Primary caregivers’ satisfaction on the provision of Speech and Language Therapy services for adults via telehealth in Sri Lankan Clinical Context

Abstract

Background: With the emergence of the COVID-19 pandemic, telehealth services became prominent as the main mode of service delivery, though it was not promptly practiced in Sri Lanka before. Therefore, speech and language therapists have started using social media platforms and social communication applications to deliver their services. In this context, the current study was conducted to determine the feasibility of utilizing telehealth for speech- language therapy services for adults with communication and swallowing difficulties in Sri Lanka. Mostly, adults with communication and swallowing difficulties may require support from a caregiver to facilitate telehealth sessions. Objectives: The study aimed 1-to determine the primary caregivers’ level of satisfaction on receiving speech- language therapy services for adults via telehealth, 2-to determine the socio-demographic factors which influence the primary caregivers’ level of satisfaction and 3- to identify the advantages and the limitations of telehealth from the perception of the primary caregivers. Methods: A mixed method study was conducted with one hundred and seven (n=107) participants who were identified from the two main adult rehabilitation hospitals and one private clinic in Sri Lanka. Study participants were Sinhala or English-speaking primary caregivers who had assisted the clients in receiving speech-language telehealth services. Every participant was asked to complete a self-administered online questionnaire which includes the adapted version of the "TeleMedicine Perception Questionnaire” (TMPQ), which was used as the main data collection instrument. Participants’ perceptions on the advantages and limitations of telehealth practices and the participants’ suggestions to overcome the limitations were collected as qualitative data. Quantitative data was analyzed using SPSS version 26.0 software. Qualitative data analysis was conducted using a simple thematic analysis to identify the themes of advantages and limitations and suggestions of telehealth practice as perceived by the caregivers. Results: The mean total score (mean=75, SD= +2.76) of the TMPQ scale revealed that most of the primary caregivers were satisfied with the service delivered. A significant negative correlation between the age of the primary caregiver and the TMPQ total score was found (r=-.27, p=.006). When comparing the mean TMPQ scores, a significant difference was reported between caregivers who are siblings of the client and caregivers who are the offspring of the client (F (3.103) = 3.107, p = .030). The satisfaction level was more when the caregiver was an offspring (mean= 75.50, SD= + 2.38) of the client than it was a sibling (mean = 72.43, SD = + 4.392). Qualitative thematic analysis revealed cost-effectiveness, time effectiveness and safety of the client due to minimum exposure to COVID were the most common advantages perceived by the primary caregivers in Sri Lanka. Conclusion: According to the researchers’ understanding, this is the first study conducted to evaluate caregivers’ perceptions on telehealth in speech-language therapy in Sri Lanka. As in any other challenging situation, there are novel and innovative approaches that people develop to continue their lifestyle. During this pandemic, the world has witnessed the utilizing of modern technology for improved healthcare provision, including various telehealth practice modes. Even in an under-resourced country like Sri Lanka, the families are satisfied with the care they received for their loved ones through telehealth modes.