explore their experiences. Data were inductively thematically analysed.
  
  
  RESULTS
  The internet intervention was reported to facilitate engagement with rehabilitation exercises, providing motivation to continue through symptom reduction and simple but helpful strategies. It was perceived as informative, reassuring, visually pleasing and easy to use. Barriers to engagement included practicalities, symptoms and doubts about exercise efficacy. Participants' perceptions did not always remain consistent over time.
  
  
  CONCLUSIONS
  The internet intervention may be a feasible method of supporting self-managed vestibular rehabilitation. More generally, longitudinal findings suggest that appearance-related perceptions of online interventions may be especially important for initial engagement. Furthermore, intervention features targeting self-efficacy seem important in overcoming barriers to engagement.
authors.affiliation: a Centre for Clinical and Community Applications of Health Psychology , University of Southampton, Highfield Campus , Southampton , UK.
authors.forename: Rosie
authors.initials: R
authors.lastname: Essery
authors.affiliation: a Centre for Clinical and Community Applications of Health Psychology , University of Southampton, Highfield Campus , Southampton , UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kirby
authors.affiliation: b Primary Care and Population Sciences , University of Southampton, Aldermoor Health Centre , Southampton , UK.
authors.forename: Adam W A
authors.initials: AWA
authors.lastname: Geraghty
authors.affiliation: a Centre for Clinical and Community Applications of Health Psychology , University of Southampton, Highfield Campus , Southampton , UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Yardley
mesh_terms: D000368:Aged; D004244:Dizziness / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020407:Internet; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D017060:Patient Satisfaction; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology; D013813:Therapy, Computer-Assisted
keywords: dizziness; older adults; online intervention; rehabilitation; self-management