The Application of Telehealth Among Community-dwelling Adults with Spinal Cord Injury

Abstract

Spinal cord injury (SCI) is a complicated disorder that leads to considerable morbidity and cost burden on the health system, primarily due to the wide range of long-term secondary complications that frequently occur following SCI. Many SCI-associated secondary complications could be prevented or managed with improved access to care for individuals with SCI in the long term who live in the community. However, accessibility to community services for SCI has been further limited when considering accessibility barriers and constraints from the Covid-19 pandemic. Thus, applying telehealth services is one optimal solution for alleviating barriers to accessing rehabilitation services for community-dwelling adults with SCI. This thesis aimed to identify telehealth service models and explore essential characteristics and potential functions of a virtual clinic to improve the provision of care for community-dwelling adults with SCI. Study One was a scoping review of the literature to identify, describe, and compare models of telehealth services in community-dwelling adults with SCI. Study two is a qualitative study using the interpretive description (ID) approach that consulted with various stakeholders to identify what they regard as the feasible, essential characteristics, and potential functions of a virtual clinic for community-dwelling adults with SCI. Findings from these two studies indicated that telehealth might offer an efficient and effective option for health service delivery for community-dwelling individuals with SCI, ensuring continuity of rehabilitation, follow-up after hospital discharge, and management of potential secondary complications following SCI. Findings suggest the benefits of virtual care in improving access over the long term, particularly for those living in rural areas. Additionally, results highlighted the need for hybridized models of care and the uptake of multidisciplinary approaches within the virtual healthcare system to create efficient care pathways, leading to the continuum of care for community-dwelling adults with SCI. The information gained from these studies could be used to inform policymakers, HCPs, and stakeholders involved with SCI rehabilitation when establishing a virtual clinic for patients with SCI.