Client-Centred Practice: What does it Mean and Does it Make a Difference?

Law, Mary; Baptiste, Sue; Mills, Jennifer N.

doi:10.1177/000841749506200504

Cited by 383 publications

(299 citation statements)

References 22 publications

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“…Discriminative measurement tools were used frequently for nerve injuries, tendon injuries and fractures of the upper limb; these are also used by hand surgeons and other health professionals which suggest possible duplication in the assessments conducted with clients. The lack of emphasis on assessments of activity and participation by occupational therapists, is worrying considering that this is a fundamental goal of occupational therapy 2,7,8 .…”

Section: Discussionmentioning

confidence: 99%

Occupational therapy hand assessment practices: Cause for concern?

Klerk

Buchanan

Pretorius

2015

S. Afr. j. occup. ther

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Introduction: Assessment is critical for measuring improvement, or lack thereof, and demonstrating the outcome of intervention. In response to the lack of research in this area, this study aimed to determine the assessment practices of occupational therapists working with clients with hand conditions. Methods: A quantitative cross sectional survey design was used. A convenience sample of occupational therapists was recruited from five provinces. Respondents completed a questionnaire developed for the study that comprised demographic information, assessments used, frequency of use and factors influencing assessment choice. Data were analysed with Statistica version 11. Results: Eighty-one respondents (n=114) completed questionnaires representing a 71% response rate. Goniometry (84.0%), manual muscle testing (76.5%) and testing for flexor tendon function (76.3%) were used most frequently. The most common reasons for not using assessments were lack of availability and unfamiliarity. Conclusion: It is of concern that the assessment practices of participants in this study focussed primarily on the assessment of body function and structure with few therapists using activity and participation measures. This could seriously limit the evidence needed to verify the outcomes achieved through occupational therapy intervention in the treatment of hand conditions.evidence of the interventions provided 5 . If therapists do not assess, they will not be able to produce evidence of the effects of the interventions offered which poses a threat to funding of services. This claim is supported in the Western Cape Department of Health Healthcare 2030 plan 6 that states that there will be an increased move towards outcome based intervention with priority being given to interventions aimed at desirable outcomes. At the time of conducting this study, no research to determine the assessment practices of occupational therapists working with hand conditions within South Africa had been published. Assessment practices are understood to encompass the type of assessment used, the frequency of use and the reasons for non-use within a particular area of practice. This study therefore set out to provide an updated account of these practices by South African occupational therapists working with clients with hand conditions. LITERATURE REVIEWA client-centred approach should be applied in assessment to obtain a "careful understanding" of the individual before starting occupational therapy intervention 7:253 . This type of approach is more likely to ensure that the client is engaged in the occupational therapy process which will encourage greater client cooperation 8 . In a client-centred approach, the client and therapist work together to establish the occupational performance problems and to set goals for the required intervention. Assessment has to take place for this to be possible. Standardised assessment provides quantitative information, useful for tracking the client's progress and demonstrating the outcome of therapy 44United Kingdom the au...

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Section: Discussionmentioning

confidence: 99%

Occupational therapy hand assessment practices: Cause for concern?

Klerk

Buchanan

Pretorius

2015

S. Afr. j. occup. ther

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“…[75][76][77][78][79] Moreover, time and resources are optimized when attention is focused on those issues of greatest importance to the client. 80 Although it might be argued that institutional demands for rapid throughputs and standardized efficiencies can militate against an individualized, needs-led approach to rehabilitation for people with SCI, the fact that the participants in the reviewed studies cited so many examples of practice excellence suggests that accountability and compassion are not inherently incompatible.…”

Section: Discussionmentioning

confidence: 99%

Experience of rehabilitation following spinal cord injury: a meta-synthesis of qualitative findings

Hammell¹

2007

Spinal Cord

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Study design: Meta-synthesis of qualitative research. Objectives: To identify, compare and synthesize published qualitative evidence concerning the experience of rehabilitation following spinal cord injury (SCI). Methods: Published articles were identified from the Medline, CINAHL and Sociological abstracts databases, a hand search through selected journals published since 1990, and from reference lists. These were assessed for their relevance to the focus of interest and appraised for rigour. The key themes that emerged from the data were summarized, compared and synthesized. Results: The search located 64 papers and four books, of which eight papers (describing seven studies) met the review criteria for relevance and rigour. Thematic comparison and synthesis resulted in the identification of seven concepts that encapsulate the important dimensions of rehabilitation from participants' perspectives: (1) the importance of specific staff qualities; (2) the need for a vision of future life possibilities; (3) the importance of peers; (4) the relevance of programme content; (5) the institutional context of rehabilitation; (6) the importance of reconnecting the past to the future; (7) the importance of meeting the needs of the real world. Conclusions: If rehabilitation services are to be evidence-based, relevant and effective in meeting the needs of people with SCI they must be informed by the perspectives of people with SCI. The findings of this review suggest that the most important dimension of rehabilitation for people with SCI is the calibre and vision of the rehabilitation staff.

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“…Research evidence demonstrates that clientcentred practice leads to improved outcomes and heightened client satisfaction. 115 Further, it would seem that a focus upon modifying individuals may be less important than efforts to modify environments. Quality in living for this group of people had been enabled by social policy initiatives that included universal health care, direct funding for personal assistants (wherein people with severe impairments receive money directly from the government with which to hire the personal assistants of their choice), accessible public transportation and housing; provision of high technology equipment and sip-and-puff power wheelchairs, access to education and employment options and financial support.…”

Section: Discussionmentioning

confidence: 99%

Quality of life among people with high spinal cord injury living in the community

Hammell¹

2004

Spinal Cord

110

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Study Design: An exploratory, qualitative methodology. Objectives: To explore perceptions of quality of life (QOL) among community-dwelling people with high spinal cord injuries (SCI) and the factors they identified as contributing to, enabling or constraining the quality of their lives. Setting: Urban communities on Vancouver Island and in the lower mainland of British Columbia, Canada. Methods: Semi-structured interviews with both men (n ¼ 11) and women (n ¼ 4) with complete high SCI (C1-C4). Interpretive analysis was grounded in the themes that arose from the interview transcripts. Results: Time since injury ranged from 4 to 28 years. The mean current age was 35 years, with a range from 21 to 50 years of age. High SCI disrupted not just a body but an entire biography of plans, daily activities and valued occupations. Initially feeling helpless and useless, the participants were unanimously glad to be alive at the time of the study and several described perceptions of very high QOL. The themes which emerged from the data were over-lapping and inter-dependent and described a process of refocusing values and re-establishing a view of the self as able and valuable following injury. The three primary themes addressed issues of autonomy, the meaningful use of time, and relationships. Conclusions: The study findings suggest that life with a high SCI can be rich and fulfilling if society is prepared to enable and support this; and that QOL outcomes might be maximized by adopting a biographical orientation to the rehabilitation process.

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Client-Centred Practice: What does it Mean and Does it Make a Difference?

Cited by 383 publications

References 22 publications

Occupational therapy hand assessment practices: Cause for concern?

Occupational therapy hand assessment practices: Cause for concern?

Experience of rehabilitation following spinal cord injury: a meta-synthesis of qualitative findings

Quality of life among people with high spinal cord injury living in the community

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