Department of Epidemiology and Preventive Medicine, Monash University, , 3004 Melbourne, Australia.
J Rehabil Med. 2019 Feb 1;51(2):120-126. doi: 10.2340/16501977-2500.
To understand clients' experiences of the recovery journey through the compensation system and to identify areas and strategies for quality improvement.
A qualitative study of 23 participants with physical or mental disabilities caused by traffic accidents, which occurred, on average, 4 years ago. Purposive sampling of long-term recovery clients who made a compensation claim after their injuries was applied until data saturation was reached. Data were collected using semi-structured interviews and analysed through conventional thematic analysis.
This study demonstrated that recovery is a complex phenomenon that can be impacted by numerous challenges of navigating the compensation system and using its services. Clients perceived the compensation provider as limited in rules around which services they could access. A common perception amongst clients was that the compensation provider did not have the capacity and knowledge to understand health and recovery processes nor did it provide adequate guidelines or instructions that would assist clients with their recovery. Many clients dealt with numerous case managers and felt insufficiently informed on what to expect and do, which led to a lack of trust in rehabilitation management and case managers' decisions. According to clients, financial impacts were neglected and not addressed effectively. Many clients felt abandoned by the system which led to perceived feelings of desertion and negligence.
Understanding modifiable barriers to recovery in compensation systems presents opportunities to amend current practices and consider a holistic, person-centred care approach. It is apparent that improved recovery management, communication and adequate provision of guidelines are needed to meet clients' needs and facilitate better outcomes. A person-centred care approach is likely to improve quality of life and help clients navigate the compensation system more effectively with assistance from health and compensation professionals, who should be actively involved in their recovery processes.
了解客户在赔偿制度下的康复体验，并确定质量改进的领域和策略。
对 23 名因交通事故导致身体或精神残疾的参与者进行了一项定性研究，这些参与者平均在 4 年前发生了事故。采用有目的地对长期康复的客户进行抽样，这些客户在受伤后提出了赔偿要求，直到达到数据饱和为止。使用半结构化访谈收集数据，并通过常规主题分析进行分析。
本研究表明，康复是一个复杂的现象，可能会受到许多挑战的影响，如赔偿系统的使用和服务的使用。客户认为赔偿提供者在他们可以获得的服务方面受到规则的限制。客户普遍认为，赔偿提供者没有能力和知识来理解健康和康复过程，也没有提供足够的指导方针或说明来帮助客户康复。许多客户与许多案件经理打交道，对自己的期望和应该做什么了解不足，这导致他们对康复管理和案件经理的决策缺乏信任。根据客户的说法，财务影响被忽视，没有得到有效处理。许多客户感到被系统抛弃，导致他们感到被遗弃和忽视。
了解赔偿系统中可改变的康复障碍为修改当前做法和考虑整体的、以患者为中心的护理方法提供了机会。显然，需要改进康复管理、沟通和充分提供指导方针，以满足客户的需求，并促进更好的结果。以患者为中心的护理方法可能会提高生活质量，并帮助患者在健康和赔偿专业人员的帮助下更有效地应对赔偿系统，这些专业人员应该积极参与他们的康复过程。
