Healthcare professionals’ beliefs, attitudes, and thoughts toward cardiopulmonary telerehabilitation: A mixed-methods study

Healthcare professionals' opinions, attitudes, and thoughts toward new digital healthcare are often overlooked. However, they play a crucial role in accepting new digital care strategies. This research aimed to understand the perceptions of cardiopulmonary rehabilitation professionals towards telerehabilitation by conducting a mixed-method study at various Fondazione Don Carlo Gnocchi centers in Italy. A total of 14 healthcare workers, including 7 experts in telerehabilitation, participated through surveys and semi-structured focus groups, covering 12 thematic areas derived from the Theoretical Domains Framework (knowledge; professional role; beliefs about capabilities; beliefs about consequences; optimism; reinforcement, goals; memory, attention, and decision process; environmental context and resources; social influences; emotions; ideal patient's profile). Participants (mean age = 45.00 ± 9.06; M:F = 3:11) shared diverse experiences and views on telerehabilitation. All participants had a good knowledge of telerehabilitation. While non-experts indicated technological expertise and preserved cognitive level as a prerequisite for telerehabilitation use, experts believed that no ideal patient exists and that all people can benefit from it. They converged in defining it as a new delivery path of rehabilitation with the same objective of face-to-face rehabilitation services, enhancing the patient's quality of life. Environmental, infrastructural, and institutional resources are needed to enhance accessibility. Positive attitude, optimism, and expectation were reported, but uncertainties about how to manage safety issues and increased workload were mentioned. The study showed a complex picture of staff rehabilitation beliefs about telerehabilitation. Overall, telerehabilitation was considered a great opportunity for patients who face barriers to in-person clinical interventions.