Article

This study aims to discuss current perceptions of rehabilitation and how
present rehabilitation practice is affected by dominating discourses in Danish
society by exploring discourses expressed in official publications and the
constructed journal notes of occupational and physiotherapists' practice of
stroke rehabilitation. Method The frame of reference is Fairclough's critical
discourse analysis. The analysis comprises seven official documents relevant to
stroke rehabilitation provided in Danish health services in 2012-2013. Also,
notes written by occupational therapists and physiotherapists in medical records
of 10 patients with a stroke diagnosis admitted to hospital in 2012. The
documents included were read thoroughly. The texts were analyzed deductively,
focusing on discursive practice on articulated understandings of rehabilitation,
health practice approaches, and social practice. Results The dominating
discourses seem to be Western neoliberalism organizational, medical and ethical
discourses. The macro level of discourses consisted of political documents
addressing rehabilitation nationally. The meso level mainly concerned medical
discourses within stroke rehabilitation whereas the micro level represented local
medical and ethical discourses. Conclusion The neoliberal discourse supports the
medical discourse with strong emphasis on evidence-based interventions. In
contrast to ethical discourses, documentation of rehabilitation practice marked
more attention being paid to facilitating the patient's independence than to
enabling the regaining of meaningful activities and participation. Implications
for Rehabilitation Individualized rehabilitation must be organized with
flexibility as it is a complex process Critical reflectiveness among health
professionals is needed to provide individualized rehabilitation of high quality
A broader range of stake holders, including patient organizations, are in demand
within health policy making The discourses that construct rehabilitation policy
and practices are sometimes in conflict, which may impact on, and impede, the
rehabilitation for the individual patient.

Langue : ANGLAIS