Preliminary Usability Assessment of Home-Based Telehealth Pulmonary Rehabilitation for Individuals with Chronic Respiratory Diseases (Preprint)
Authors: Chien Shih-Ying , Hu Han-Chung , Wong Alice M.K 
Published: July 2024

BACKGROUND

Telehealth pulmonary rehabilitation (telePR) has been proven equally effective as standard pulmonary rehabilitation (PR). Although PR can improve symptoms and the quality of life for patients with chronic lung diseases, the potential challenges that users face in operating a rehabilitation system at home are not well understood from the perspective of the user experience. To assess the feasibility of implementing a telePR system for home use, this study developed a telePR intervention system called the Intelligent Pulmonary Rehabilitation Exercise System (IPRES) and evaluated its effectiveness for patients with chronic lung diseases upon being discharged and returning home. The components of the telePR intervention system included physical components such as an ergonomic recumbent bike, a telehealth electronic tablet, and connected wearable devices.

OBJECTIVE

The aim of this study was to employ a human-centric approach to examine the system operation of the IPRES through user experiences, thereby reducing potential barriers to implementation for home use. Serving as a preliminary investigation, this study involved usability testing, acceptability, and satisfaction assessments. The objective was to refine this telePR intervention before the recruitment of a larger sample of chronic pulmonary disease patients for a more extensive home-based telePR study.

METHODS

This study employed the System Usability Scale (SUS) and Post-Study System Usability Questionnaire (PSSUQ) as tools by which to assess the feasibility and usability of IPRES as a non-pharmacological intervention as well as to investigate participants' operational capabilities and acceptance of the system. The experiment comprised two phases. The first phase involved feasibility testing, in which observations were made regarding technology, user safety, physical components, and environmental factors to ensure optimal placement and practical support for all intervention components. In the second phase, usability testing was conducted. Following the completion of physical and environmental feasibility assessments, participants engaged in the IPRES experience and subsequently completed the SUS and PSSUQ scales.

RESULTS

The study identified several system issues and implemented improvements, including adjustments to the recumbent bike, enhancements to the tablet messaging interface, and improvements in network stability. These factors could impact the level of patient engagement and willingness to participate in rehabilitation. Additionally, usability testing indicated that participants rated the equipment, ease of operation, and user experience highly. Nonetheless, a number of details still require further refinement.

CONCLUSIONS

The feasibility and usability assessments revealed that the IPRES was rated by participants as intuitive and easy to use, with high satisfaction with and acceptance of the system. Although some details still require improvement, these surveys and qualitative data analysis provide deeper insights into the needs of telePR and essential design factors.

CLINICALTRIAL

This research was approved by the Research Ethics Committee of the Chang Gung Medical Foundation (IRB NO. 202200070B0).