부산대학교 도서관

Introduction:While speech rehabilitation therapy (SRT) for stroke survivors with residual speech and cognitive impairment is standard of care, SRT delivered in person in the clinic imposes several burdens on stroke survivors and their care partners. This is especially true with more frequent, higher intensity SRT. SRT delivered via telehealth has the potential to mitigate such travel-related financial, physical stress and psychological stress burdens.Hypothesis:The High-Intensity Tele-speech Therapy for Stroke (HITTS) pilot program will reduce burden for the stroke survivor:care partner dyad compared with in-person visits.Methods:We adapted evidence-based aphasia therapies implemented into a telehealth delivery model for four stroke survivor:care partner dyads over a six-week period. Following an initial face-to-face evaluation, skilled SRT was delivered via telehealth for five hours per week. The projected cost of travel between their home and VA medical center (VAMC) was obtained via VA Managerial Accounting System. Appointment preparation and travel time was calculated based on a combination of dyad report and GoogleMaps. All completed a survey at the end of HITTS regarding potential value of HITTS, perceived burden, and open text fields.Results:HITTS saved dyads (mean ± SD) both money ($370.96 ± 63.26) and time (16.47 ± 3.55 hours) over the six-week period. Increased burden was commonly reported for in-person appointments but not for telehealth appointments. Patients more commonly reported physical burden of attending in-person appointments whereas care partners more commonly reported psychological burden (Table).Conclusions:Dyad burden was not associated with a high intensity STR program, likely attributable to the reduction in resources required to attend in-person visits. HITTS is a promising healthcare delivery model which can also promote social distancing and reduce COVID exposure for high-risk stroke patients and their care partners.