Satisfaction With In-Home Speech Telerehabilitation in Post-Stroke Aphasia: an Exploratory Analysis
Patient satisfaction with healthcare has a major impact on clinical outcomes and compliance. Satisfaction with telehealth services for speech and language problems has been documented but not in post-stroke aphasia. The main objective here was to evaluate patient satisfaction with speech tele rehabilitation based on the PACE pragmatic rehabilitation approach in post-stroke aphasia. This study was embedded in a pre-/post-test feasibility and efficacy study in which 20 patients with chronic post-stroke aphasia received 3 weeks of speech therapy (9 sessions) through in-home tele-rehabilitation. A telerehabilitation platform based on a commercial videoconferencing system (Tandberg 550 MXP) with custom software was used to transmit audio, video and data through a high-speed Internet connection between the participant’s home and the clinician. Participants’ satisfaction with in-home telerehabilitation and healthcare received was assessed using French adaptations of the Telemedicine Satisfaction Questionnaire and Health Care Satisfaction Questionnaire. Satisfaction with functional communication, i.e. communication in common situations of daily life, was compared pre- and post-intervention with participants and caregivers. Participants’ satisfaction with in-home telerehabilitation was excellent (94%±4.3%). Satisfaction with healthcare received was good overall (80%±11.4%) and for three factors measured independently, i.e. relationship with healthcare professional (84%±12.5%), services delivered (73%±13.8%), and general healthcare organization (84%±12.0%). Participants’ and caregivers’ satisfaction with communication was higher after the intervention (p=0.001 and p<0.001, respectively) and was correlated with age (r=-0.60; p=0.007). Patients with post-stroke aphasia receiving speech tele-therapy were very satisfied with this service delivery method. Also, technology use was not an issue for seniors post-stroke.
Hakim AM, Silver F, Hodgson C. Organized stroke care: A new era in stroke prevention and treatment. CMAJ 1998;159(6):S1.
Agence de la santé publique du Canada. Suivi des maladies du cœur et des accidents vasculaires cérébraux (AVC) au Canada – Faits saillants sur les AVC 2011. (2011). Available at: http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/sh-fs-2011/index-fra.php accessed 9 August 2017.
Watila MM, Balarabe SA. Factors predicting post-stroke aphasia recovery. J Neurol Sci 2015; 352(1-2):12-8.
Pedersen P, Vinter K, Olsen T. Aphasia after stroke: type, severity and prognosis. The Copenhagen aphasia study. Cerebrovasc Dis 2004;17(1):35-43.
Davis G. Aphasiology: Disorders and clinical practice. Boston, Allyn & Bacon, 2007.
Mazeaux JM, Brun V, Pélissier J. Aphasie 2000- Rééducation et réadaptation des aphasies vasculaires. Paris, Massion, 2000.
McNeil MR, Pratt SR. Defining aphasia: some theoretical and clinical implications of operating from a formal definition. Aphasiology 2011;15(10-11):901-911.
Hilari K, Wiggins R, Roy P, Byng S, Smith S. Predictors of health-related quality of life (HRQL) in people with chronic aphasia. Aphasiology 2011;17(4):365-381.
Ross K, Wertz R. Quality of life with and without aphasia. Aphasiology 2003;17(4):355–364
Hilari K, Needle JJ, Harrison KL. What are the important factors in health-related quality of life for people with aphasia? A systematic review. Arch Phys Med Rehabil 2012;93(1 Suppl):S86-95.
Johansson MB, Carlsson M, Sonnander K. Communication difficulties and the use of communication strategies: from the perspective of individuals with aphasia. Int J Lang Commun Disord 2012;47(2):144-55.
Dalemans RJ, de Witte L, Wade D, van den Heuvel W. Social participation through the eyes of people with aphasia. Int J Lang Commun Disord 2010;45(5):537-50.
Cruice M, Worrall L, Hickson L. Perspectives of quality of life by people with aphasia and their family: suggestions for successful living. Top Stroke Rehabil 2006;13(1):14-24.
Brady MC, Kelly H, Godwin J, Enderby P. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev 2012;(5):CD000425.
Hearth and Stroke Foundation. Together against a rising tide: Advancing Stroke systems of care. Stroke Report. (2014). Available at http://www.strokebestpractices.ca/wp-content/uploads/2014/06/HSF_SMReport2014E_Final.pdf accessed 9 August 2017.
Hoover EL, Carney A. Integrating the iPad into an intensive, comprehensive aphasia program. Semin Speech Lang 2014;35(1):25-37.
Choi YH, Park HK, Paik NJ. A Telerehabilitation Approach for Chronic Aphasia Following Stroke. Telemed J E Health 2016;22(5):434-440.
Kiran S, Des Roches C, Balachandran I, Ascenso E. Development of an impairment-based individualized treatment workflow using an iPad-based software platform. Semin Speech Lang 2014;35(1):38-50.
Saposnik G, Chow CM, Gladstone D, et al. iPad Technology for Home Rehabilitation after Stroke (iHOME): A proof-of-concept randomized trial. Int J Stroke 2014;9(7):956-962.
Rand D, Zeilig G, Kizony R. Rehab-let: touchscreen tablet for self-training impaired dexterity post stroke: study protocol for a pilot randomized controlled trial. Trials 2015;16(277).
Stark BC,Warburton EA. Improved language in chronic aphasia after self-delivered iPad speech therapy. Neuropsychol Rehabil 2016;29:1-14
Kurland J, Wilkins AR, Stokes P. iPractice: piloting the effectiveness of a tablet-based home practice program in aphasia treatment. Semin Speech Lang 2014;35(1):51-63.
White J, Janssen H, Jordan L, Pollack M. Tablet technology during stroke recovery: a survivor's perspective. Disabil Rehabil 2015;37(13):1186-92.
Molini-Avejonas DR, Rondon-Melo S, Amato CA, Samelli AG. A systematic review of the use of telehealth in speech, language and hearing sciences. J Telemed Telecare 2015;21(7):367-76.
Macoir J, Martel Sauvageau V, Boissy P, Tousignant M, Tousignant M. In-Home Synchronous Telespeech Therapy to Improve Functional Communication in Chronic Poststroke Aphasia: Results from a Quasi-Experimental Study. Telemed J E Health 2017;23(8):630-639.
Piron L, Turolla A, Tonin P, et al. Satisfaction with care in post-stroke patients undergoing a telerehabilitation programme at home. J Telemed Telecare 2008;14(5):257-260.
Keith RA. Patient satisfaction and rehabilitation services. Arch Phys Med Rehabil 1998;79(9):1122-1128.
Ellenberg DB. Outcomes research: the history, debate, and implications for the field of occupational therapy. Am J Occup Ther 1996;50(6):435-441.
Kielhofner G, Hammel J, Finlayson M, Helfrich C, Taylor RR. Documenting outcomes of occupational therapy: the center for outcomes research and education. Am J Occup Ther 2004;58(1):15-23.
Laska AC, Hellblom A, Murray V, Kahan T, Von Arbin M. Aphasia in acute stroke and relation to outcome. J Intern Med 2001;249(5):413-422.
Nespoulous JL, Lecours AR, Lafond D, et al. Protocole Montréal-Toulouse d'examen linguistique de l'aphasie MT 86 - module standard initial : Édition révisée. Isbergues, France, Ortho Édition, 1992.
Joanette Y, Ska B, Côté H. Protocole MEC : protocole Montréal d'évaluation de la communication. Isbergues, France, Ortho Édition, 2004.
Clerebaut N, Coyette F, Feyereisen P, Seron X. Une méthode de rééducation fonctionnelle des aphasiques: La P.A.C.E. Rééducation Orthophonique 1984;22(138):329-345.
Yip MP, Chang AM, Chan J, MacKenzie AE. Development of the Telemedicine Satisfaction Questionnaire to evaluate patient satisfaction with telemedicine: a preliminary study. J Telemed Telecare 2003;9(1):46-50.
Tousignant M, Boissy P, Moffet H, et al. Patients' satisfaction of healthcare services and perception with in-home telerehabilitation and physiotherapists' satisfaction toward technology for post-knee arthroplasty: an embedded study in a randomized trial. Telemed J E Health 2011;17(5):376-382.
Gagnon M, Hebert R, Dube M, Dubois MF. Development and validation of the Health Care Satisfaction Questionnaire (HCSQ) in elders. J Nurs Meas 2006;14(3):190-204.
Faucher ME, Maxès-Fournier C, Ouimet C-A, Macoir J. Évaluation de la communication fonctionnelle des personnes aphasiques: avantages et limites de l’Échelle de communication verbale de Bordeaux. RCOA 2009;33(2):89-98.
Nespoulous JL, Lecours AR, Lafond D, et al. Protocole Montréal-Toulouse d'examen linguistique de l'aphasie MT 86. Isbergues, France, Ortho Édition, 1986.
Kairy D, Tousignant M, Leclerc N, et al. The patient's perspective of in-home telerehabilitation physiotherapy services following total knee arthroplasty. Int J Environ Res Public Health 2013;10(9):3998-4011.
Corriveau H, Tousignant M, Gosselin S, Boissy P. Patients satisfaction with an in-home telerehabilitation exercise program and physiotherapists’ satisfaction toward technology for an acute stroke population: a pilot study. Association for the Advancement of Assistive Technology in Europe (AAATE 2013). 2013.
Copyright (c) 2018 Michel Tousignant
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.