Factors influencing the willingness to adopt telerehabilitation among rehabilitation professionals in Austria and Germany: a survey comparing data before and during COVID-19

To investigate determinants of willingness to adopt telerehabilitation, willingness of technology use, core affect regarding using telerehabilitation, and digital competencies in rehabilitation professionals in Austria and Germany before and during the COVID-19 pandemic.
A cross-sectional paper-based and online survey was conducted before and during COVID-19, respectively, with three cohorts of rehabilitation professionals. Outcomes were the willingness to adopt telerehabilitation evaluated using the extended Unified Theory of Acceptance and Use of Technology; willingness of technology use using the short scale for assessing the willingness of technology use; digital competencies and core affect using the Digital Competence Framework and semantic differential, respectively. Multivariate ordinal regression analysis was performed to determine predictors.
Included were 603 rehabilitation professionals. Analysis revealed differences between Austria and Germany and before and during the pandemic for most outcomes. German residency, the pandemic, and a higher educational level were most important predictors of higher willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect.
The pandemic increased most aspects of willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. Results confirm that rehabilitation professionals with higher degrees are more prone to adopt innovations in healthcare.Registration: German Clinical Trials Register (DRKS00021464)IMPLICATIONS FOR REHABILITATION
The willingness to adopt telerehabilitation is associated with external factors increasing the need for alternative rehabilitation delivery, such as COVID-19, and with financial facilitators, such as reimbursement.
As the willingness to adopt telerehabilitation is higher among speech and language therapists and dietitians, efforts are necessary to enhance its use in physiotherapists and occupational therapists.
As a higher willingness to adopt telerehabilitation was observed in younger rehabilitation professionals and those with higher education, increasing the importance of telerehabilitation in education curricula and further knowledge transfer into practice for those already working in the field seems necessary.

The willingness to adopt telerehabilitation is associated with external factors increasing the need for alternative rehabilitation delivery, such as COVID-19, and with financial facilitators, such as reimbursement.
As the willingness to adopt telerehabilitation is higher among speech and language therapists and dietitians, efforts are necessary to enhance its use in physiotherapists and occupational therapists.
As a higher willingness to adopt telerehabilitation was observed in younger rehabilitation professionals and those with higher education, increasing the importance of telerehabilitation in education curricula and further knowledge transfer into practice for those already working in the field seems necessary.

本研究旨在探究新冠疫情暴发前后，奥地利与德国康复专业人员采纳远程康复（telerehabilitation）的意愿、技术使用意愿、使用远程康复时的核心情绪状态，以及数字胜任力的影响因素。
研究分别在新冠疫情前与疫情期间，针对三批康复专业人员开展了横断面纸质与线上调查。本研究的结局指标包括：采用扩展版技术接受与使用统一理论（Unified Theory of Acceptance and Use of Technology）评估的远程康复采纳意愿、采用技术使用意愿简化量表评估的技术使用意愿，以及分别采用数字胜任力框架（Digital Competence Framework）与语义差异量表评估的数字胜任力与核心情绪状态。随后采用多元有序回归分析确定其预测因子。
最终纳入603名康复专业人员。分析结果显示，多数结局指标在奥地利与德国之间，以及疫情前后均存在显著差异。德国居留身份、新冠疫情与较高学历是远程康复采纳意愿、技术使用意愿、数字胜任力及积极核心情绪状态提升的最重要预测因子。
新冠疫情提升了远程康复采纳意愿、技术使用意愿、数字胜任力及积极核心情绪状态的多数维度。研究结果证实，学历较高的康复专业人员更倾向于采纳医疗健康领域的创新技术。
注册信息：德国临床试验注册库（German Clinical Trials Register，DRKS00021464）
康复领域应用启示
远程康复的采纳意愿与提升替代康复服务供给需求的外部因素（如新冠疫情）及报销等金融支持因素密切相关。
由于言语治疗师与营养师的远程康复采纳意愿更高，因此需采取措施提升物理治疗师与作业治疗师对远程康复的使用意愿。
鉴于年轻康复专业人员与高学历群体的远程康复采纳意愿更高，因此有必要在教育课程中强化远程康复的重要性，并为已在职的从业者进一步推进相关知识向临床实践的转化。
远程康复的采纳意愿与提升替代康复服务供给需求的外部因素（如新冠疫情）及报销等金融支持因素密切相关。
由于言语治疗师与营养师的远程康复采纳意愿更高，因此需采取措施提升物理治疗师与作业治疗师对远程康复的使用意愿。
鉴于年轻康复专业人员与高学历群体的远程康复采纳意愿更高，因此有必要在教育课程中强化远程康复的重要性，并为已在职的从业者进一步推进相关知识向临床实践的转化。