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  • Listening to the client voice – A constructivist grounded theory study of the experiences of client‐centred practice after stroke

    Author(s)
    Walder, Kim
    Molineux, Matthew
    Griffith University Author(s)
    Walder, Kim A.
    Molineux, Matthew
    Year published
    2019
    Metadata
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    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 ...
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    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.
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    Journal Title
    Australian Occupational Therapy Journal
    DOI
    https://doi.org/10.1111/1440-1630.12627
    Note
    This publication has been entered into Griffith Research Online as an Advanced Online Version
    Subject
    Public Health and Health Services
    Clinical Sciences
    grounded theory
    occupational therapy
    patients
    rehabilitation services
    stroke
    Publication URI
    http://hdl.handle.net/10072/389915
    Collection
    • Journal articles

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