Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.
Department of Health and Social Welfare, Drammen Municipiality, Norway.
Health Soc Care Community. 2019 Jul;27(4):907-916. doi: 10.1111/hsc.12708. Epub 2018 Dec 26.
Many welfare states offer reablement, also known as restorative care, as an intervention to promote healthy ageing and support older adults in regaining or maintaining their independence in daily life. Reablement is a time-limited, intensive, multidisciplinary, person-centred and goal-directed rehabilitative intervention. Reablement emanates from the user's goals, thus user-involvement is a key factor. The aim of our study was to explore healthcare professionals' experiences of user-involvement in reablement. The context for the study was an urban municipality in south-eastern Norway where reablement had been implemented into home-care services 1.5 years prior to the study. Eighteen healthcare professionals recruited from home-care services participated in focus groups. The material was analysed using qualitative content analysis. The findings resulted in one main theme: Transforming user-involvement from ideal to reality-a demanding process, and four sub-themes: (a) An ideal of self-determination and co-operation; (b) Diverse ability to commit to what user-involvement requires; (c) Continuous co-creation processes; and (d) Challenged by old traditions. User-involvement is a valued ideal that professionals strive towards when providing healthcare. Two main strategies that professionals use to enable user-involvement were identified here: spending sufficient time and having patience with users during the initial stage of an intervention, and starting an intervention by introducing small tasks that users can master. It was also seen that if the time and arenas for interdisciplinary meetings were lacking, professionals could demonstrate traditional attitudes and practice when faced with limited user-involvement in the intervention. There is a need for follow-up over time at the structural, personal, and cultural levels to develop reablement as an intervention with a strong person-centred approach. The findings of this study have relevance for practice development in several reablement settings.
许多福利国家提供康复治疗,也称为恢复性护理,作为促进健康老龄化和支持老年人在日常生活中重新获得或保持独立的干预措施。康复治疗是一种限时、强化、多学科、以患者为中心和以目标为导向的康复干预措施。康复治疗源于患者的目标,因此患者参与是一个关键因素。我们的研究目的是探讨医疗保健专业人员在康复治疗中患者参与的经验。研究背景是挪威东南部的一个城市自治市,在研究之前的 1.5 年,康复治疗已经被纳入家庭护理服务中。从家庭护理服务中招募了 18 名医疗保健专业人员参加焦点小组。使用定性内容分析对材料进行分析。研究结果得出一个主要主题:将患者参与从理想转变为现实——一个具有挑战性的过程,以及四个副标题:(a)自主和合作的理想;(b)对患者参与所需内容的承诺能力参差不齐;(c)持续的共同创造过程;(d)受到旧传统的挑战。患者参与是医疗保健专业人员提供医疗保健时所追求的有价值的理想。研究人员确定了专业人员使用的两种主要策略来实现患者参与:在干预的初始阶段,花足够的时间和耐心与患者在一起,并通过引入用户可以掌握的小任务开始干预。还可以看出,如果缺乏跨学科会议的时间和场所,专业人员在干预中患者参与度有限的情况下,可能会表现出传统的态度和做法。需要在结构、个人和文化层面进行长期跟踪,以发展以患者为中心的康复治疗干预措施。本研究的结果对几个康复治疗环境的实践发展具有相关性。