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Acceptance of Telerehabilitation Among Physiotherapists in Turkey and Factors Affecting Acceptance: A Cross-Sectional Analysis

Year 2024, Volume: 9 Issue: 2, 221 - 243, 29.07.2024
https://doi.org/10.31201/ijhmt.1492798

Abstract

Aim: This study aimed to assess the factors influencing the acceptance of telerehabilitation among physiotherapists in Istanbul.
Methods: A cross-sectional study was conducted among 170 PTs (F/M: 94/76, mean age:29.4 years) working in Istanbul. Data were collected through a questionnaire regarding scales of ‘‘Unified Theory of Acceptance and Use of Technology’’ (UTAUT) and ‘‘Perception of Innovation’’ (PoI). UTAUT has 5 components which are ‘‘Performance Expectancy’’ (PE), ‘‘Effort Expectancy’’ (EE), ‘‘Social Influence’’ (SI), ‘‘Facilitating Conditions’’ (FC), ‘‘Behavioral Intention’’ (BI). The model was modified by adding ‘‘Telerehabilitation Usage Behavior’’ (TUB) and ‘‘PoI’’ to these structures. After preliminary analyses, structural equation modelling was employed to assess relationships between key constructs and variables within the proposed model.
Results: The modified UTAUT model demonstrated a good fit for understanding the acceptance of telerehabilitation among physiotherapists, as indicated by favorable goodness-of-fit indices (SRMR = 0.03, GFI = 0.99, AGFI = 0.92, CFI = 0.97, and RMSEA = 0.00). This model accounted for 68% of the variance in ‘‘BI’’ to use telerehabilitation and 28% of the variance in ‘‘TUB’’. The results revealed that ‘‘BI” directly influenced ‘‘TUB’’ (β = 0.53) and ‘‘SI’’ directly affected ‘‘BI’’ (β = 4.96). Additionally, the relationship between ‘‘SI’’ and ‘‘BI’’ was found to vary with age (β =-5.81, p <0.05) when examining moderator variables.
Conclusion: This study emphasized the need to bridge the intention-behavior gap and consider context-specific factors to develop strategies for integrating telerehabilitation into clinical practice.

References

  • Albahrouh, S. I., & Buabbas, A. J. (2021). Physiotherapists’ perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC medical informatics and decision making, 21, 1-12.
  • Alonazi, A. (2021). Effectiveness and acceptability of telerehabilitation in physical therapy during COVID-19 in children: findings of a systematic review. Children, 8(12), 1101.
  • AlQudah, A. A., Al-Emran, M., & Shaalan, K. (2021). Technology acceptance in healthcare: a systematic review. Applied Sciences, 11(22), 10537.
  • Alrushud, A., Alamam, D., Alharthi, A., Shaheen, A., Alotaibi, N., AlSabhan, R., Alharbi, S., Ali, N., Mohammed, E., & Sweeh, J. (2022). Physical therapists' perceptions of and satisfaction with delivering telerehabilitation sessions to patients with knee osteoarthritis during the Covid‐19 pandemic: Preliminary study. Musculoskeletal Care, 20(4), 926-936.
  • Avkiran, N. K. (2018). An in-depth discussion and illustration of partial least squares structural equation modeling in health care. Health care management science, 21, 401-408.
  • Barry Walsh, C., Cahalan, R., Hinman, R. S., & O’Sullivan, K. (2024). Exploring attitudes of people with chronic health conditions towards the use of group-based telerehabilitation: A qualitative study. Clinical Rehabilitation, 38(1), 130-142.
  • Başer Seçer, M., & Çeliker Tosun, Ö. (2022). Examination of telerehabilitation knowledge, awareness, and opinions of physical therapy and rehabilitation students. Medical Science Educator, 32(6), 1355-1365.
  • Bezuidenhout, L., Joseph, C., Thurston, C., Rhoda, A., English, C., & Conradsson, D. M. (2022). Telerehabilitation during the COVID-19 pandemic in Sweden: a survey of use and perceptions among physiotherapists treating people with neurological diseases or older adults. BMC health services research, 22(1), 555.
  • Brand, D., Nienaber McKay, A. G., & Cengiz, N. (2023). What constitutes adequate legal protection for the collection, use and sharing of mobility and location data in health care in South Africa?. South African Journal of Science, 119(5-6), 1-7.
  • Buabbas, A. J., Albahrouh, S. E., Alrowayeh, H. N., & Alshawaf, H. (2022). Telerehabilitation during the COVID-19 pandemic: patients and physical Therapists’ experiences. Medical Principles and Practice, 31(2), 156-164.
  • Cottrell, M. A., Hill, A. J., O'Leary, S. P., Raymer, M. E., & Russell, T. G. (2017). Service provider perceptions of telerehabilitation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: a qualitative study. Musculoskeletal Science and Practice, 32, 7-16.
  • Cranen, K., Drossaert, C. H., Brinkman, E. S., Braakman‐Jansen, A. L., IJzerman, M. J., & Vollenbroek‐Hutten, M. M. (2012). An exploration of chronic pain patients’ perceptions of home telerehabilitation services. Health expectations, 15(4), 339-350.
  • D'Souza, A. F., & Rebello, S. R. (2021). Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. International journal of telerehabilitation, 13(2).
  • Ding, L., Velicer, W. F., & Harlow, L. L. (1995). Effects of estimation methods, number of indicators per factor, and improper solutions on structural equation modeling fit indices. Structural Equation Modeling: A Multidisciplinary Journal, 2(2), 119-143.
  • Duyck, P., Pynoo, B., Devolder, P., Voet, T., Adang, L., Ovaere, D., & Vercruysse, J. (2010). Monitoring the PACS implementation process in a large university hospital--discrepancies between radiologists and physicians. J Digit Imaging, 23(1), 73-80. https://doi.org/10.1007/s10278-008-9163-7
  • Godin, G., Bélanger-Gravel, A., Eccles, M., & Grimshaw, J. (2008). Healthcare professionals' intentions and behaviours: a systematic review of studies based on social cognitive theories. Implementation science, 3, 1-12.
  • Godin, G., & Kok, G. (1996). The theory of planned behavior: a review of its applications to health-related behaviors. American journal of health promotion, 11(2), 87-98.
  • Karaçelik, B. T., Beyhan, T. E., Aksu, P. K., Kitapçı, N. Ş., Kitapçı, O. C., Köksal, L., Yay, M., İşçi, E., Çatar, R. Ö., & Mumcu, G. THE INNOVATION PERSPECTIVE OF EMPLOYEES IN A PRIVATE HOSPITAL. International Journal of Health Management and Tourism, 6(3), 579-593.
  • Liu, L., Miguel Cruz, A., Rios Rincon, A., Buttar, V., Ranson, Q., & Goertzen, D. (2015). What factors determine therapists’ acceptance of new technologies for rehabilitation – a study using the Unified Theory of Acceptance and Use of Technology (UTAUT). Disability and Rehabilitation, 37(5), 447-455. https://doi.org/10.3109/09638288.2014.923529
  • Lu, J., Yao, J. E., & Yu, C.-S. (2005). Personal innovativeness, social influences and adoption of wireless Internet services via mobile technology. The Journal of Strategic Information Systems, 14(3), 245-268. https://doi.org/https://doi.org/10.1016/j.jsis.2005.07.003
  • Mącznik, A. K., Ribeiro, D. C., & Baxter, G. D. (2015). Online technology use in physiotherapy teaching and learning: a systematic review of effectiveness and users’ perceptions. BMC medical education, 15, 1-12.
  • McCue, M., Fairman, A., & Pramuka, M. (2010). Enhancing quality of life through telerehabilitation. Physical Medicine and Rehabilitation Clinics, 21(1), 195-205.
  • Moro-Visconti, R., & Moro-Visconti, R. (2021). E-Health and Telemedicine Startup Valuation. Startup Valuation: From Strategic Business Planning to Digital Networking, 341-361.
  • Morri, M., Ruisi, R., Culcasi, A., & Peccerillo, V. (2024). The Effectiveness of Telerehabilitation for Functional Recovery After Orthopedic Surgery: A Systematic Review and Meta-Analysis. Telemedicine Reports, 5(1), 78-88.
  • Niknejad, N., Ismail, W., Bahari, M., & Nazari, B. (2021). Understanding telerehabilitation technology to evaluate stakeholders’ adoption of telerehabilitation services: a systematic literature review and directions for further research. Archives of Physical Medicine and Rehabilitation, 102(7), 1390-1403.
  • Rahimi, B., Nadri, H., Afshar, H. L., & Timpka, T. (2018). A systematic review of the technology acceptance model in health informatics. Applied clinical informatics, 9(03), 604-634.
  • Riley, W. T., Rivera, D. E., Atienza, A. A., Nilsen, W., Allison, S. M., & Mermelstein, R. (2011). Health behavior models in the age of mobile interventions: are our theories up to the task?. Translational behavioral medicine, 1(1), 53-71.
  • Saaei, F., & Klappa, S. G. (2021). Rethinking telerehabilitation: attitudes of physical therapists and patients. Journal of patient experience, 8, 23743735211034335.
  • Schaper, L. K., & Pervan, G. P. (2007). ICT and OTs: A model of information and communication technology acceptance and utilisation by occupational therapists. International Journal of Medical Informatics, 76, S212-S221.
  • Seron, P., Oliveros, M.-J., Gutierrez-Arias, R., Fuentes-Aspe, R., Torres-Castro, R. C., Merino-Osorio, C., Nahuelhual, P., Inostroza, J., Jalil, Y., & Solano, R. (2021). Effectiveness of telerehabilitation in physical therapy: a rapid overview. Physical therapy, 101(6), pzab053.
  • Smith, T. D., & McMillan, B. F. (2001). A Primer of Model Fit Indices in Structural Equation Modeling.
  • Sood, S., Mbarika, V., Jugoo, S., Dookhy, R., Doarn, C. R., Prakash, N., & Merrell, R. C. (2007). What is telemedicine? A collection of 104 peer-reviewed perspectives and theoretical underpinnings. Telemedicine and e-Health, 13(5), 573-590.
  • Stephenson, A., Howes, S., Murphy, P. J., Deutsch, J. E., Stokes, M., Pedlow, K., & McDonough, S. M. (2022). Factors influencing the delivery of telerehabilitation for stroke: A systematic review. PLoS One, 17(5), e0265828.
  • Suso-Martí, L., La Touche, R., Herranz-Gómez, A., Angulo-Díaz-Parreño, S., Paris-Alemany, A., & Cuenca-Martínez, F. (2021). Effectiveness of telerehabilitation in physical therapist practice: an umbrella and mapping review with meta–meta-analysis. Physical therapy, 101(5), pzab075.
  • The jamovi project (2024). jamovi (Version 2.5) [Computer Software]. Retrieved from https://www.jamovi.org
  • Theodoros, D., Russell, T., & Latifi, R. (2008). Telerehabilitation: current perspectives. Studies in health technology and informatics, 131(1), 191-210.
  • Tousignant, M., Boissy, P., Moffet, H., Corriveau, H., Cabana, F., Marquis, F., & Simard, J. (2011). Patients' satisfaction of healthcare services and perception with in-home telerehabilitation and therapists' satisfaction toward technology for post-knee arthroplasty: an embedded study in a randomized trial. Telemedicine and e-Health, 17(5), 376-382.
  • Turner, M., Kitchenham, B., Brereton, P., Charters, S., & Budgen, D. (2010). Does the technology acceptance model predict actual use? A systematic literature review. Information and software technology, 52(5), 463-479.
  • Tyagi, S., Lim, D. S., Ho, W. H., Koh, Y. Q., Cai, V., Koh, G. C., & Legido-Quigley, H. (2018). Acceptance of tele-rehabilitation by stroke patients: perceived barriers and facilitators. Archives of Physical Medicine and Rehabilitation, 99(12), 2472-2477. e2472.
  • Vellata, C., Belli, S., Balsamo, F., Giordano, A., Colombo, R., & Maggioni, G. (2021). Effectiveness of telerehabilitation on motor impairments, non-motor symptoms and compliance in patients with Parkinson's disease: a systematic review. Frontiers in neurology, 12, 627999.
  • Venkatesh, V., & Davis, F. D. (2000). A theoretical extension of the technology acceptance model: Four longitudinal field studies. Management science, 46(2), 186-204.
  • Venkatesh, V., Morris, M. G., Davis, G. B., & Davis, F. D. (2003). User acceptance of information technology: Toward a unified view. MIS Quarterly, 425-478.
  • Whitten, P., Holtz, B., & Nguyen, L. (2010). Keys to a successful and sustainable telemedicine program. International journal of technology assessment in health care, 26(2), 211-216.
  • Williams, M. D., Rana, N. P., & Dwivedi, Y. K. (2015). The unified theory of acceptance and use of technology (UTAUT): a literature review. Journal of enterprise information management, 28(3), 443-488.
Year 2024, Volume: 9 Issue: 2, 221 - 243, 29.07.2024
https://doi.org/10.31201/ijhmt.1492798

Abstract

References

  • Albahrouh, S. I., & Buabbas, A. J. (2021). Physiotherapists’ perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic. BMC medical informatics and decision making, 21, 1-12.
  • Alonazi, A. (2021). Effectiveness and acceptability of telerehabilitation in physical therapy during COVID-19 in children: findings of a systematic review. Children, 8(12), 1101.
  • AlQudah, A. A., Al-Emran, M., & Shaalan, K. (2021). Technology acceptance in healthcare: a systematic review. Applied Sciences, 11(22), 10537.
  • Alrushud, A., Alamam, D., Alharthi, A., Shaheen, A., Alotaibi, N., AlSabhan, R., Alharbi, S., Ali, N., Mohammed, E., & Sweeh, J. (2022). Physical therapists' perceptions of and satisfaction with delivering telerehabilitation sessions to patients with knee osteoarthritis during the Covid‐19 pandemic: Preliminary study. Musculoskeletal Care, 20(4), 926-936.
  • Avkiran, N. K. (2018). An in-depth discussion and illustration of partial least squares structural equation modeling in health care. Health care management science, 21, 401-408.
  • Barry Walsh, C., Cahalan, R., Hinman, R. S., & O’Sullivan, K. (2024). Exploring attitudes of people with chronic health conditions towards the use of group-based telerehabilitation: A qualitative study. Clinical Rehabilitation, 38(1), 130-142.
  • Başer Seçer, M., & Çeliker Tosun, Ö. (2022). Examination of telerehabilitation knowledge, awareness, and opinions of physical therapy and rehabilitation students. Medical Science Educator, 32(6), 1355-1365.
  • Bezuidenhout, L., Joseph, C., Thurston, C., Rhoda, A., English, C., & Conradsson, D. M. (2022). Telerehabilitation during the COVID-19 pandemic in Sweden: a survey of use and perceptions among physiotherapists treating people with neurological diseases or older adults. BMC health services research, 22(1), 555.
  • Brand, D., Nienaber McKay, A. G., & Cengiz, N. (2023). What constitutes adequate legal protection for the collection, use and sharing of mobility and location data in health care in South Africa?. South African Journal of Science, 119(5-6), 1-7.
  • Buabbas, A. J., Albahrouh, S. E., Alrowayeh, H. N., & Alshawaf, H. (2022). Telerehabilitation during the COVID-19 pandemic: patients and physical Therapists’ experiences. Medical Principles and Practice, 31(2), 156-164.
  • Cottrell, M. A., Hill, A. J., O'Leary, S. P., Raymer, M. E., & Russell, T. G. (2017). Service provider perceptions of telerehabilitation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: a qualitative study. Musculoskeletal Science and Practice, 32, 7-16.
  • Cranen, K., Drossaert, C. H., Brinkman, E. S., Braakman‐Jansen, A. L., IJzerman, M. J., & Vollenbroek‐Hutten, M. M. (2012). An exploration of chronic pain patients’ perceptions of home telerehabilitation services. Health expectations, 15(4), 339-350.
  • D'Souza, A. F., & Rebello, S. R. (2021). Perceptions and willingness of physiotherapists in India to use telerehabilitation during the COVID-19 pandemic. International journal of telerehabilitation, 13(2).
  • Ding, L., Velicer, W. F., & Harlow, L. L. (1995). Effects of estimation methods, number of indicators per factor, and improper solutions on structural equation modeling fit indices. Structural Equation Modeling: A Multidisciplinary Journal, 2(2), 119-143.
  • Duyck, P., Pynoo, B., Devolder, P., Voet, T., Adang, L., Ovaere, D., & Vercruysse, J. (2010). Monitoring the PACS implementation process in a large university hospital--discrepancies between radiologists and physicians. J Digit Imaging, 23(1), 73-80. https://doi.org/10.1007/s10278-008-9163-7
  • Godin, G., Bélanger-Gravel, A., Eccles, M., & Grimshaw, J. (2008). Healthcare professionals' intentions and behaviours: a systematic review of studies based on social cognitive theories. Implementation science, 3, 1-12.
  • Godin, G., & Kok, G. (1996). The theory of planned behavior: a review of its applications to health-related behaviors. American journal of health promotion, 11(2), 87-98.
  • Karaçelik, B. T., Beyhan, T. E., Aksu, P. K., Kitapçı, N. Ş., Kitapçı, O. C., Köksal, L., Yay, M., İşçi, E., Çatar, R. Ö., & Mumcu, G. THE INNOVATION PERSPECTIVE OF EMPLOYEES IN A PRIVATE HOSPITAL. International Journal of Health Management and Tourism, 6(3), 579-593.
  • Liu, L., Miguel Cruz, A., Rios Rincon, A., Buttar, V., Ranson, Q., & Goertzen, D. (2015). What factors determine therapists’ acceptance of new technologies for rehabilitation – a study using the Unified Theory of Acceptance and Use of Technology (UTAUT). Disability and Rehabilitation, 37(5), 447-455. https://doi.org/10.3109/09638288.2014.923529
  • Lu, J., Yao, J. E., & Yu, C.-S. (2005). Personal innovativeness, social influences and adoption of wireless Internet services via mobile technology. The Journal of Strategic Information Systems, 14(3), 245-268. https://doi.org/https://doi.org/10.1016/j.jsis.2005.07.003
  • Mącznik, A. K., Ribeiro, D. C., & Baxter, G. D. (2015). Online technology use in physiotherapy teaching and learning: a systematic review of effectiveness and users’ perceptions. BMC medical education, 15, 1-12.
  • McCue, M., Fairman, A., & Pramuka, M. (2010). Enhancing quality of life through telerehabilitation. Physical Medicine and Rehabilitation Clinics, 21(1), 195-205.
  • Moro-Visconti, R., & Moro-Visconti, R. (2021). E-Health and Telemedicine Startup Valuation. Startup Valuation: From Strategic Business Planning to Digital Networking, 341-361.
  • Morri, M., Ruisi, R., Culcasi, A., & Peccerillo, V. (2024). The Effectiveness of Telerehabilitation for Functional Recovery After Orthopedic Surgery: A Systematic Review and Meta-Analysis. Telemedicine Reports, 5(1), 78-88.
  • Niknejad, N., Ismail, W., Bahari, M., & Nazari, B. (2021). Understanding telerehabilitation technology to evaluate stakeholders’ adoption of telerehabilitation services: a systematic literature review and directions for further research. Archives of Physical Medicine and Rehabilitation, 102(7), 1390-1403.
  • Rahimi, B., Nadri, H., Afshar, H. L., & Timpka, T. (2018). A systematic review of the technology acceptance model in health informatics. Applied clinical informatics, 9(03), 604-634.
  • Riley, W. T., Rivera, D. E., Atienza, A. A., Nilsen, W., Allison, S. M., & Mermelstein, R. (2011). Health behavior models in the age of mobile interventions: are our theories up to the task?. Translational behavioral medicine, 1(1), 53-71.
  • Saaei, F., & Klappa, S. G. (2021). Rethinking telerehabilitation: attitudes of physical therapists and patients. Journal of patient experience, 8, 23743735211034335.
  • Schaper, L. K., & Pervan, G. P. (2007). ICT and OTs: A model of information and communication technology acceptance and utilisation by occupational therapists. International Journal of Medical Informatics, 76, S212-S221.
  • Seron, P., Oliveros, M.-J., Gutierrez-Arias, R., Fuentes-Aspe, R., Torres-Castro, R. C., Merino-Osorio, C., Nahuelhual, P., Inostroza, J., Jalil, Y., & Solano, R. (2021). Effectiveness of telerehabilitation in physical therapy: a rapid overview. Physical therapy, 101(6), pzab053.
  • Smith, T. D., & McMillan, B. F. (2001). A Primer of Model Fit Indices in Structural Equation Modeling.
  • Sood, S., Mbarika, V., Jugoo, S., Dookhy, R., Doarn, C. R., Prakash, N., & Merrell, R. C. (2007). What is telemedicine? A collection of 104 peer-reviewed perspectives and theoretical underpinnings. Telemedicine and e-Health, 13(5), 573-590.
  • Stephenson, A., Howes, S., Murphy, P. J., Deutsch, J. E., Stokes, M., Pedlow, K., & McDonough, S. M. (2022). Factors influencing the delivery of telerehabilitation for stroke: A systematic review. PLoS One, 17(5), e0265828.
  • Suso-Martí, L., La Touche, R., Herranz-Gómez, A., Angulo-Díaz-Parreño, S., Paris-Alemany, A., & Cuenca-Martínez, F. (2021). Effectiveness of telerehabilitation in physical therapist practice: an umbrella and mapping review with meta–meta-analysis. Physical therapy, 101(5), pzab075.
  • The jamovi project (2024). jamovi (Version 2.5) [Computer Software]. Retrieved from https://www.jamovi.org
  • Theodoros, D., Russell, T., & Latifi, R. (2008). Telerehabilitation: current perspectives. Studies in health technology and informatics, 131(1), 191-210.
  • Tousignant, M., Boissy, P., Moffet, H., Corriveau, H., Cabana, F., Marquis, F., & Simard, J. (2011). Patients' satisfaction of healthcare services and perception with in-home telerehabilitation and therapists' satisfaction toward technology for post-knee arthroplasty: an embedded study in a randomized trial. Telemedicine and e-Health, 17(5), 376-382.
  • Turner, M., Kitchenham, B., Brereton, P., Charters, S., & Budgen, D. (2010). Does the technology acceptance model predict actual use? A systematic literature review. Information and software technology, 52(5), 463-479.
  • Tyagi, S., Lim, D. S., Ho, W. H., Koh, Y. Q., Cai, V., Koh, G. C., & Legido-Quigley, H. (2018). Acceptance of tele-rehabilitation by stroke patients: perceived barriers and facilitators. Archives of Physical Medicine and Rehabilitation, 99(12), 2472-2477. e2472.
  • Vellata, C., Belli, S., Balsamo, F., Giordano, A., Colombo, R., & Maggioni, G. (2021). Effectiveness of telerehabilitation on motor impairments, non-motor symptoms and compliance in patients with Parkinson's disease: a systematic review. Frontiers in neurology, 12, 627999.
  • Venkatesh, V., & Davis, F. D. (2000). A theoretical extension of the technology acceptance model: Four longitudinal field studies. Management science, 46(2), 186-204.
  • Venkatesh, V., Morris, M. G., Davis, G. B., & Davis, F. D. (2003). User acceptance of information technology: Toward a unified view. MIS Quarterly, 425-478.
  • Whitten, P., Holtz, B., & Nguyen, L. (2010). Keys to a successful and sustainable telemedicine program. International journal of technology assessment in health care, 26(2), 211-216.
  • Williams, M. D., Rana, N. P., & Dwivedi, Y. K. (2015). The unified theory of acceptance and use of technology (UTAUT): a literature review. Journal of enterprise information management, 28(3), 443-488.
There are 44 citations in total.

Details

Primary Language English
Subjects Health Management
Journal Section Makaleler
Authors

Meral Timurtas

Gonca Mumcu

Publication Date July 29, 2024
Submission Date May 30, 2024
Acceptance Date July 12, 2024
Published in Issue Year 2024 Volume: 9 Issue: 2

Cite

APA Timurtas, M., & Mumcu, G. (2024). Acceptance of Telerehabilitation Among Physiotherapists in Turkey and Factors Affecting Acceptance: A Cross-Sectional Analysis. International Journal of Health Management and Tourism, 9(2), 221-243. https://doi.org/10.31201/ijhmt.1492798