Acceptability of two mobile applications to support cross-sectoral, person-centred and empowering stroke rehabilitation – a process evaluation

Abstract

Aim

To evaluate the acceptability of two co-designed mobile applications Mit Sygehus [a knowledge-based solution] and Genoptræn.dk [a self-training solution] to support a cross-sectoral, person-centred and empowering stroke rehabilitation.

Setting

The applications were implemented and tested throughout two stroke rehabilitation trajectories in Southern Denmark, comprising two acute, two sub-acute and two municipal stroke rehabilitation settings.

Methods, participants and analysis

A process evaluation focusing on acceptability was conducted. Individual and dyadic interviews were performed with ten stroke survivors (three women and seven men, aged 50–84) with moderate stroke and seven significant others (five women and two men, aged 50–78) post-rehabilitation. A constructivist Grounded Theory analysis was used to explore what, why, when, and how the apps worked or did not work throughout the stroke rehabilitation trajectory and if adaptions were needed.

Results

Participants found that Mit Sygehus provided adequate and sufficient knowledge and was easy to use, however, acceptability of Mit Sygehus declined throughout the rehabilitation process. Also, knowledge on ‘return-to-work’ and ‘re-gaining driver’s license/permission to drive’ needed to be developed. The content in Genoptræn.dk was perceived as acceptable, through content being person-centred, motivating and meaningful. Genoptræn.dk furthermore, supported the transfer between rehabilitation settings, provided a sense of progress throughout the rehabilitation process, facilitated positive habits regarding self-training, and relieved the burden on significant others. Genoptræn.dk was perceived most acceptable in the sub-acute rehabilitation setting and declined when rehabilitation continued in the municipal setting.

Conclusion

Stroke survivors and their significant others found Mit Sygehus and Genoptræn.dk acceptable to support cross-sectoral, person-centred and empowering stroke rehabilitation, however acceptability declined throughout the rehabilitation process. Further investigations are required to determine how cognitive rehabilitation can play a greater role in app-supported stroke rehabilitation and how the need for more long-term follow-up can be supported.

KEY MESSAGES

• By using process evaluation, the user acceptability of newly developed and complex interventions can be evaluated.

• ICT and app-based solutions can support cross-sectoral person-centred and empowering stroke rehabilitation.

• Therapists play an important role in implementing and supporting stroke survivors using app-based solutions to support person-centred and empowering stroke rehabilitation.

Keywords:

• Stroke rehabilitation
• person-centered rehabilitation
• cross-sectoral rehabilitation
• mobile applications
• mobile apps
• empowerment
• occupational therapy
• physiotherapy

Acknowledgements

The authors thank the stroke survivors, significant others, and therapists for participating, engaging, and sharing their experiences throughout the research process.

Authors contributions

All authors have contributed to the conception and design, analysis, and interpretation of the data, drafting and critically reviewing the content of the paper, and have given final approval for the version to be published. All authors agree to be accountable for all aspects of the work.

Disclosure statement

The authors have no conflicts of interest to declare.

Data availability statement

Can be shared upon request.

Additional information

Funding

This study was supported by the University College of South Denmark and the Danish Organization for Physiotherapists Grant Number R39-A1042).