Increasing Patient Participation: The Effects of Training Physical and Occupational Therapists to Involve Geriatric Patients in the Concerns-Clarification and Goal-Setting Processes

2009 ◽  
Vol 23 (1) ◽  
pp. 55-63 ◽  
Author(s):  
Bob Tripicchio ◽  
Kris Bykerk ◽  
Curt Wegner ◽  
Jen Wegner
Keyword(s):  
Goal Setting ◽  
Patient Participation ◽  
Geriatric Patients ◽  
Occupational Therapists

Exploring the meaning of value-based occupational therapy services from the perspectives of managers, therapists and clients

2021 ◽  
pp. 030802262110300
Author(s):  
Su Ren Wong ◽  
Bi Xia Ngooi ◽  
Fang Yin Kwa ◽  
Xiang Ting Koh ◽  
Rachel J J Chua ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Goal Setting ◽  
Management Strategies ◽  
Perceived Value ◽  
Occupational Therapists ◽  
Therapeutic Relationships ◽  
Structured Interviews ◽  
Therapeutic Communication ◽  
Main Concept ◽  
Therapy Services

Introduction There is a worldwide trend towards value-based health care, which strives to control healthcare costs while maximising value for clients. The main concept of value has been defined as health outcomes achieved per US dollar spent. This research explored how clients of occupational therapy services, managers and occupational therapists perceived value in occupational therapy services. Method A qualitative design was used to explore the perspectives of clients ( n = 11), occupational therapists ( n = 7) and occupational therapy managers ( n = 7). Appreciative inquiry guided the two phases of semi-structured interviews ( n = 5) and focus groups ( n = 6). Inductive and deductive coding were used to establish themes. Findings Three themes encompassed the participants’ perceived value of occupational therapy services: (1) outcomes which are meaningful to daily life, (2) a constructive client–therapist relationship and (3) affordable, coordinated and understandable therapy. Conclusion Participants attributed value to occupational therapy services when they encountered personalised goal setting, focused on meaningful outcomes, managed personal costs and experienced positive therapeutic relationships. Enhancing services could focus on (1) developing skills in collaborative goal setting, (2) determining suitable outcome measures which are meaningful at personal- and service-level reporting, (3) encouraging self-management strategies, and (4) emphasising therapeutic relationships and supporting therapeutic communication skill development.

scholarly journals Patient Participation in Physical Therapy Goal Setting

2001 ◽  
Vol 81 (5) ◽  
pp. 1118-1126 ◽  
Author(s):  
Susan M Baker ◽  
Helen H Marshak ◽  
Gail T Rice ◽  
Grenith J Zimmerman
Keyword(s):  
Patient Satisfaction ◽  
Physical Therapy ◽  
Elderly Patients ◽  
Goal Setting ◽  
Patient Participation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Assessment Instrument ◽  
Initial Examination ◽  
Goals And Objectives

Abstract Background and Purpose. An important part of treatment planning in physical therapy is effective goal setting. The Guide to Physical Therapist Practice recommends that therapists should identify the patient's goals and objectives during the initial examination in order to maximize outcomes. The purpose of this study was to examine whether therapists seek to involve patients in goal setting and, if so, what methods they use. Therapists' attitudes toward participation and patient satisfaction with the examination were also examined. Subjects and Methods. Twenty-two physical therapists audiotaped the initial examination of 73 elderly patients (X̄=76.4 years of age, SD=7.1, range=65–94). The audiotaped examinations were then scored using the Participation Method Assessment Instrument (PMAI) to determine the frequency of attempts made by therapists to involve patients in goal setting. Therapists and patients completed surveys following the examinations. Results. Therapists' use of participation methods during examinations ranged from a minimum of 1 to a maximum of 19 out of 21 possible items on the PMAI. The therapists stated that they believed that it is important to include patients in goal-setting activities and that outcomes will be improved if patients participate. Patients also indicated that participation is important to them. Discussion and Conclusion. In most cases, the therapists did not fully take advantage of the potential for patient participation in goal setting. Patient and therapist education is needed regarding methods for patient participation during initial goal-setting activities.

scholarly journals Training in client-centeredness enhances occupational therapist documentation on goal setting and client participation in goal setting in the medical records of people with stroke

2016 ◽  
Vol 30 (12) ◽  
pp. 1200-1210 ◽  
Author(s):  
Maria Flink ◽  
Ann-Sofie Bertilsson ◽  
Ulla Johansson ◽  
Susanne Guidetti ◽  
Kerstin Tham ◽  
...  
Keyword(s):  
Goal Setting ◽  
Medical Records ◽  
Controlled Trial ◽  
Occupational Therapists ◽  
Healthcare Setting ◽  
Occupational Therapist ◽  
Control Group ◽  
Stroke Severity ◽  
Client Participation

Objective: The aim of the present study was to compare client-centeredness as it was documented by the occupational therapists in the units randomized to the intervention clusters with documentation by occupational therapists in the control clusters. Design: Comparison of medical records. Setting: The study is conducted in a context of a randomized controlled trial in Sweden, with 16 post-stroke rehabilitation units cluster randomized to intervention or control group. Subjects: Occupational therapist documentation in medical records of 279 clients with stroke. Main measures: The medical records were reviewed for their level of client-centeredness using a protocol developed from the Stewart et al model. The occupational therapists in the intervention groups participated in a workshop training to enhance their client-centeredness. Results: Occupational therapists with training in client-centeredness documented significantly more on goal setting (OR = 4.1; 95% CI, 1.87-8.81), on client participation in goal setting (OR=11.34; 95% CI, 5.97-21.57), on how the goals could be reached (OR=2.8; 95% CI, 1.7-4.62), on client participation in how goals could be reached (OR=4.56; 95% CI, 2.73-7.64), on the follow-up on goals (OR=5.77; 95% CI, 2.78-11-98) and on client participation in follow-up on goals (OR=7.44, 95% CI, 4.33-12.8). This association remained after adjustment for healthcare setting, client socio-demographic variables, and stroke severity. Conclusion: Documentation of goal setting and client participation in goal setting can be influenced by training.

scholarly journals Choice, Voice, and Coproduction in Intermediate Care: Exploring Geriatric Patients’ and Their Relatives’ Perspectives on Patient Participation

SAGE Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 215824401987631 ◽  
Author(s):  
Linda Aimée Hartford Kvæl ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Anne Langaas ◽  
Astrid Bergland
Keyword(s):  
Patient Participation ◽  
Patient Engagement ◽  
Geriatric Patients ◽  
Patient Choice ◽  
Intermediate Care ◽  
Rehabilitation Process ◽  
Compliant Patient

Geriatric patients in intermediate care (IC) often do not feel involved in their rehabilitation process. We conducted interviews with 15 patients and 12 relatives to explore their experiences and preferences regarding patient participation in IC and identify types of patient participation and their potential empowering or disempowering effect. The analysis disclosed a lack of patient choice in a predetermined IC pathway. Being deserving of help meant being sick enough and was associated with the compliant patient who fits the system. Some main additional features were the need of a rehabilitation perspective and patient engagement to enable coproduction as well as the important contribution of relatives as advocates and allies. Finally, the results show the patients’ vulnerable voice in the meeting with the experts’ views. The study will add important knowledge on how staff can contribute to the tailoring of good interventions in IC and improve the understanding of underlying structures.

When Clients are Dying: Occupational Therapists’ Perspectives

1998 ◽  
Vol 18 (1) ◽  
pp. 3-24 ◽  
Author(s):  
Rosalind A. Bye
Keyword(s):  
Occupational Therapy ◽  
Goal Setting ◽  
Participant Observation ◽  
Terminally Ill ◽  
Occupational Therapists ◽  
Daily Practice ◽  
Observation Data ◽  
The Core ◽  
Depth Interview ◽  
Making A Difference

Occupational therapists working with people who are terminally ill potentially face a contradiction between the principles and assumptions of rehabilitation-oriented practice and the needs and experiences of clients who are dying. This research investigated experiences of occupational therapists working with clients who are terminally ill to examine if such a contradiction existed and, if so, how it was managed in daily practice. Ten occupational therapists working with people who are terminally ill shared their perspectives through in-depth interview and participant observation. Data analysis followed grounded theory procedures. Nine conceptual categories were generated from the data: Making a Difference, Referral to Occupational Therapy, Assessing the Situation, Goal Setting, Building Against Loss, “Normality Within a Changed Reality,” Client Control, Supported and Safe Care, and Closure. Analysis of relationships between categories resulted in the development of a conceptual framework of occupational therapy practice with people who are terminally ill. The core phenomenon of the framework emerged as Affirming Life: Preparing for Death. Results indicate that occupational therapists manage this contradiction between their rehabilitation training and their work with people who are dying by reframing the process and outcomes of practice to acknowledge clients’ dual states of living and dying.

Goal Setting Among Experienced and Novice Occupational Therapists in a Rehabilitation Center

2020 ◽  
Vol 87 (4) ◽  
pp. 287-297
Author(s):  
Lea Šuc ◽  
Andreja Švajger ◽  
Urša Bratun
Keyword(s):  
Occupational Therapy ◽  
Goal Setting ◽  
Thematic Analysis ◽  
Work Experience ◽  
Occupational Therapists ◽  
Performance Measure ◽  
Rehabilitation Center ◽  
Occupational Performance ◽  
Canadian Occupational Performance Measure ◽  
Similarities And Differences

Background. Collaborative goal setting is an important part of client-centered occupational therapy. However, not all therapists have comparable skills when it comes to setting goals. Purpose. The aim of our study was to explore the experiences of novice and expert occupational therapists who use the Canadian Occupational Performance Measure in the process of goal setting. Method. This study followed a focused ethnography approach. Four beginners and four experienced occupational therapists were interviewed about their experiences with goal setting. We also observed them during a goal setting session. Data were analyzed using thematic analysis. Findings. The four main themes that emerged from the analysis showed both similarities and differences between novice and experienced therapists, especially in the areas of communication, guidance, and flexibility, as well as dilemmas they were facing. Implications. Our findings challenge the client-centeredness of the participants and the relevance of work experience when it comes to collaborative goal setting.

Selecting from their toolbox of interventions – A realist study of the role of occupational therapists in reablement services

2021 ◽  
pp. 030802262110543
Author(s):  
Lisa Dibsdall
Keyword(s):  
Focus Groups ◽  
Conceptual Framework ◽  
Goal Setting ◽  
Qualitative Case Study ◽  
Occupational Therapists ◽  
Case Study Design ◽  
Shared Purpose ◽  
Synthesis Approach

Introduction Reablement services support people to regain skills and increase their independence. This aim resonates with occupational therapy philosophy. This article presents results of a study of the role of occupational therapists in reablement services that involve two organisations. Method Theories on the role of occupational therapists in reablement were identified using a realist synthesis approach and were tested and expanded using a qualitative case study design. Each of the three case studies consisted of one reablement service in England. Methods of the study included observations and interviews with occupational therapists, interviews with managers in both organisations and focus groups and interviews with reablement support workers. Findings Findings conclude that occupational therapists’ education and experience underpin their ability to undertake assessments and person-centred goal setting. They utilise a range of intervention techniques selecting from their toolbox of interventions to support people. Occupational therapists have a role in training reablement support workers to work in an enabling way. Regular communication and co-location support levels of trust and shared purpose between members of the reablement team. Conclusion The conceptual framework developed from the study can be used by organisations when commissioning and developing reablement services to consider the different contextual layers of reablement.

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