Telerehabilitering in Prevention of Pressure Ulcer Recurrence after Flap Surgery in Individuals with Spinal Cord Injury

State of the Art and Project Objectives: Individuals with spinal cord injury (SCI) are at high risk of developing pressure ulcers due to reduced mobility and skin sensation, with 20-30% experiencing ulcers at least once in their lifetime. Plastic surgical flap procedures can be effective but carry a high risk of complications, including recurrence. The need for digital telerehabilitation (TELERESCI) is critical to enhance collaboration, knowledge-sharing, and user involvement in preventing pressure ulcer recurrence post-surgery. Findings from this study may improve health and quality of life for SCI patients and benefit other groups. Novelty and Ambition: This is the first study exploring experiences with a digital follow-up program for SCI patients after flap surgery. TELERESCI provides structured telerehabilitation using video conferencing and digital resources within the first post-operative year, ensuring tailored follow-up, improved collaboration among healthcare providers, and knowledge-sharing. The program includes webinars, wound care videos, and e-learning courses to promote user participation, competence sharing, and motivation for prevention. The study aims to establish a user-centered digital health service to improve collaboration between specialist and municipal healthcare, boost user and professional competence, and address challenges like healthcare workforce shortages. The study includes 40 participants, including at least 10 spinal cord injury (SCI) patients, their relatives, healthcare professionals, and leaders from both specialist and municipal healthcare services. Participants must be over 18, have undergone flap surgery for pressure ulcers, and have been admitted to a Norwegian spinal unit. Healthcare professionals are selected based on their involvement in post-operative care. The study employs a qualitative design with three work packages based on the updated Medical Research Council (MRC) framework for complex interventions: Exploring user and relative experiences with TELERESCI, focusing on participation, collaboration, and motivation (10 users, 5-10 relatives). Understanding the knowledge needs and experiences of healthcare providers and leaders regarding collaboration and telerehabilitation organization (15 professionals/leaders). Identifying factors that influence the implementation of TELERESCI through workshops (20 participants including users, relatives, and professionals). Risks involve participant time and resource demands for interviews and workshops. However, the training provided outweighs the burden. Technical and logistical challenges are mitigated with IT support and previous study experience. Ethical considerations include voluntary participation, written consent, secure data storage, and adherence to guidelines from ethical committees. The project is supported by national organizations and healthcare leaders, ensuring thorough planning and execution.