Self-determination Theory as a Lens to Explore the Implementation Challenges of Telehealth
DOI:
https://doi.org/10.5195/ijt.2024.6648Keywords:
Autonomy, Competence, Motivation, Relatedness, Remote rehabilitationAbstract
Many benefits can be gained from telehealth, including reduced travel time, flexible work schedules, increased patient satisfaction, and a cost-effective method of providing care. Furthermore, telehealth provides rehabilitation professionals with the opportunity to observe people in their natural environment as they conduct their daily activities and identify any barriers to their functioning. Despite these advantages, and after a substantial amount of research supporting its effectiveness, telehealth remains relatively underutilized.
Self-determination theory (SDT) is a theoretical framework for explaining motivation in terms of three basic psychological needs: competence, relatedness, and autonomy. Using the SDT, we suggest analyzing the motivational challenges faced by the therapists when implementing telehealth.
We assert that the transition to a remote treatment model can be advantageous for rehabilitation professionals since it provides them with a greater degree of autonomy. Nevertheless, a turning point can only be achieved if relatedness and competence are maintained.
References
Abbott-Gaffney, C. R., Gafni-Lachter, L., Cason, J., Sheaffer, K., Harasink, R., Donehower, K., & Jacobs, K. (2022). Toward successful future use of telehealth in occupational therapy practice: What the COVID-19 rapid shift revealed. Work, 71(2), 385-394 https://doi.org/10.3233/wor-210789
Almog, T., & Gilboa, Y. (2022). Remote delivery of service: A survey of occupational therapists’ perceptions. Rehabilitation Process and Outcome, 11, 11795727221117503. https://doi.org/10.1177/11795727221117503.
Baffert, S., Hadouiri, N., Fabron, C., Burgy, F., Cassany, A., & Kemoun, G. (2023). Economic evaluation of telerehabilitation: Systematic literature review of cost-utility studies [review]. JMIR Rehabilitation and Assistive Technologies, 10, e47172. https://doi.org/10.2196/47172
Beckel, J. L., & Fisher, G. G. (2022). Telework and worker health and well-being: A review and recommendations for research and practice. International Journal of Environmental Research and Public Health, 19(7), 3879. https://doi.org/10.3390/ijerph19073879
Beit Yosef, A., Jacobs, J. M., Shames, J., Schwartz, I., & Gilboa, Y. (2022). A performance-based teleintervention for adults in the chronic stage after acquired brain injury: An exploratory pilot randomized controlled crossover study. Brain Sciences, 12(2), 213. https://doi.org/10.3390/brainsci12020213
Beit Yosef, A., Maeir, T., Khalailh, F., & Gilboa, Y. (2022). Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong Journal of Occupational Therapy, 35(1), 62-70. https://doi.org/10.1177/15691861221080311
Ben Zagmi, S., Rozen, D., Amar, E., Hershkowitz, F., & Gilboa, Y. (2021). Occupational therapists' perspective on remote service after initial experience trail during the COVID-19 pandemic. Israeli Journal of Occupation Therapy, 30(2), E35-36
Borges do Nascimento, I. J., Abdulazeem, H., Vasanthan, L. T., Martinez, E. Z., Zucoloto, M. L., Østengaard, L., Azzopardi-Muscat, N., Zapata, T., & Novillo-Ortiz, D. (2023). Barriers and facilitators to utilizing digital health technologies by healthcare professionals. NPJ Digital Medicine, 6(1), 161. https://doi.org/10.1038/s41746-023-00899-4
Brigo, E., Rintala, A., Kossi, O., Verwaest, F., Vanhoof, O., Feys, P., & Bonnechère, B. (2022). Using telehealth to guarantee the continuity of rehabilitation during the COVID-19 pandemic: A systematic review. International Journal of Environmental Research and Public Health, 19(16), 10325. https://doi.org/10.3390/ijerph191610325
Chow, J. S. F., Palamidas, D., Marshall, S., Loomes, W., Snook, S., & Leon, R. (2022). Teleworking from home experiences during the COVID-19 pandemic among public health workers (TelEx COVID-19 study). BMC Public Health, 22, 674. https://doi.org/10.1186/s12889-022-13031-0
Creswell, J. W., & Hirose, M. (2019). Mixed methods and survey research in family medicine and community health. Family Medicine and Community Health, 7(2), e000086. https://doi.org/10.1136/fmch-2018-000086
Damhus, C. S., Emme, C., & Hansen, H. (2018). Barriers and enablers of COPD telerehabilitation–a frontline staff perspective. International Journal of Chronic Obstructive Pulmonary Disease, 2473-2482. https://doi.org/10.2147/COPD.S167501
De Vries, H., Tummers, L., & Bekkers, V. (2019). The benefits of teleworking in the public sector: Reality or rhetoric? Review of Public Personnel Administration, 39(4), 570-593. https://doi.org/10.1177/0734371X18760124
Deci, E. L., Olafsen, A. H., & Ryan, R. M. (2017). Self-determination theory in work organizations: The state of a science. Annual Review of Organizational Psychology and Organizational Behavior, 4(1), 19-43. https://doi.org/10.1146/annurev-orgpsych-032516-113108
Deci, E. L., & Ryan, R. M. (2013). Intrinsic motivation and self-determination in human behavior. Springer Science & Business Media
Gagné, M., Parker, S. K., Griffin, M. A., Dunlop, P. D., Knight, C., Klonek, F. E., & Parent-Rocheleau, X. (2022). Understanding and shaping the future of work with self-determination theory. Nature Reviews Psychology, 1(7), 378-392. https://doi.org/0.1038/s44159-022-00056-w
Garavand, A., Aslani, N., Nadri, H., Abedini, S., & Dehghan, S. (2022). Acceptance of telemedicine technology among physicians: A systematic review. Informatics in Medicine Unlocked, 30, 100943. https://doi.org/https://doi.org/10.1016/j.imu.2022.100943
Gilboa, Y., Maeir, T., Karni, S., Eisenberg, M. E., Liebergall, M., Schwartz, I., & Kaufman, Y. (2019). Effectiveness of a tele-rehabilitation intervention to improve performance and reduce morbidity for people post hip fracture-study protocol for a randomized controlled trial. BMC Geriatrics, 19, 1-9. https://doi.org/10.1186/s12877-019-1141-z
Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003). Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. American Journal of Public Health, 93(8), 1261-1267. https://doi.org/10.2105/ajph.93.8.1261
Hibbert, D., Mair, F. S., May, C. R., Boland, A., O'Connor, J., Capewell, S., & Angus, R. M. (2004). Health professionals' responses to the introduction of a home telehealth service. Journal of Telemedicine and Telecare 10(4), 226-230. https://doi.org/10.1258/1357633041424386
Keel, S., Schmid, A., Keller, F., & Schoeb, V. (2023). Investigating the use of digital health tools in physiotherapy: Facilitators and barriers. Physiotherapy Theory and Practice, 39(7), 1449-1468. https://doi.org/10.1080/09593985.2022.2042439
Knepley, K. D., Mao, J. Z., Wieczorek, P., Okoye, F. O., Jain, A. P., & Harel, N. (2021). Impact of telerehabilitation for stroke-related deficits. Telemedicine and e-Health, 27(3), 239-246. https://doi.org/10.1089/tmj.2020.0019
Kordelas, S. (2023). The impact of technology on the therapeutic alliance-Examining the perspectives of health professionals. University of Twente.
Kringle, E. A., Skidmore, E. R., Baum, M. C., Shih, M., Rogers, C., & Hammel, J. M. (2023). Stakeholders’ experiences using videoconferencing for a group-based stroke intervention during COVID-19: A thematic analysis. American Journal of Occupational Therapy, 77(3), 7703205100. https://doi.org/10.5014/ajot.2023.050111
La Guardia, J. G. (2009). Developing who I am: A self-determination theory approach to the establishment of healthy identities. Educational Psychologist, 44(2), 90-104. https://doi.org/10.1080/00461520902832350
Little, L. M., Wallisch, A., Pope, E., & Dunn, W. (2018). Acceptability and cost comparison of a telehealth intervention for families of children with autism. Infants & Young Children, 31(4), 275-286. https://doi.org/10.1097/IYC.0000000000000126
Loubani, K., & Rand, D. (2023). Implementing telehealth among occupational therapists working in the health care system: A survey on the current practice and experiences. Telemedicine and e-Health, 30(3), 705-714. https://doi.org/10.1089/tmj.2023.0261
Maeir, T., Makranz, C., Peretz, T., Odem, E., Tsabari, S., Nahum, M., & Gilboa, Y. (2023). Cognitive Retraining and Functional Treatment (CRAFT) for adults with cancer related cognitive impairment: A preliminary efficacy study. Support Care Cancer, 31(3), 152. https://doi.org/10.1007/s00520-023-07611-y
Ninnis, K., Van Den Berg, M., Lannin, N. A., George, S., & Laver, K. (2019). Information and communication technology use within occupational therapy home assessments: A scoping review. British Journal of Occupational Therapy, 82(3), 141-152. https://doi.org/https://doi.org/10.1177/0308022618786928
Pang, D., Sun, A., Wang, F., Lu, J., Guo, Y., & Ding, W. (2023). The efficacy and safety of telerehabilitation for patients following total knee arthroplasty: A overviews of systematic reviews. BioMedical Engineering OnLine, 22(1), 1-15. https://doi.org/10.1186/s12938-023-01158-z.
Peretti, A., Amenta, F., Tayebati, S. K., Nittari, G., & Mahdi, S. S. (2017). Telerehabilitation: Review of the state-of-the-art and areas of application. JMIR Rehabilitation and Assistive Technologies, 4(2), e7511
Stampa, S., Thienel, C., Tokgöz, P., Razum, O., & Dockweiler, C. (2024). Factors facilitating and inhibiting the implementation of relerehabilitation—A scoping review. Healthcare, 12(6), 619. https://www.mdpi.com/2227-9032/12/6/619
Steinhart, S., Raz-Silbiger, S., Beeri, M., & Gilboa, Y. (2021). Occupation based telerehabilitation intervention for adolescents with myelomeningocele: A pilot study. Physical & Occupational Therapy In Pediatrics, 41(2), 176-191. https://doi.org/10.1080/01942638.2020.1807448
Tavares, A. I. (2017). Telework and health effects review. International Journal of Healthcare, 3(2), 30-36. https://doi.org/https://doi.org/10.5430/ijh.v3n2p30
Vestergaard, K. (2021). Changes in professionalism through the practice of telemedicine: Conceptualizing a situated sense filter. Professions and Professionalism, 11(2). https://doi.org/https://doi.org/10.7577/pp.3857
WHO. (2024). Rehabilitation. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/rehabilitation
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