Existential struggle and self‐reported needs of patients in rehabilitation

Abstract

Title. Existential struggle and self-reported needs of patients in rehabilitation Aim. This paper is a report of a study to increase understanding of patients' experience of rehabilitation and their self-reported needs in that context. Background. Nurses need to be able to recognize patient needs to plan effective and individualized care. Needs-led nursing care is emphasized in the nursing literature, but few studies in rehabilitation have explored needs from the patient's perspective.Method. The sample of this phenomenological study was purposively selected and the data consisted of 16 in-depth interviews with 12 people aged between 26 and 85 years. The data were collected in 2005. Findings. The findings showed that being a patient in rehabilitation involves existential struggling, as the reason behind patients' rehabilitation, accident or illness usually leads to trying to cope with existential changes while needing to adapt to new characteristics of life and self. This makes patients vulnerable and their selfreported needs include individualized caring and emotional support from family, peers and staff. Participants also reported a need for a sense of security in a stable and homelike environment, with assistance, help and presence. Finally, they reported needing goal-oriented and progressive care in which realistic and achievable goals were established. Individualized patient education enhanced their independence and empowered them towards a new and progressive lifestyle. Conclusion. A new emphasis is needed in rehabilitation nursing, involving assessment of existential well-being of patients by means of skilful interpersonal relationship based on individualized caring and emotional support and recognition of each patient's own hierarchy of needs.

Exacerbated vulnerability in existential changes: the essence of dealing with reduced working capacity

“…Negative thoughts had the opposite effect on the participants' recovery. In a qualitative study about people's experience of rehabilitation, Sigurgeirsdottir and Halldorsdottir (2007) found that the participants felt they needed to hold on to faith, hope, and optimism as an essential aspect of adapting to a new self and getting through the difficulties involved with dealing with sudden illness or accident. This is comparable to the participants in our study, who also claimed how joy and humor had positive effects and made daily life easier, a finding also supported by Koch et al (2005).…”

“…Encounters characterized by uncaring attitudes, lack of counseling and lack of support disempowered them, increased their vulnerability and negatively affected their recovery. It is important in counseling to support and encourage clients to build new ideas about themselves and their possibilities and help them to find new ways Sharf, 2002). This exacerbated vulnerability and need for counseling and support must be illuminated in further studies.…”

“…An individual's view of her or his own capability can affect career development (Krumboltz & Henderson, 2001;Sharf, 2002). Theorists in school and employment counseling emphasize that individuals can respond effectively to unexpected changes in their careers in order to adapt and cope (Savickas, 2005;Super & Knasel, 1981).…”

“…When people face an unexpected and difficult situation, such as dealing with reduced working capacity, it is important for them to believe in their own capacity, and to stay positive. It can influence how easily they find suitable activity (Savickas, 2000;Sharf, 2002). To be able to work again, individuals must remain active when undergoing rehabilitation (Amundson, 2003;Jacobs & Blustein, 2008).…”

“…That view is determined by their experience and shapes their perception of the opportunities presented at each time. It is important in counseling to support and encourage clients to develop new ideas about themselves and their opportunities and help the individuals to find new ways Sharf, 2002).…”