PhD: Evaluation of the provision of post-stroke telerehabilitation in Ireland

This project aims to provide an in-depth understanding of telerehabilitation and assist in understanding how we identify effective interventions and implement these successfully for improved stroke recovery.

Project description

Stroke is the third-leading cause of disability worldwide, with five million people annually becoming permanently disabled (WHO, 2012; WSA, 2020). Stroke survivors often require ongoing therapy post-discharge from inpatient rehabilitation. Outpatient therapy may be limited or inaccessible for many reasons including: lengthy waiting lists, transportation issues and distance (Sheehy et al, 2019). In addition to this, the current coronavirus (COVID-19) pandemic represents an unprecedented challenge to stroke care services, bringing intense pressure and radical change to health systems and organisations.

There is recognition that telerehabilitation can be used for providing ongoing post-stroke care. Telerehabilitation is the provision of rehabilitation services to patients at a remote  location using information and communication technologies (Brennan et al, 2009). This can allow for convenient access to rehabilitation services, without the risk of exposure to COVID-19.

Required now is a greater understanding of how to best use the opportunity provided to us by telerehabilitation, to benefit recovery for stroke survivors. This research project aims to expand on the existing work of the team to synthesise the evidence regarding telerehabilitation platforms being used in the stroke population. There is a need to gain a better understanding of how telerehabilitation is being used in Ireland. In particular, the barriers and facilitators to its use, and the role it is played in the COVID-19 pandemic to continue socially distanced rehabilitation services.

The final design of the research programme will be dependent on the strengths and interests of the doctoral researcher. However, we propose to use a mixed-methods approach to address the research question via a programme of interlinked research studies. This may include a review and update to the experimental, observational and qualitative evidence relating to telerehabilitation for stroke to map the literature on the area, and provide context for further workstreams.

The use of the RE-AIM model (Glasgow et al, 1999) would then allow for the evaluation of the provision of post-stroke telerehabilitation in Ireland. This framework assesses the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of a project in order to estimate its impact. Failure to adequately evaluate programmes on all five of these levels can lead to a waste of resources, discontinuities between stages of research and failure to improve health services.

To explore patients', carers and clinician experiences of using telerehabilitation, a qualitative approach using semi-structured interviews/focus groups will be implemented. This will assist in identifying barriers and facilitators, benefits of telerehabilitation, establish issues around training and delivery, and make recommendations for an infrastructure to support effective telerehabilitation for stroke recovery. 

Tenure: 3-4 years

Specification

Minimum requirements:

  • At least a 2.1 degree in a health-related discipline, including, but not limited to, physiotherapy and occupational therapy.
  • A keen interest in a health-promoting role

Desirable candidate specifications include:

  • Experience in a clinical setting
  • A good understanding of research methods
  • Excellent communication, organisational and administrative skills

Application process

There is an open rolling registration for this position.

Please apply with an up-to-date CV, a 500-word statement outlining your interest in and suitability for the position, and contact details of two referees to suzannemcdonough@rcsi.com.

Successful candidates will be able to attend a virtual interview if they wish.