a Department of Physical Therapy , Hospital Gelderse Vallei , Ede , The Netherlands.
b Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare , Nijmegen , The Netherlands.
Disabil Rehabil. 2018 May;40(10):1220-1226. doi: 10.1080/09638288.2017.1290153. Epub 2017 Feb 24.
To get insight into personal meaning of a person involved in a physical therapy intervention.
Mrs. A, a 76-year-old woman is referred to a physical therapist (PT) for assessment of functioning and training before total hip arthroplasty (THA). The patient, her daughter, and PT were asked to write a story about their daily life. Stories were analyzed according to the narrative scheme based on a method to find meaning in daily life, which consists of four phases: 1. Motivation; 2. Competences; 3. Performance; and 4.
Mrs. A was mainly motivated by her will to do enjoyable social activities and stay independent. Although she tried her best to undertake activities (performance) that made her proud (evaluation), her pain and physical limitations were anti-competences that motivated her to attend healthcare. Although the PT seemed to be aware of personal participation goals, her main motivation was to improve and evaluate functions and activities. The daughter was motivated by good relationships and did not see herself as informal caregiver.
The narrative method was a valuable tool to clarify motivations, competences, and values in the process of creating personal meaning related to functioning. This knowledge could help caregivers in applying patient-centered goal-setting and treatment on a participation level. Implications for rehabilitation Personal meaning of people's functioning within their daily context can be clarified from daily life stories. This case report demonstrates that motivations and goals may differ between patient and therapist; the PT seems to focus on improving and evaluating functions and activities, while the patient seems to focus her motivations and personal meaning on participation. This approach may help in patient-centered goal-setting at the level of activities and participation.
深入了解参与物理治疗干预的个人的意义。
一位 76 岁的妇女 A 女士被转介给物理治疗师 (PT)，以评估她在全髋关节置换术 (THA) 前的功能和训练情况。要求患者、她的女儿和 PT 写一个关于他们日常生活的故事。根据基于在日常生活中寻找意义的方法的叙事方案分析故事，该方法包括四个阶段：1.动机；2.能力；3.表现；4.。
A 女士的主要动机是她渴望参加愉快的社交活动并保持独立。尽管她尽力承担让她感到自豪的活动（表现）（评估），但她的疼痛和身体限制是反能力，促使她接受医疗保健。尽管 PT 似乎意识到个人参与目标，但她的主要动机是改善和评估功能和活动。女儿的动机是良好的关系，并不认为自己是非正式的照顾者。
叙事方法是澄清与功能相关的个人意义过程中的动机、能力和价值观的有用工具。这些知识可以帮助护理人员在参与层面上应用以患者为中心的目标设定和治疗。
可以从日常生活故事中阐明人们在日常生活背景下的功能的个人意义。本案例报告表明，患者和治疗师之间的动机和目标可能不同；PT 似乎专注于改善和评估功能和活动，而患者似乎专注于参与的动机和个人意义。这种方法可能有助于以活动和参与为基础的以患者为中心的目标设定。
