ACCEPTABILITY OF PULMONARY TELEREHABILITATION: FACTORS ASSOCIATED WITH PATIENT PERSPECTIVE
本研究调查了慢性呼吸疾病患者对居家肺远程康复的接受度，发现数字设备使用信心和频率、互联网接入及安全感知是影响兴趣的关键因素，其中安全感知是唯一独立预测因子。
Introduction: Respiratory rehabilitation (RR) is a cornerstone in the management of chronic respiratory diseases, yet access is often hindered by logistical and economic constraints. Telerehabilitation (TR) emerges as a potential solution. This study aimed to identify variables associated with higher patient acceptability in telerehabilitation programs. Materials and Methods: A cross-sectional observational study assessed the acceptability of a home-based pulmonary telerehabilitation program in a tertiary hospital, using an investigator-developed questionnaire. Eligible participants were adults referred to RR who provided informed consent. Results: Ninety-nine participants were included, mostly male (74.8%, mean age of 65±9 years). Most had COPD (61.6%), lived less than 20km from the hospital (72.7%), travelled by car (70.7%), had internet access (82,8%) and owned a digital device such as a computer, tablet or smartphone (67,7%). More than half had low confidence and frequency of use of digital devices (53.5% and 54.5% respectively). Approximately half had previously attended RR and all of them expressed interest in re-enrolling. Overall, 50.5% reported interest in telerehabilitation with 55.6% considering it safe. Younger age (p=0.006), internet access (p=0.003), ownership of digital devices (p<0.001) and both higher frequency (p<0.001) and greater confidence in using these devices (p<0.001) were significantly associated with higher interest in telerehabilitation. The perception of safety regarding the program was also a significant factor (p<0.001). In a multivariate regression analysis, safety perception was the only independent predictor that remained significantly associated with interest in TR (p<0.001). Conversely, factors such as gender, distance to the hospital, past attendance in RR and the availability of information technology assistance did not significantly influence interest. Conclusions: Telerehabilitation is a feasible intervention but its success is closely linked to digital literacy and perceived safety of the digital environment. Beyond providing technological access, strategies to improve patient confidence and ensure a sense of safety are essential for the successful implementation of telerehabilitation.