A Framework for Patient-Centered Design in Remote Medical Rehabilitation Programs

Thesis Abstract

The increasing adoption of remote medical rehabilitation (RMR) programs necessitates the development of patient-centered frameworks that enhance engagement, adherence, and clinical outcomes. Despite the proliferation of telehealth services, there remains a significant gap in systematically integrating patient preferences, experiences, and needs into the design of RMR interventions. This study aims to develop and validate a comprehensive framework for patient-centered design in remote medical rehabilitation programs, with specific objectives to (1) identify key patient-centered elements influencing RMR effectiveness, (2) explore healthcare professionals' and patients’ perspectives on optimal design features, and (3) synthesize these insights into a practical and theoretically grounded framework. Employing a mixed-methods research design, the study integrates qualitative and quantitative approaches to ensure a holistic understanding of patient-centered factors in RMR. The qualitative phase involves semi-structured interviews with 30 patients undergoing various forms of remote rehabilitation (e.g., stroke, musculoskeletal, neurological conditions) and 15 healthcare providers experienced in tele-rehabilitation services. Thematic analysis, guided by the Self-Determination Theory and the Technology Acceptance Model, is used to identify core patient-centric themes and design principles. The quantitative phase deploys a structured survey instrument, developed based on the qualitative findings, to a larger sample of 200 patients across multiple clinics, and employs exploratory factor analysis and multiple regression analysis to validate the framework components and assess their predictive validity regarding patient satisfaction and adherence. Preliminary expected findings indicate that patient-centered design elements, including personalized goal-setting, user-friendly interfaces, real-time feedback, and culturally sensitive communication practices, significantly influence patient engagement and perceived quality of care. The study anticipates identifying a set of core constructs—such as autonomy support, usability, trust, and motivational factors—that form the basis of the proposed framework. The integration of qualitative insights with quantitative validation aims to produce a theoretically sound and practically applicable model that informs both the design of RMR systems and clinical practice guidelines. The contribution to knowledge resides in offering a novel, empirically validated framework that explicitly incorporates patient perspectives into the engineering and implementation of remote rehabilitation programs. This framework bridges the gap between existing technological solutions and the nuanced needs of diverse patient populations, thereby promoting more inclusive and effective tele-rehabilitation strategies. It advances the understanding of how patient-centered principles can be operationalized in digital health environments, aligning technological innovation with human-centered care. Main conclusions suggest that adopting a patient-centered design approach enhances patient satisfaction, improves adherence to prescribed regimens, and ultimately leads to better health outcomes. Consequently, the study recommends the integration of the framework into the development of tele-rehabilitation technologies, training programs for healthcare providers, and policy formulations that prioritize patient engagement in remote care settings. Future research directions include longitudinal assessments of the framework's impact on clinical outcomes and explorations of its applicability across different healthcare systems and cultural contexts.