User involvement and experiential knowledge in interprofessional rehabilitation: a grounded theory study

Slomic, Mirela; Christiansen, Bjørg; Søberg, Helene Lundgaard; Sveen, Unni

doi:10.1186/s12913-016-1808-5

Cited by 19 publications

(21 citation statements)

References 26 publications

(37 reference statements)

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“…There is no information on the extent to which the participants in the present study were involved in such shared decision-making nor on healthcare services that can be defined as person-centred. However, in previous studies both patients [58] and staff [59] have described the informal parts of the patient-staff relationship, such as human connectedness and incorporating the patients' experiential knowledge in daily rehabilitation https://doi.org/10.1371/journal.pone.0227867.t001 Table 2. Final logistic regression models for the association of the independent variables and met needs with regard to the 11 problem areas, odds ratios (OR) and 95% confidence intervals (CI).…”

Section: Discussionmentioning

confidence: 99%

Factors related to met needs for rehabilitation 6 years after stroke

et al. 2020

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Introduction Research on stroke rehabilitation mainly concerns the first year of recovery, and there is a lack of knowledge regarding long-term rehabilitation needs and associated factors. Aim The aim was to explore the perceived needs for rehabilitation services of people six years after stroke and factors associated with having rehabilitation services needs met. Methods The study was a 6-year follow up of a prospective study on the rehabilitation process after stroke. Data on perceived needs for rehabilitation, personal factors, disease specific factors, and patient-reported disability were collected through face-to-face interviews in the participants' homes. Logistic regression models were created to explore associations between having rehabilitation services needs met in 11 problem areas (dependent variable) and the independent variables: involvement in decisions regarding care and treatment, sex, age, sense of coherence, self-defined level of private financing, stroke severity, frequency of social everyday activities, perceived impact of stroke, and life satisfaction. Results The 121 participants had a mean age of 63 years at stroke onset and 58% were men. In all problem areas the majority (53-88%) reported having needs met at six years after stroke, however 47% reported unmet needs regarding fatigue and 45% regarding mobility. A lower perceived impact on participation was found to be associated with having rehabilitation services needs met in seven problem areas: mobility, falls, pain, fatigue, concentration, memory, and sight. The strongest association for having needs met was found for the independent variable, involvement in care and treatment, within the three problem areas mobility, falls, and speaking.

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Section: Discussionmentioning

confidence: 99%

Factors related to met needs for rehabilitation 6 years after stroke

et al. 2020

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“…Specifically, research has been aimed at identifying selfmanagement strategies. Engaging in sports activities and having a good day and night rhythm are examples of strategies that are perceived as helpful when coping with depression [26,36,37]. Collectively, the results indicate that deploying self-management strategies can provide a positive contribution to recovery and coping with depression, such as lower depressive symptoms, an improvement of self-efficacy, and empowerment [20,22,27].…”

Section: Introductionmentioning

confidence: 92%

An exploration of the conditions for deploying self-management strategies: a qualitative study of experiential knowledge in depression

et al. 2020

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Background Living with recurrent, and/or chronic depression requires long-term management in addition to active coping on a day-to-day basis. Previous research on long-term management, and coping with depression mainly focused on identifying self-management strategies. However, research on the conditions for deploying self-management strategies in depression is lacking. By means of exploring the development of experiential knowledge in depression, and its relation with coping with depression, this study aims to gain insight into the conditions for deploying self-management strategies. Methods In the current qualitative study, individual pathways to recovery, living with depression, and recurrence risk were assessed, including but not limited to long-term management. ‘Experiential knowledge’, which can be defined as patients’ unique knowledge and own lived experiences in facilitating and debilitating factors in the recovery process and coping with the disorder, was used as a sensitizing concept. Thirteen semi-structured interviews were conducted with individuals who experienced at least two depressive episodes and were currently in (partial) remission, plus two deviant cases were interviewed to check for saturation. Until saturation was achieved, participants were purposively selected to include diverse perspectives on coping with depression. Data were analysed using a narrative research method. Results The results show that deploying self-management strategies are an integral part of ‘experiential knowledge’. The evolvement of experiential knowledge can be seen as a cyclical process of the main themes that were identified as relevant when coping with depression: introspection, empowerment, self-management strategies, and external moderators of the environment. The identification of supporting and impeding factors in coping with depression from a patient perspective might increase a sustainable use of self-management strategies. Conclusion These results highlight the need for an individualised holistic model of coping with depression, both in research, and in practice. By means of integrating experiential knowledge in this holistic approach, the conditions for deployment of self-management strategies in depressive patients can be specified.

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“…However, patients and healthcare professionals did have different views of how to actually co-produce. While the importance of combining patients’ experiential knowledge with professionals’ expert knowledge [ 37 ] was enthusiastically reflected upon by patients, healthcare professionals did not fully recognise these as two equally important knowledge bases. In this matter, healthcare professionals’ opinions were somewhat ambiguous.…”

Section: Discussionmentioning

confidence: 99%

Patient involvement in quality improvement – a ‘tug of war’ or a dialogue in a learning process to improve healthcare?

Bergerum

Engström

Thor

et al. 2020

BMC Health Serv Res

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Background Co-production and co-design approaches to quality improvement (QI) efforts are gaining momentum in healthcare. Yet, these approaches can be challenging, not least when it comes to patient involvement. The aim of this study was to examine what might influence QI efforts in which patients are involved, as experienced by the patients and the healthcare professionals involved. Methods This study involved a qualitative design inspired by the constructivist grounded theory. In one mid-sized Swedish hospital’s patient process organisation, data was collected from six QI teams that involved patients in their QI efforts, addressing care paths for patients with transient, chronic and/or multiple parallel diagnoses. Field notes were collected from participant observations during 53 QI team meetings in three of the six patient processes. Individual, semi-structured interviews were conducted with 12 patients and 12 healthcare professionals in all the six QI teams. Results Patients were involved in QI efforts in different ways. In three of the QI teams, patient representatives attended team meetings regularly. One team consulted patient representatives on a single occasion, one team collected patient preferences structurally from individual interviews with patients, and one team combined interviews and a workshop with patients. The patients’ and healthcare professionals’ expressions of what might influence the QI efforts involving patients were similar in several ways. QI team members emphasized the importance of organisational structure and culture. Furthermore, they expressed a desire for ongoing interaction between patients and healthcare professionals in healthcare QI. Conclusions QI team members recognised continuous dialogue and collective thinking by the sharing of experiences and preferences between patients and healthcare professionals as essential for achieving better matches between healthcare resources and patient needs in their QI efforts. Significant structural and cultural aspects of performing QI in complex hospital organisations were considered to be obstructions to progress. Therefore, to sustain learning and behaviour change through QI efforts at the team level, a deeper understanding of how structural and cultural aspects of QI promote or prevent success appears essential.

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User involvement and experiential knowledge in interprofessional rehabilitation: a grounded theory study

Cited by 19 publications

References 26 publications

Factors related to met needs for rehabilitation 6 years after stroke

Factors related to met needs for rehabilitation 6 years after stroke

An exploration of the conditions for deploying self-management strategies: a qualitative study of experiential knowledge in depression

Patient involvement in quality improvement – a ‘tug of war’ or a dialogue in a learning process to improve healthcare?

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