The goal of this feasibility study is to explore rehabilitation outcomes, usability and user experience of a web-based platform for delivering treatment for cognitive and language impairment amongst adults with acquired neurological disorders in critical illness and stroke disorders. The main question it aims to answer is: " Is it feasible to use a web-based platform for delivering rehabilitation treatment in a large acute National Health Care Organisation" Participants will undergo therapy sessions prescribed by therapists on a web-based platform instead of the conventional paper-based therapy sessions for their cognitive and speech rehabilitation needs.
The population group will be adult patients admitted to critical care unit and stroke unit and diagnosed to have speech and cognitive impairment. The intervention is to provide therapy prescribed by therapist through Cognishine, a web-based platform instead of paper-based therapy session. The primary objective is to assess feasibility of using the Cognishine web-based platform in a large NHS Trust in acute care setting measured by number of completed therapy sessions, per patient days.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
80
The Cognishine platform is a digital (web-based) general health and wellness monitoring platform. It is designed to support health care professionals specialised in rehabilitation of patients with neurological disorders, through a wide range of multi-media based generalised activities across speech, language, social-emotional, and cognition.
Liverpool University Hospitals NHS Foundation Trust
Liverpool, United Kingdom
RECRUITINGTo assess the feasibility of using the Cognishine web-based platform in a large NHS Trust in acute care setting.
Total number of completed sessions per patient on the cognishine platform
Time frame: From recruitment until discharge from rehabilitation therapy or discharge from hospital, which ever comes first. Time frames will vary dependent on patient recovery .The anticipated time frame is 1 to 6 months. Maximum follow up is 12 months.
To assess staff and patient experience of using the Cognishine platform during therapy sessions.
Patients \& therapists will be asked to complete the Mobile Health App Usability Questionnaire (MAUQ)for Interactive Mobile Health Apps used by patients. The questionnaire is designed and validated to evaluate the usability of interactive health apps from the users perspective. The MAUQ questionnaire comprises of 21 questions which cover 3 main usability domains. 1. Ease of use-Navigation, learnability and clarity. 2. Interface and satisfaction-Visual appeal, confidence and overall satisfaction. 3. Usefulness-Perceived value and effectiveness in helping users achieve their health goals. Scoring is via a 7 point Likert scale (1 - strongly disagree, 2 - disagree, 3 - somewhat disagree, 4 - neither agree nor disagree, 5 - somewhat agree, 6 -agree, 7 - strongly agree.),with higher scores indicating greater usability and satisfaction.
Time frame: Patients will be asked to complete this on discharge from hospital. Therapists will be asked to complete the questionnaire one month after starting the study (in the middle of recruitment)
To generate qualitative data about how to improve the end user experience for therapist to target barriers to implementation
Focus groups composed of therapists who have used the platform will be asked to provide end user information about using the system. This qualitative data will be used to improve the platform.
Time frame: 12 month into the study.
To generate preliminary data on the rehabilitation progress associated with the use of the Cognishine platform.
The Montreal Cognitive Assessment (MoCA) is a standard clinical measurement tool. The tool comprises assessment of visuospatial/executive functions ,naming, memory, attention, language ,abstraction and orientation. The scoring range is 0-30,with higher scores indicating better cognition, scores of \<26 indicating possible cognitive impairment. Scores will be collected from clinical notes at initial assessment and at discharge from rehabilitation therapy.
Time frame: As recovery is highly individualised time frames will vary amongst participants .It is anticipated that the time frame will range from 1 to 6 months.
To generate preliminary data on the rehabilitation progress associated with the use of the Cognishine platform.
The Oxford Cognitive Screen(OCS) is specifically for stroke patients and reduces visual or language bias. It assesses attention, executive function, memory, language, number processing and praxis. Each domain is scored with results interpreted as impaired or not impaired. Scores from clinical notes will be collected at initial assessment and at discharge from rehabilitation therapy.
Time frame: As recovery is highly individualised time frames will vary amongst participants .It is anticipated that the time frame will range from 1 to 6 months
To generate preliminary data on the rehabilitation progress associated with the use of the Cognishine platform.
The Orientation log(O-Log) score measures orientation, time place and situation. 10 items are measured , with each item scoring 0-3.The scoring range is 0-30,with higher scores reflecting better function. Scores \<25 indicate disorientation. Scores will be collected at initial assessment and at discharge from rehabilitation therapy
Time frame: As recovery is highly individualised time frames will vary amongst participants .It is anticipated that the time frame will range from 1 to 6 months.
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