Factors associated with willingness to use eRehabilitation
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Table IIa. Five highest scoring statements (based on median and mean) for willingness to use eRehabilitation (range 1–4) among
stroke patients, informal caregivers and professionals, as medians (interquartile range)
Statement
I would use eRehabilitation, if… Factor Patients
(n = 125) Informal caregivers Healthcare
(n = 43)
professionals (n = 102)
it has a positive influence on recovery
it offers an easy way to contact a professional again after discharge
it offers a way to independently continue treatment after discharge
exercises for cognitive functioning are available
decisions that were made during a consultation are documented for patients
it contains no flashes
logging in is easy
a helpdesk is available for patients
video instructions on how to use eRehabilitation are available for patients
the patient can read information about stroke Motivation to change
Motivation to change
Motivation to change
Attractiveness
Advantage of use
Attractiveness
Accessibility
Feasibility
Feasibility
Attractiveness 4 (4–4)
4 (3–4)
4 (3–4)
4 (3–4)
4 (3–4)
ns
ns
ns
ns
ns 4 (4–4)
4 (4–4)
4 (4–4)
ns
ns
4 (4–4)
4 (4–4)
ns
ns
ns
4 (4–4)
ns
ns
ns
ns
ns
4 (4–4)
4 (4–4)
4 (4–4)
4 (4–4)
ns: not shown, not in top-5 highest-scoring statments.
Table IIb. Five highest scoring statements (based on median and mean) for willingness to use eRehabilitation (range 1–4) after stroke,
for each individual discipline, as medians (interquartile range)
Statement
I would use eRehabilitation, if… Factor Physicians Physiotherapists
(n = 47)
(n = 41) Psychologists (n = 14)
a helpdesk is available for patients
it has a positive influence on recovery of the patient
the patient can read information about stroke
video instructions on how to use e–rehabilitation are available for patients
module about how to deal with stroke (psycho-education) is available
ICT-problems are solved directly
logging in is easy
physical exercises are available
decisions that were made during a consultation are documented for patients
the patient wants to use eRehabilitation
content of eRehabilitaion can be tailored to the patients’ situation Feasibility
Motivation to change
Attractiveness
Feasibility
Attractiveness
Organization of care
Accessibility
Attractiveness
Advantage of use
Motivation to change
Feasibility 4 (4–4)
4 (4–4)
4 (4–4)
4 (4–4)
4 (4–4)
ns
ns
ns
ns
ns
ns 4 (4–4)
4 (4–4)
ns
ns
ns
ns
4 (4–4)
ns
ns
4 (4–4)
4 (4–4)
4 (4–4)
ns
ns
ns
ns
4 (4–4)
4 (4–4)
4 (4–4)
4 (4–4)
ns
ns
ns: not shown, not in top-5 highest-scoring statments.
agenda, online survey, etc.) and Motivation to change,
at the level of individual patients (i.e. benefits of using
eRehabilitation for patients, such as reduced travel time
and increased motivation). Healthcare professionals
mostly endorsed statements belonging to the factor
Feasibility (such as support from a helpdesk, video-
instructions or frequently asked questions (FAQs)).
A ranking for all statements based on the median and
mean is shown in Appendix I.
When calculated for each discipline separately, only
the facilitator “A helpdesk is available for patients”
in the factor Feasibility was found in the top 5 for all
disciplines (see Table IIb). The top 5 for physicians
mostly involved statements belonging to the factor At-
tractiveness (such as the content of an eRehabilitation
programme), while that for psychologists consisted
mostly of statements belonging to the factor Motivation
to change at the level of individual patients (such as
benefits of using of eRehabilitation). Physiotherapists
endorsed statements in 5 different factors (Organiza-
tion of care, Accessibility, Attractiveness, Advantage
of use, and Feasibility).
Association between influencing factors and
willingness to use eRehabilitation
A confirmatory factor analysis (step 1) showed that
the mean Cronbach’s alpha of statements merged into
factors was 0.82 (range 0.6–0.9), with 1 factor loading
below 0.7.
In step 2 (univariate regression analyses), a statisti-
cally significant association was found for all end-users
between willingness to use eRehabilitation and the fac-
tors Feasibility, Organization of care and Motivation to
change (at the level of the individual patient, see Table
III). For the patients, the factors Accessibility, Attracti-
veness, Advantages of use, Time and Knowledge were
also significantly associated with willingness to use
eRehabilitation; for informal caregivers, an association
was found for the factors Accessibility and Advantages
of use; for the healthcare professionals, an association
was found for the factors Time and Motivation not to
Change (at the level of the individual professional). In
addition to the factors in the model by Grol (25), we
tested the responder characteristics of age, discipline
and previous use of eRehabilitation, and these were
found not to be significantly associated with willing-
ness to use eRehabilitation (see Table III).
Step 3 (the multivariate logistic regression analysis)
showed that the factor Motivation to change at the le-
vel of the individual patient was positively associated
with willingness to use eRehabilitation by patients
(OR 2.68; 95% CI 1.34–5.33), informal caregivers
(OR 8.98, 95% CI 1.70–47.33) and healthcare profes-
sionals (OR 4.08, 95% CI 1.36–12.23). For patients,
the factor Knowledge (including the statement “I don’t
J Rehabil Med 51, 2019