Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
Disabil Rehabil. 2022 Nov;44(23):7134-7144. doi: 10.1080/09638288.2021.1984591. Epub 2021 Oct 6.
To propose a holistic approach and an accompanying tool to facilitate conversations about expectations of therapy in pediatric rehabilitation based on meanings generated through metaphor.
In this study, five parents and nine service providers took part in narrative interviews. Topics included the content and development of expectations over time. Participants reviewed written summaries of their interviews and provided feedback. Data analysis was grounded in a narrative methodological approach. Multiple levels of meaning from participant experiences were constructed through a parallel thematic analysis and metaphor analysis, revealing meaning participants attributed to expectations directly, and inferred indirectly.
The thematic analysis produced three themes related to the difficult to define characteristics and mixed value of expectations. The metaphor analysis produced four metaphorical concepts related to how expectations affect the therapy process by adding a sense of Force (i.e., therapy momentum), Appreciation (i.e., understanding of the client), Illumination (i.e., envisioning new therapy activities), and Relationship (i.e., therapeutic rapport).
We propose the "F.A.I.R." approach and tool comprising terminology that can help reframe the meaning of expectations away from focusing on binary realistic or unrealistic outcomes, and toward focusing on a plurality of optimal therapy processes.Implications for RehabilitationMeaningful conversations about expectations for therapy between parents and service providers in pediatric rehabilitation can be challenging, one-sided, or missed.Attention to metaphors used to describe expectations for therapy introduces additional terminology parents and service providers may use to help facilitate conversations.Service providers are encouraged to use a resource proposed here to learn about parents' expectations for therapy through a collaborative process involving shared questioning, observation, and reflection.
提出一种整体方法和配套工具，以基于隐喻所产生的意义，促进儿科康复治疗期望的对话。
在这项研究中，5 名家长和 9 名服务提供者参与了叙事访谈。主题包括随着时间的推移期望的内容和发展。参与者回顾了他们访谈的书面总结，并提供了反馈。数据分析基于叙事方法学方法。通过平行主题分析和隐喻分析构建了参与者经验的多层次意义，直接揭示了参与者对期望赋予的意义，并间接推断出隐喻。
主题分析产生了三个与期望的难以定义特征和混合价值相关的主题。隐喻分析产生了四个隐喻概念，涉及期望如何通过增加力量感（即治疗动力）、欣赏（即理解客户）、启发（即设想新的治疗活动）和关系（即治疗融洽）来影响治疗过程。
我们提出了“F.A.I.R.”方法和工具，其中包括术语，可以帮助重新构建期望的含义，避免关注二元现实或不现实的结果，而是关注多种最佳治疗过程。
康复意义 儿科康复中父母和服务提供者之间关于治疗期望的有意义对话可能具有挑战性、片面性或被忽视。关注用于描述治疗期望的隐喻，可以为父母和服务提供者提供更多的术语，以帮助促进对话。鼓励服务提供者使用这里提出的资源，通过涉及共同提问、观察和反思的协作过程，了解父母对治疗的期望。
