Chang L H, Hasselkus B R
School of Occupational Therapy, National Cheng-Kung University, Tainan, Taiwan.
Am J Occup Ther. 1998 Sep;52(8):629-37. doi: 10.5014/ajot.52.8.629.
The purpose of this study was to gain understanding of the satisfactions and dissatisfactions in the work of occupational therapists with clients after stroke.
Data consisted of narrative descriptions by 32 therapists of especially satisfying and dissatisfying experiences in practice. Phenomenology and grounded theory strategies were used for the study design and data analysis.
"Expectation" emerged as the core meaning of occupational therapy in stroke rehabilitation. Strong satisfaction was expressed when therapist-informants believed that they had fulfilled their expectations for clients to achieve the following: (a) maximum neuromuscular and functional recovery in affected upper extremities; (b) independence in daily activities; and (c) return to living in the community. Major sources of informants' dissatisfactions were reaching the "plateau" stage of neurological recovery, disagreement between therapist expectations and client and family member expectations, and working with clients perceived as poorly motivated.
American ideologies about the value of hard work, independence, and self-sufficiency appear to strongly shape therapists' expectations, satisfaction, and dissatisfaction in stroke rehabilitation. For occupational therapists, a tension may exist between the idealism of their therapeutic expectations and the realities of stroke recovery as it is experienced within the context of clients' ongoing lives.
本研究旨在了解职业治疗师对中风后患者工作的满意与不满意之处。
数据由32名治疗师对实践中特别满意和不满意经历的叙述性描述组成。研究设计和数据分析采用现象学和扎根理论策略。
“期望”成为中风康复中职业治疗的核心意义。当提供信息的治疗师认为他们实现了对患者的以下期望时，表达了强烈的满意度：(a) 患侧上肢最大程度的神经肌肉和功能恢复；(b) 日常生活中的独立性；(c) 回归社区生活。提供信息者不满意的主要原因是达到神经恢复的“平台期”、治疗师期望与患者及家属期望之间的分歧，以及与积极性不高的患者合作。
美国关于努力工作、独立和自给自足价值的观念似乎强烈影响着治疗师对中风康复的期望、满意和不满意。对于职业治疗师来说，他们治疗期望的理想主义与患者实际生活中中风恢复的现实之间可能存在矛盾。
