DISCUSSION
confidence interval,
www.medicaljournals.se/jrm
ns
ns
(1.48–7.11)
(0.39–1.82)
(1.24–6.36)
(1.42–6.99)
(0.79–5.52)
ns
0.8
0.8
have sufficient knowledge to use eRehabilitation”)
was negatively associated with willingness to use
eRehabilitation (OR 0.36 and 95% CI 0.17–0.74).
B. Brouns et al.
670
This cross-sectional study among patients, informal
caregivers and healthcare professionals has shown
that barriers/facilitators influencing willingness to
use eRehabilitation are largely similar for patients
and caregivers, but are different for healthcare pro-
fessionals. Whereas its use by patients/caregivers
is more associated with the opportunity to improve
their health via eRehabilitation, its use by healthcare
professionals is more associated with its feasibility.
In addition, willingness to use eRehabilitation by
patients, informal caregivers and healthcare profes-
sionals was positively associated with its expected
benefits for stroke patients (e.g. reduced travel time,
increased motivation, better health outcomes, in-
creased therapy adherence, etc.). Patients’ willing-
ness to use eRehabilitation was negatively associated
with a lack of knowledge regarding its use.
For all end-users, the 5 most important factors
found in this study have shown that a “positive in-
fluence on patient recovery” is the most important
facilitator for willingness to use eRehabilitation. This
might sound obvious, but, in fact, many potential
barriers/facilitators for all kinds of healthcare inno-
vations are quite obvious. The logistical regression
analyses has revealed that other factors that might
seem obvious, such as sufficient time for education
and proper financial arrangements, are not associated
with willingness to use eRehabilitation and should
therefore have lower priority in an implementation
strategy. In any case, “positive influence on patient
recovery” stands out for all stakeholders, so there
is an urgent need for more evidence regarding this
positive influence. This is one of the most important
challenges in eRehabilitation. Although the potential
advantages of eRehabilitation seem clear, the lack of
currently available evidence hampers its implemen-
tation in stroke rehabilitation, therefore more high-
quality research determining the effectiveness of
eRehabilitation interventions is urgently required (6).
In contrast to the above-mentioned similarity, this
study has also identified differences between end-
users regarding certain factors that are important
for willingness to use eRehabilitation. Patients/
caregivers were more willing to use eRehabilita-
tion because of its benefits (in this study merged
in the factor Motivation to change). Many of these
benefits were found important in previous studies,
viz. the possibility to train at home (29), indepen-