Van de Veldea Dominique, Bracke Piet, Van Hove Geert, Josephsson Staffan, Vanderstraeten Guy
Department of RehabilitationSciences and Physiotherapy, Ghent University, Ghent, Belgium.
Int J Rehabil Res. 2010 Dec;33(4):346-55. doi: 10.1097/MRR.0b013e32833cdf2a.
It is suggested that participation should be achieved at the end of the rehabilitation process. However, there is a lack of consensus on the definition, the conceptualization and the measurement of participation. This study aims to add to the existing body of knowledge of participation by exploring the 'person perceived participation' in individuals with spinal cord injury (SCI). On the basis of the 'grounded theory' approach, in-depth, semistructured interviews were conducted with 11 SCI patients from a rehabilitation cohort in their transition period from hospital to home, to gain an insider perspective on the concept of participation. Results identified three different categories of participation: social participation, occupational participation and socio occupational participation. The participants conceptualize participation as a set of values, including experiencing free choice to perform activities, performing according to the person's identity, experiencing personal growth, belonging by experiencing trust and security, feeling validated, having a sense of control, experiencing a sense of importance and finding equal identities. In conclusion, from a client perspective, participation is a complex,multidimensional construct and can be considered asa dyad between the individual's social interactions and his specific activities performed. Participation was not experienced by the SCI patients as an objective way of performing activities within a societal context or as frequencies of activities performed, but rather as an internal process of negotiation that seemed to be based on balancing personal and societal values.
建议在康复过程结束时实现参与。然而,在参与的定义、概念化和测量方面缺乏共识。本研究旨在通过探索脊髓损伤(SCI)个体的“个人感知参与”来增加现有的参与知识体系。基于“扎根理论”方法,对11名处于从医院到家庭过渡期的康复队列中的SCI患者进行了深入的半结构化访谈,以获得关于参与概念的内部视角。结果确定了三种不同类型的参与:社会参与、职业参与和社会职业参与。参与者将参与概念化为一组价值观,包括体验自由选择进行活动、根据个人身份进行活动、体验个人成长、通过体验信任和安全感而归属感、感到被认可、有控制感、体验重要感以及找到平等身份。总之,从患者角度来看,参与是一个复杂的、多维度的结构,可以被视为个体社会互动与其所进行的特定活动之间的二元关系。SCI患者并未将参与体验为在社会背景下进行活动的客观方式或活动执行频率,而是作为一个似乎基于平衡个人和社会价值观的内部协商过程。