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      Barriers and enablers of COPD telerehabilitation – a frontline staff perspective

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          Abstract

          Background

          Telerehabilitation (TR) aimed at patients with COPD has shown promising effects on symptoms, physical function, and quality of life, but little research has been conducted to understand the impact of implementation on frontline health professionals. Therefore, the aim of this study was to examine the barriers and enablers of health professionals to online exercise-based TR in patients with COPD, to support a successful implementation process.

          Methods

          Semistructured individual and focus group interviews were conducted with 25 health professionals working with conventional COPD rehabilitation or TR. Interviews were audio-taped and transcribed verbatim. Investigator triangulation was applied during data generation. The Theoretical Domains Framework directed the interview guide and was used as a coding framework in the analysis.

          Results

          We identified six predominant domains essential in understanding the enablers and barriers of TR from a staff perspective: 1) skills, 2) professional role and identity, 3) beliefs about capabilities, 4) beliefs about consequences, 5) environmental context and resources, and 6) social influences. We found that health professionals held both enablers and barriers important for the implementation process of TR. TR introduces new work tasks and new ways for the health professionals to communicate and exercise with the patients, which influence their professional role and self-perceived capability.

          Conclusion

          Specific attention toward involvement of the health professionals in the decision process combined with sufficient education and skill training is highly essential to support a successful implementation of TR in clinical practice.

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          Most cited references 30

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          Widespread application of pulmonary rehabilitation (also known as respiratory rehabilitation) in chronic obstructive pulmonary disease (COPD) should be preceded by demonstrable improvements in function (health-related quality of life, functional and maximal exercise capacity) attributable to the programmes. This review updates the review reported in 2006.
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            In the literature on focus groups, far more attention has been devoted to how groups are organized and conducted than to issues of analysis. Although exploitation of group dynamics is touted as a virtue of focus groups, there is very little guidance in the literature with respect to how differences between group and individual discourse impact the analysis and interpretation of focus group data. In this article, the authors describe analytical challenges inherent in the interpretation of focus group data and suggest approaches for enhancing the rigor of analysis and the reliability and validity of focus group findings.
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              Factors affecting front line staff acceptance of telehealth technologies: a mixed-method systematic review.

              To synthesize qualitative and quantitative evidence of front-line staff acceptance of the use of telehealth technologies for the management of Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                1176-9106
                1178-2005
                2018
                17 August 2018
                : 13
                : 2473-2482
                Affiliations
                [1 ]Research Unit of Chronic Diseases and Telemedicine – Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark,
                [2 ]Department of Quality and Education, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
                Author notes
                Correspondence: Henrik Hansen, Research Unit of Chronic Diseases and Telemedicine – Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark, Tel +45 2 894 6780, Email
                Article
                copd-13-2473
                10.2147/COPD.S167501
                6103610
                © 2018 Damhus et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Original Research

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