Why is rehabilitation not yet fully person-centred and should it be more person-centred?

Gzil, Fabrice; Lefève, Céline; Cammelli, Michele; Pachoud, Bernard; Ravaud, Jean‐François; Leplège, Alain

doi:10.1080/09638280701618620

Cited by 65 publications

(49 citation statements)

References 17 publications

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“…A move toward a client-centred, caring, strengths-based approach may help rehabilitation be more individualised and promote engagement in rehabilitation [6,30]. It is possible that starting by getting to know the person and their story, and maintaining a focus on working alongside a person, rather than doing to, may be one way to operationalise a client-centred approach to rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Implementing a client-centred approach in rehabilitation: an autoethnography

Bright

Boland

Rutherford

et al. 2011

Disability and Rehabilitation

100

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Purpose: Client-centred practice is widely considered a key element of rehabilitation.However, there is limited discussion of how it should be implemented. This study explored how client-centred practice was operationalised during a clinical trial of innovative goalsetting techniques.Method: This study drew on principles of co-autoethnography. The personal experiences of three clinical researchers were explored to identify insights into client-centred practice, and seek understanding of this within the broader socio-cultural context. Data were collected through group discussions and written reflections. Thematic analysis and coding were used to identify the dominant themes from the data. Results:The primary way that client-centred practice was operationalised was through listening in order to get to know, to uncover and to understand what was meaningful. Four strategies were identified: utilising mindful listening, allowing time, supporting clients to prioritise what is meaningful and viewing the therapists' role differently.Conclusion: Whilst technical competence in rehabilitation is important, our study suggested a starting point of 'being with' rather than 'doing to' may be beneficial for engaging people in their rehabilitation. We have highlighted a number of practical strategies that can be used to facilitate more client-centred practice. These approaches are consistent with what clients report they want and need from rehabilitation services.

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Section: Discussionmentioning

confidence: 99%

Implementing a client-centred approach in rehabilitation: an autoethnography

Bright

Boland

Rutherford

et al. 2011

Disability and Rehabilitation

100

View full text Add to dashboard Cite

show abstract

“…While widely recognized that providing patients with greater choice and control over decisions is advantageous (Gzil et al, 2007), the application of this patient-centred approach raises difficulties, such as potential conflicts between service priorities and available resources (Turner-Stokes, 2007). Further guidance is needed to translate recommendations from 'rhetoric to reality' (Wise, 2011:343).…”

Section: Introductionmentioning

confidence: 97%

‘Finding a Balance’ in Involving Patients in Goal Setting Early After Stroke: A Physiotherapy Perspective

Lloyd

Roberts

Freeman

2013

Physiotherapy Res Intl

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Physiotherapists perceived that collaborating with patients in goal setting was important but challenging. Goal setting interactions with other professionals, patients and families were perceived as complex, difficult and requiring significant effort. The importance of individuality and temporality were recognized suggesting that the goal setting approach needs to be adapted to the context and the individuals involved.

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“…1 Person-centeredness represents a key aspect of best practice in health care, not only from the viewpoint of professional conduct and ethics, but also for the quality and efficacy of rehabilitation. 2 Person-centeredness implies that for optimal health care, it is necessary to consider the patients' insider perspective, the individual perception of functioning and the affected persons' own perception of individual needs and goals. This information can make an essential contribution to assessment, goal setting and assignment of interventions, and to evaluation and documentation in rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

The individual experience of functioning and disability in Switzerland—patient perspective and person-centeredness in spinal cord injury

et al. 2011

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Study design: Qualitative, multi-center study. Objectives: The objective of this study is to explore the aspects of functioning and disability that are relevant to individuals with spinal cord injury (SCI), using a comprehensive approach based on the International Classification of Functioning, Disability and Health (ICF). Methods: Forty-nine people with SCI from early post-acute and long-term rehabilitation settings participated in nine focus groups. Five open-ended questions based on the ICF were used to initiate discussion about relevant Body Functions and Structures, Activities and Participation, Environmental and Personal Factors. The focus groups were audiotaped and the recording was transcribed verbatim. Qualitative analyses included the identification, extraction and coding of meaningful concepts from the transcribed dialogue. Concepts were coded according to established rules using ICF categories and were summarized semi-quantitatively. Results: In the analysis, 1582 different concepts were identified. For coding one concept, an average of 1.4 ICF categories was used. This resulted in 2235 concept-ICF category links, 1068 in the early postacute and 1167 in the long-term context, respectively. For the coding, 274 out of the 1454 categories contained in the ICF were used. Conclusion: The ICF coding showed the broad range of relevant aspects in the functioning experience of persons with SCI. Besides body limitations (especially paralysis and pain), the most relevant concepts covered mainly barriers in physical environment, assistive devices and social support, as well as the impact on everyday life regarding leisure and work. The resulting list of ICF categories can be helpful in facilitating person-centered clinical care and research.

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Why is rehabilitation not yet fully person-centred and should it be more person-centred?

Cited by 65 publications

References 17 publications

Implementing a client-centred approach in rehabilitation: an autoethnography

Implementing a client-centred approach in rehabilitation: an autoethnography

‘Finding a Balance’ in Involving Patients in Goal Setting Early After Stroke: A Physiotherapy Perspective

The individual experience of functioning and disability in Switzerland—patient perspective and person-centeredness in spinal cord injury

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