With medical advancements, more Canadians are surviving a stroke. However, many live with residual impairments that can affect their everyday function. Regaining the ability to drive is often a priority among patients after stroke. Current evidence indicates there is a critical need for evidence-based interventions that support their return to this occupation.
In the first study, OTs identified assessments and interventions they used to address driving post-stroke. From the breadth of interventions, the use of mobile applications was identified as a major and significant knowledge gap by clinicians, as to how their patients perceived and used this technology when deployed. Following this study, community-dwelling patients with stroke and their caregivers were provided with DriveFocus®; a new mobile application for driving rehabilitation. Their use of DriveFocus® was tracked for four weeks from which distinct patterns with using this technology emerged. Follow-up interviews with participants explored these patterns. Guided by a technology acceptance model, this mixed-methods analysis showed how the presence and absence of certain factors (e.g., having a ‘tech-savvy’ caregiver) can support technology adoption. Participants also described how OTs play a key role with introducing and monitoring their use of this technology during stroke rehabilitation.
In the final study, clinicians from the first study as well as additional OTs were recruited. Their interviews identified factors that influenced how they selected and deployed mobile applications, like DriveFocus®, to address a patient’s goal of returning to driving. These factors included clinician awareness of emerging technology and mobile applications, workplace policies that support the upkeep and integration of technology as well as the patients’ level of impairment and comfort with using mobile technology. Having caregivers to facilitate uptake of this technology was also raised during these interviews.
This thesis opened by exploring the process by which the occupation of driving is addressed by OTs in stroke rehabilitation where subsequent studies identified factors specific to the uptake of mobile application by individuals with stroke, their caregivers, as well as clinicians to address this occupation. In the closing chapter, these factors are described using an OT model that highlighted opportunities and challenges for implementing mobile technology for driving within stroke rehabilitation. / Thesis / Doctor of Philosophy (PhD) / Returning to driving is often a goal for individuals after their stroke. This thesis examined how driving is addressed during stroke rehabilitation. The first study investigated assessments and interventions used by occupational therapists (OTs) where mobile applications were identified as a promising approach to address this goal. In the next study, individuals with stroke and their caregivers trialled a mobile application called DriveFocus®. While some reported difficulty learning to use this application, family and friends who were comfortable with technology helped participants navigate these difficulties. The final study identified factors that can influence the uptake of mobile applications by OTs working in stroke rehabilitation. Factors included selecting suitable applications, having workplace policies that support the integration of technology, and how a patients’ level of stroke impairment alongside caregiver support can affect technology adoption. Overall, this thesis identified areas of priority to facilitate the adoption of mobile applications for driving in stroke rehabilitation.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/29977 |
| Date | January 2024 |
| Creators | Cammarata, Michael |
| Contributors | Vrkljan, Brenda, Rehabilitation Science |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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