Johansson Karin, Borell Lena, Lilja Margareta
Division of Occupational Therapy, Department NVS, Karolinska Institutet, Huddinge, Sweden.
Scand J Occup Ther. 2009;16(4):227-37. doi: 10.3109/11038120802684307.
Home modifications are part of the occupational therapy interventions provided to persons with functional limitations in the home environment. Home modification services often involve many different actors, and persons experiencing a need for home modifications have to navigate through a network of service organizations and professional actors. The aim of this study was to explore and describe how older adults in one Swedish municipality tried to find their way and navigate through the service system in order to receive home modification services that could meet their experienced needs. A case study design was used, including four older adults with different experiences and expectations of home modification services. The relationship between the participants' expectations, experiences, and their ways to navigate through the service system was described through the metaphor of a "geographical map". Satisfaction with the service process was found when there was a match in understandings of responsibilities and eligibility between what could be read from the older persons' map and the professionals' perspective. The findings have implications for client-centred occupational therapy practice, indicating that this match can be achieved when professionals translate clients' experienced problems in everyday life into a terminology that fits into the service system.
家庭改造是为家庭环境中存在功能限制的人提供的职业治疗干预措施的一部分。家庭改造服务通常涉及许多不同的参与者,有家庭改造需求的人必须在服务组织和专业人员组成的网络中周旋。本研究的目的是探索和描述瑞典一个市镇的老年人如何试图找到门路并在服务系统中周旋,以获得能够满足他们实际需求的家庭改造服务。采用了案例研究设计,包括四名对家庭改造服务有不同经历和期望的老年人。通过 “地理地图” 的比喻描述了参与者的期望、经历与他们在服务系统中周旋方式之间的关系。当从老年人的 “地图” 中读出的责任和资格理解与专业人员的观点相匹配时,就会发现对服务过程感到满意。研究结果对以客户为中心的职业治疗实践具有启示意义,表明当专业人员将客户在日常生活中遇到的实际问题转化为适合服务系统的术语时,就可以实现这种匹配。