Open Collections

Esfandiari, Elham

University of British Columbia

Background: Self-management education equips individuals with lower limb loss (LLL) with knowledge and skills to better manage their condition. Support of a peer mentor may also improve the effect of self-management programs and enhance the patient’s self-efficacy. Given the limited provision of rehabilitation programs, especially in remote areas, alternative approaches, such as eHealth, may improve delivery of programs. Purpose: To co-create an online self-management program for individuals with LLL, Self-Management for Amputee Rehabilitation using Technology (SMART), through stakeholders’ input, and to evaluate the feasibility and perceived benefits of SMART for community dwelling adults with LLL. Methods: We conducted three studies: Focus groups and interviews with clinicians and individuals with LLL; a systematic review and meta-analysis designed to assess the effect of eHealth interventions compared to usual care on mobility in peer-reviewed randomized controlled trials and identify the Behavior Change Techniques (BCTs) underpinning SMART content; assess the usability using a think-aloud approach; and a mixed-methods pre-post intervention study to assess feasibility. Results: Clinicians and individuals with LLL perceived education as important to adapt to amputation, however, in their experience, education was limited to traditional physical materials/booklets and inaccessible in remote areas. Goal setting and support of a peer mentor were identified as helpful program components to facilitate self-management. Participants indicated an accessible, complementary source for LLL education may augment their rehabilitation. Very-low certainty evidence showed a small positive change in mobility in favor of the eHealth intervention. The BCTs, such as goal setting, and action planning, were identified and embedded within SMART content. Difficulties with navigating SMART, content presentation, and unclear language were identified and addressed. SMART delivered with the support of a peer mentor was feasible and could potentially benefit individuals with LLL. Participants felt they had benefited from SMART and the support of a peer mentor who facilitated goal setting and goal achievement. Conclusion: SMART could support individuals with LLL to learn self-management skills in an effective timeframe, regardless of geographical boundaries, and serve as a complementary educational resource. Future studies should evaluate SMART efficacy compared to usual care and assess the feasibility of integrating SMART into clinical practice.

Text

2024-03-31

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/81051

Rehabilitation Sciences

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/