Listening to the client voice - A constructivist grounded theory study of the experiences of client-centred practice after stroke.

Abstract:

INTRODUCTION:Collaboration, choice and power-sharing are cornerstones of practice as occupational therapists support individuals to re-establish an occupational identity and reintegrate into the community following stroke. Yet evidence of unmet client needs suggests client-centred care is not optimal, and little is known of client perspectives of client-centred practice. A deeper understanding of the client experience of therapeutic relationships during adjustment following stroke, will help facilitate client-centred practice. This paper reports on a study exploring the research question: how do stroke survivors perceive their relationship with their health care team as they adjust to life following stroke? METHODS:In this constructivist grounded theory study, in-depth interviews were conducted with six adult stroke survivors from South-East Queensland, Australia. Transcribed interviews were analysed using a constant comparative approach, identifying emerging concepts and patterns, to construct a theoretical understanding of the experience and meaning of adjustment and reintegration back into the community, with a specific focus on perceptions of therapeutic relationships and client-centred practice. RESULTS:Participant perspectives of client-centred care during their rehabilitation following stroke were revealed and implications of this for their recovery identified. Themes of being understood; out of the driver's seat; knowing what's going on; and what I need when I need it emerged. Participants described not being: involved in decision making, provided with information, or receiving services aligned to their needs. Periods of frustration, loss of hope and fluctuating motivation were also common. CONCLUSION:Findings shed further light on previously reported health service and discharge experiences. The insight gained into individual experiences of client-centred care following stroke suggest ways therapists can understand and address each client's adjustment experience and the impact this has on their needs, goal-setting, motivation, and confidence. Client-centred care must be grounded in client reality.

journal_name

Aust Occup Ther J

authors

Walder K,Molineux M

doi

10.1111/1440-1630.12627

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

100-109

issue

2

eissn

0045-0766

issn

1440-1630

journal_volume

67

pub_type

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