Date Presented 04/01/2022
Postpandemic, OT practitioners must make clinical judgments about the continuation of telehealth for specific clients. However, there is a lack of research on the factors that influence both practitioners’ and clients’ decision-making processes in using telehealth and promote success. The purpose of this research was to uncover ways in which OT practitioners drew from clinical reasoning, expertise, and resilience to guide service delivery modality decision making.
Primary Author and Speaker: Timothy Dionne
Additional Authors and Speakers: Lauren Little, Megan E. Gately
PURPOSE: The use of telehealth (i.e., live videoconferencing) to provide occupational therapy (OT) services to clients across settings and populations rapidly expanded during the pandemic. Despite this rapid expansion, barriers, such as decreased access to requisite devices, technological issues like poor broadband, and reliance on others due to low technological skills, were common. Resilience, as defined by enduring performance of occupations in environments that limit individuals or groups in specified ways, is a relatively new concept in occupational science (Muriithi & Muriithi 2020). Little is known about the extent to which resilience, the ability of clients and practitioners to persevere, in spite of challenges during telehealth, influences the relative success or failure.
DESIGN: This qualitative study employs grounded theory to explore the influence of resilience on clients and practitioners’ ability to overcome challenges during telehealth therapy sessions. We drew from preliminary findings of related studies which highlighted enabling factors of success in telehealth, including presence of caregivers, as well as barriers such as decreased attendance, in order to develop interview questions that explored resilience in telehealth.
METHOD: Semi-structured qualitative interviews were conducted with 15 clients and 15 practitioners. We asked participants to describe their experiences with telehealth during the pandemic, including challenges and solutions. Probes included the level of assistance they required, their feelings during the sessions, any barriers encountered, and subjects’ resilience. We then utilized the constant comparison coding process, reaching saturation, in order to build a preliminary theory grounded in the interview data (Charmaz, 2014).
RESULTS: Employing findings from interviews , we constructed a model that outlines factors influencing individuals’ participation in telehealth. Findings point to the importance of resilience in both clients’ and practitioners’ ability to navigate and overcome challenges during telehealth, both in terms of preparation and set-up before and during the telehealth session. Major concepts such as communication, coaching, comfort with novel situations in novel contexts were revealed.
CONCLUSION: This study used constructivist grounded theory to elucidate concepts of telehealth from clients and practitioners’ perspectives.
IMPACT STATEMENT: By explicating factors influencing the concept of resilience in telehealth, this study has the potential to provide evidence-based direction for positive sustained integration of telehealth as a service delivery option for Occupational Therapy.
Charmaz, K. (2014). Constructing grounded theory. Sage.
Muriithi B., & Muriithi, J. (2020). Occupational Resilience: A New Concept in Occupational Science. American Journal of Occupational Therapy, 74(4, Suppl. 1), 7411505137.