Gustafsson Louise, Fleming Jennifer, Cornwell Petrea, Worrall Linda, Brauer Sandra
School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Brisbane, Queensland, Australia.
Top Stroke Rehabil. 2014 Sep-Oct;21(5):413-20. doi: 10.1310/tsr2105-413.
Client-centered practice in stroke rehabilitation is strongly influenced by interprofessional team functioning and collaborative goal setting. The hospital context is problematic for client-centered practice and reduces the ability of the health care team and client with stroke to appreciate the impact of stroke on functioning within the home environment.
The purpose of this study was to trial Stroke Rehabilitation Enhancing and Guiding Transition Home (STRENGTH), an approach to rehabilitation that provides clients, carers, and hospital-based therapists with weekly opportunities to develop goals and undertake therapy sessions in the home and community before hospital discharge.
Nine participants, comprising 3 occupational therapists, 4 physiotherapists, and 2 speech pathologists, completed a custom-made survey and participated in a semi-structured focus group at the completion of the 6-month trial of STRENGTH. The survey and focus group questioned the participants on their experiences and impressions of STRENGTH.
Inductive thematic analysis of the focus group identified 2 themes: "influences of context on team functioning" and "experiences of the program." The quantitative data supported the value of STRENGTH for team functioning and client outcomes.
The findings provide an overall endorsement for STRENGTH from the therapists' perspectives and highlight the positive impact of environmental context on team functioning, collaborative goal setting, and ultimately client-centered practice.
以患者为中心的卒中康复实践受到跨专业团队协作及共同目标设定的显著影响。医院环境对以患者为中心的实践存在问题,降低了医疗团队和卒中患者认识卒中对家庭环境中功能影响的能力。
本研究旨在试验“增强并指导卒中康复回家过渡(STRENGTH)”方法,这是一种康复方法,为患者、护理人员和医院治疗师提供每周一次的机会,在出院前在家庭和社区中制定目标并进行治疗。
9名参与者,包括3名职业治疗师、4名物理治疗师和2名言语病理学家,在“STRENGTH”6个月试验结束时完成了一份定制调查问卷,并参加了一次半结构化焦点小组讨论。调查问卷和焦点小组讨论询问了参与者对“STRENGTH”的体验和印象。
焦点小组的归纳主题分析确定了2个主题:“环境对团队协作的影响”和“项目体验”。定量数据支持了STRENGTH对团队协作和患者结局的价值。
研究结果从治疗师的角度总体认可了“STRENGTH”,并强调了环境背景对团队协作、共同目标设定以及最终以患者为中心的实践的积极影响。