Factors Influencing Therapists' Decision-Making in the Acceptance of New Technology Devices in Stroke Rehabilitation

Chen CC, Bode RK: Factors influencing therapists' decision-making in the acceptance of new technology devices in stroke rehabilitation. Am J Phys Med Rehabil 2011;90:415-425. Objective: The aims of this study were to identify factors or barriers in therapists' decisions to acquire and use new technology devices (NTDs) and to examine rating differences across therapy disciplines. Design: Literature review, key informant interviews, and focus group sessions were conducted to define a conceptual framework of acceptance/resistance of NTDs and to develop survey items. The survey was subsequently mailed to therapists. Results: The survey responses showed that billability of services, having a sufficient caseload using a device, and initial cost were the most important factors in acquisition decisions; that patient acceptance, suitability for the setting, and logistics were the most important factors in use decisions; and that negative patient outcomes, problems with reimbursement, and perceived lack of patient interest were the most significant barriers to their use. Patient safety, motivation, and cognition were the most important patient considerations in the therapist's decision to use NTDs with a particular patient, whereas lack of progress, unavailability of the participants post discharge, and requiring too much patient effort were the most significant barriers to the use of NTDs with particular patients. Some rating variations existed across disciplines. Conclusions: This study confirmed that rehabilitation therapists consider clinical and practical factors, as well as the match between the patient and the device, when making acquisition and use decisions of NTDs. Research and education implications were discussed.