Abstract：
BACKGROUND: Digital interventions are becoming increasingly popular in rehabilitation. Understanding of device features which impact clinician adoption and satisfaction is limited. Research in the field should be conducted across diverse settings to ensure digital interventions do not exacerbate healthcare inequities.
OBJECTIVE: This study aimed to understand rehabilitation clinicians\' preferences regarding device attributes and included a cross-cultural comparison.
METHODS: Choice experiment methodology (best-worst scaling) was used to survey rehabilitation clinicians across Australia and Brazil. Participants completed 10 best-worst questions, choosing the most and least important device attributes from subsets of 31 attributes in a partially balanced block design. Results were analysed using multinomial models by country and latent class. Attribute preference scores (PS) were scaled to 0-100 (least to most important).
RESULTS: A total of 122 clinicians from Brazil and 104 clinicians from Australia completed the survey. Most respondents were physiotherapists (83%) working with neurological populations (51%) in the private/self-employed sector (51%) who had experience using rehabilitation devices (87%). Despite preference heterogeneity across country and work sector (public/not-for-profit versus private/self-employed/other), clinicians consistently prioritised patient outcomes (PS 100.0, 95%CI: 86.2-100.0), patient engagement (PS 93.9, 95%CI: 80.6-94.2), usability (PS 81.3, 95%CI: 68.8-82.5), research evidence (PS 80.4, 95%CI: 68.1-81.7) and risk (PS 75.7, 95%CI: 63.8-77.3). In Australia, clinicians favoured device attributes which facilitate increased therapy dosage (PS 79.2, 95%CI: 62.6-81.1) and encourage patient independent practice (PS 66.8, 95%CI: 52.0-69.2). In Brazil, clinicians preferred attributes enabling device use for providing clinical data (PS 67.6, 95%CI: 51.8-70.9) and conducting clinical assessments (PS 65.6, 95%CI: 50.2-68.8).
CONCLUSIONS: Clinicians prioritise patients\' needs and practical application over technical aspects of digital rehabilitation devices. Contextual factors shape clinician preferences rather than individual clinician characteristics. Future device design and research should consider preferences and influences, involving diverse stakeholders to account for context-driven variations across cultures and healthcare settings.
OBJECTIVE: This study aimed to understand rehabilitation clinicians\' preferences regarding device attributes and included a cross-cultural comparison.
METHODS: Choice experiment methodology (best-worst scaling) was used to survey rehabilitation clinicians across Australia and Brazil. Participants completed 10 best-worst questions, choosing the most and least important device attributes from subsets of 31 attributes in a partially balanced block design. Results were analysed using multinomial models by country and latent class. Attribute preference scores (PS) were scaled to 0-100 (least to most important).
RESULTS: A total of 122 clinicians from Brazil and 104 clinicians from Australia completed the survey. Most respondents were physiotherapists (83%) working with neurological populations (51%) in the private/self-employed sector (51%) who had experience using rehabilitation devices (87%). Despite preference heterogeneity across country and work sector (public/not-for-profit versus private/self-employed/other), clinicians consistently prioritised patient outcomes (PS 100.0, 95%CI: 86.2-100.0), patient engagement (PS 93.9, 95%CI: 80.6-94.2), usability (PS 81.3, 95%CI: 68.8-82.5), research evidence (PS 80.4, 95%CI: 68.1-81.7) and risk (PS 75.7, 95%CI: 63.8-77.3). In Australia, clinicians favoured device attributes which facilitate increased therapy dosage (PS 79.2, 95%CI: 62.6-81.1) and encourage patient independent practice (PS 66.8, 95%CI: 52.0-69.2). In Brazil, clinicians preferred attributes enabling device use for providing clinical data (PS 67.6, 95%CI: 51.8-70.9) and conducting clinical assessments (PS 65.6, 95%CI: 50.2-68.8).
CONCLUSIONS: Clinicians prioritise patients\' needs and practical application over technical aspects of digital rehabilitation devices. Contextual factors shape clinician preferences rather than individual clinician characteristics. Future device design and research should consider preferences and influences, involving diverse stakeholders to account for context-driven variations across cultures and healthcare settings.
摘要：
背景：数字干预在康复中变得越来越流行。对影响临床医生采用和满意度的设备特征的理解是有限的。该领域的研究应在不同的环境中进行，以确保数字干预不会加剧医疗保健不平等。
目的：本研究旨在了解康复临床医生对器械属性的偏好，并包括跨文化比较。
方法：选择实验方法（最佳-最差量表）用于调查澳大利亚和巴西的康复临床医生。参与者完成了10个最佳-最差的问题，在部分平衡块设计中，从31个属性的子集中选择最重要和最不重要的设备属性。使用多项式模型按国家和潜在类别分析结果。属性偏好得分(PS)被缩放为0-100(至少到最重要)。
结果：共有122名来自巴西的临床医生和104名来自澳大利亚的临床医生完成了调查。大多数受访者是物理治疗师（83％），与私人/自雇部门（51％）的神经系统人群（51％）一起工作，他们有使用康复设备的经验（87％）。尽管国家和工作部门的偏好异质性(公共/非营利与私人/自雇/其他)，临床医生始终优先考虑患者的预后（PS100.0，95CI：86.2-100.0），患者参与度（PS93.9，95CI：80.6-94.2），可用性（PS81.3，95CI：68.8-82.5），研究证据（PS80.4，95CI：68.1-81.7）和风险（PS75.7，95CI：63.8-77.3）。在澳大利亚,临床医生青睐有助于增加治疗剂量的器械属性(PS79.2,95CI:62.6-81.1),并鼓励患者独立实践(PS66.8,95CI:52.0-69.2).在巴西,临床医生首选能够使用器械提供临床数据(PS67.6,95CI:51.8~70.9)和进行临床评估(PS65.6,95CI:50.2~68.8)的属性.
结论：临床医生优先考虑患者的需求和实际应用，而不是数字康复设备的技术方面。背景因素决定了临床医生的偏好而不是个体临床医生的特征。未来的设备设计和研究应考虑偏好和影响，让不同的利益相关者参与进来，以解释不同文化和医疗环境的上下文驱动的变化。
目的：本研究旨在了解康复临床医生对器械属性的偏好，并包括跨文化比较。
方法：选择实验方法（最佳-最差量表）用于调查澳大利亚和巴西的康复临床医生。参与者完成了10个最佳-最差的问题，在部分平衡块设计中，从31个属性的子集中选择最重要和最不重要的设备属性。使用多项式模型按国家和潜在类别分析结果。属性偏好得分(PS)被缩放为0-100(至少到最重要)。
结果：共有122名来自巴西的临床医生和104名来自澳大利亚的临床医生完成了调查。大多数受访者是物理治疗师（83％），与私人/自雇部门（51％）的神经系统人群（51％）一起工作，他们有使用康复设备的经验（87％）。尽管国家和工作部门的偏好异质性(公共/非营利与私人/自雇/其他)，临床医生始终优先考虑患者的预后（PS100.0，95CI：86.2-100.0），患者参与度（PS93.9，95CI：80.6-94.2），可用性（PS81.3，95CI：68.8-82.5），研究证据（PS80.4，95CI：68.1-81.7）和风险（PS75.7，95CI：63.8-77.3）。在澳大利亚,临床医生青睐有助于增加治疗剂量的器械属性(PS79.2,95CI:62.6-81.1),并鼓励患者独立实践(PS66.8,95CI:52.0-69.2).在巴西,临床医生首选能够使用器械提供临床数据(PS67.6,95CI:51.8~70.9)和进行临床评估(PS65.6,95CI:50.2~68.8)的属性.
结论：临床医生优先考虑患者的需求和实际应用，而不是数字康复设备的技术方面。背景因素决定了临床医生的偏好而不是个体临床医生的特征。未来的设备设计和研究应考虑偏好和影响，让不同的利益相关者参与进来，以解释不同文化和医疗环境的上下文驱动的变化。
