Implementação de um protocolo de avaliação biopsicossocial via videochamada em pacientes com doença pulmonar intersiticial: análise da viabilidade, satisfação, barreiras e facilitadores da aplicação por avaliação remota

Abstract

Introduction: Telehealth, including telerehabilitation, enables the remote delivery of care for individuals with Interstitial Lung Disease (ILD), improving access to and adherence to healthcare services. However, its implementation requires the assessment of factors such as connectivity, technological resources, and user satisfaction. Objective: To evaluate the usability of a biopsychosocial protocol delivered via video calling in individuals with ILD, considering feasibility, satisfaction, and factors associated with remote assessment. Methods: A mixed-methods study was conducted in two phases. Initially, clinical and psychosocial data were collected using self-reported instruments to assess body function, emotional status, activities, participation, and environmental factors. Subsequently, open-ended questions were administered to explore barriers and facilitators to remote assessment, followed by an evaluation of usability using the TUQ-Brazil. Quantitative analysis included means, standard deviations, frequencies, and participation and completion rates. Qualitative analysis was conducted using thematic analysis, involving data familiarization, coding, and categorization. Results: Remote assessment demonstrated high usability, acceptability, and feasibility among individuals with ILD. Most participants considered the approach feasible (93.5%), reported having internet access, and experienced minimal difficulty using technology. Usability perceptions were favorable across all TUQ-Brazil domains, although greater variability was observed in responses related to equivalence with in-person care and video quality. Usability was significantly associated with income (rho = 0.437; p = 0.014), perceived feasibility of the approach (rho = −0.397; p = 0.027), and the perceived intensity of access barriers (rho = −0.428; p = 0.016). The main challenges included connectivity issues, the absence of a physical examination, limited digital literacy and digital security, and the need for assistance from a third party when using the technology. Key facilitators included time and cost savings, accessibility, communication with the healthcare professional, and interaction with the system. Overall, remote assessment was perceived as a complementary strategy to in-person care, particularly for follow-up and triage, rather than as a complete substitute for face-to-face assessment. Conclusion: Remote assessment delivered via video call demonstrated generally positive perceptions of usability, as well as acceptability and feasibility, among individuals with ILD. The findings suggest that this approach may improve access to healthcare services and inform the cautious implementation of hybrid assessment models, particularly for triage, follow-up, symptom monitoring, and biopsychosocial assessment using PROMs in the presence of geographic or logistical barriers. However, its implementation should consider factors related to connectivity, digital literacy, technical 12 support, and the need for an in-person physical examination, supporting its use as a complementary rather than substitutive strategy for in-person care.