Best practice recommendations for physiotherapists providing telerehabilitation to First Nations people: a modified Delphi study

Abstract

Objectives

This study aimed to develop best practice recommendations for physiotherapists providing telerehabilitation to First Nations people.

Design

Modified Delphi study.

Participants

Eighteen experts from four groups were selected: (a) physiotherapists who provide telerehabilitation to First Nations people, (b) Carrier Sekani Family Services leaders (CSFS, First Nations-led health organization/research partners), (c) telehealth experts from British Columbia (BC), Canada, and (d) First Nations individuals (end users) with experience in telerehabilitation.

Methods

Panelists rated recommendations on telehealth best practices in two rounds using an online questionnaire. Recommendations were synthesized from a scoping review and two qualitative studies. Each statement was rated on a four-point Likert scale indicating whether it was essential, useful, not useful, or unnecessary for inclusion in the best practices. Statements endorsed by ≥80% of panel members were considered for inclusion in the final document.

Results

Following the Delphi process, 77 recommendations covering foundational components, information technology utilization, professional expertise, therapeutic relationships, cultural safety, and the telehealth visit were validated for inclusion in the policy document. Participants also validated the methodology.

Conclusion

The recommendations offer a valuable resource for continuing education and professional development, empowering physiotherapists to enhance their skills and competencies in delivering culturally competent telerehabilitation to the First Nations population. The adoption of these best practices ensures that First Nations people are getting the best standard of care, potentially enhancing uptake and experiences with telehealth. It also enables healthcare organizations and policymakers to monitor adherence to established standards and identify areas for improvement.

Contribution of the Paper

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  This paper provides best practice recommendations for physiotherapists delivering telerehabilitation to First Nations people, addressing unique cultural aspects and virtual relationship building.
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  The study offers physiotherapists expert guidance to enhance the quality and cultural appropriateness of telerehabilitation services for First Nations populations.
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  The recommendations serve as a valuable resource for continuing education and professional development, enabling physiotherapists to deliver culturally competent and effective care.
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  These best practices facilitate accountability and quality assurance, helping healthcare organizations and policymakers monitor adherence to standards and identify areas for improvement.