Factors That Influence the Provision of Home-Based Rehabilitation Services for People Needing Rehabilitation: A Qualitative Evidence Synthesis
Cochrane Database of Systematic Reviews
Velez, M., Lugo-Agudelo, L. H., et al. (2023).
Cochrane Database of Systematic Reviews, 2(2), Cd014823.
This systematic review investigates factors that influence the provision of in-home rehabilitation services either in-person or via telepractice.
The Cochrane Collaboration; Universidad de Antioquia (Colombia); Norwegian Ministry of Health and Care Services
From database inception to June 16, 2022
Published and unpublished primary studies using qualitative methods for data collection and analysis
170 studies included but not sampled; 53 sampled studies
<div>The following findings were reported for home-based care and telerehabilitation services for individuals needing rehabilitation:</div>
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<li>High- and moderate-quality evidence indicated that advantages of home-based services included increased convenience, self-management, and empowerment for individuals receiving rehabilitation services.</li>
<li>Telepractice has the opportunity to increase accessibility of rehabilitation services and increase communication and shared decision-making in the patient-provider relationship.</li>
<li>Challenges of home-based rehabilitation included loss of privacy when providers have access to the home.</li>
<li>Challenges for telerehabilitation included usability issues, lack of familiarity with technology, loss of rapport, and feelings of abandonment, with individuals receiving services calling for provision of at least some in-person services and increased training in the use of technology.</li>
<li>When individuals receiving rehabilitation services received equipment, they perceived telepractice as affordable.</li>
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<div>High- and moderate-quality evidence indicated that providers also faced challenges with the provision of telerehabilition such as difficulty assessing patients and their environment as well as interruptions by others in the home. Providers reported the need for adequate equipment, infrastructure, and maintenance, but differed on whether equipment was cost-effective.<br><br>Factors influencing the success of home-based rehabilitation included resources available in the home setting during the transition from hospital to home, support from healthcare providers and care partners, good communication with providers, and the presence of comorbidities. Factors influencing the success of telerehabilitation included personalization of services.</div>
