Maitra Kinsuk K, Erway Frances
Occupational Therapy Department, College of Health Science, Collier Building-4216, Medical University of Ohio, 3015 Arlington Avenue, Toledo, Ohio 43614-5803, USA.
Am J Occup Ther. 2006 May-Jun;60(3):298-310. doi: 10.5014/ajot.60.3.298.
The purpose of this study was to comparatively analyze the perceptions of clients and occupational therapists regarding their involvement in the process of client-centered practice.
Participants (11 occupational therapists, 30 clients) in adult/geriatric health care facilities were each engaged in a semistructured interview to determine their perceptions of client-centered practice, specifically in the goal-setting process. Descriptive statistics were used to analyze the item data. In addition, one-way analysis of variance was computed to identify the differences of opinions in clients and occupational therapists on the process of client-centered practice in four facilities: long-term-care or rehabilitation, hospital outpatient, hospital inpatient, and nursing homes.
The occupational therapists in this study indicated use of the principles of client-centered practice in their delivery of occupational therapy services. Their clients, however, displayed mixed perceptions about their role as active participants in client-centered practice and all responded in the negative when asked if they were aware of the approach. Perceptual differences existed between the occupational therapists and their clients in relation to the use of client-centered practice, because their responses to similar questions varied. Last, type of facility significantly influenced clients' knowledge of certain aspects of their treatment processes in the following four areas: (a) treatment goal selection, (b) encouragement provided in setting clients' goals, (c) clients' perception of the importance in the goal-setting process, and (d) education of clients about their participatory role in the goal-setting process.
Results suggest that a perceptual gap exists between occupational therapists and their clients in relation to their stated use of and participation in client-centered practice. In light of the results, development of a systematic strategy by occupational therapists to elicit the roles that their clients desire to play in the therapeutic process may be an effective intervention to ensure that occupational therapists and their clients are able to fulfill their roles in client-centered practice.
本研究旨在比较分析客户和职业治疗师对他们参与以客户为中心的实践过程的看法。
对成人/老年保健机构的参与者（11名职业治疗师、30名客户）分别进行半结构化访谈，以确定他们对以客户为中心的实践的看法，特别是在目标设定过程中的看法。使用描述性统计分析项目数据。此外，进行单因素方差分析，以确定四个机构（长期护理或康复机构、医院门诊、医院住院部和疗养院）的客户和职业治疗师在以客户为中心的实践过程中的意见差异。
本研究中的职业治疗师表示在提供职业治疗服务时采用了以客户为中心的实践原则。然而，他们的客户对自己作为以客户为中心的实践中的积极参与者的角色看法不一，当被问及是否了解该方法时，所有人的回答都是否定的。职业治疗师和他们的客户在以客户为中心的实践的使用方面存在认知差异，因为他们对类似问题的回答各不相同。最后，机构类型在以下四个方面显著影响客户对其治疗过程某些方面的了解：（a）治疗目标选择，（b）设定客户目标时提供的鼓励，（c）客户对目标设定过程重要性的认知，以及（d）关于客户在目标设定过程中参与角色的教育。
结果表明，职业治疗师和他们的客户在他们所宣称的对以客户为中心的实践的使用和参与方面存在认知差距。鉴于这些结果，职业治疗师制定一种系统策略以引出客户在治疗过程中希望扮演的角色，可能是一种有效的干预措施，以确保职业治疗师和他们的客户能够在以客户为中心的实践中履行各自的角色。
