Article

OBJECTIVE: To describe the rehabilitation experiences, expectations, and
treatment adherence of patients receiving upper extremity (UE) rehabilitation who
demonstrated discrepancy between functional gains and overall improvement.
DESIGN: Qualitative (phenomenologic) interviews and analysis. SETTING:
Outpatient UE rehabilitation. PARTICIPANTS: Patients with acute UE injuries (N=10).
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Concerns related to UE
rehabilitation patients demonstrating discrepancy between outcome measures.
RESULTS: Five key themes emerged from the interviews of patients demonstrating
discrepancy in their self-reported patient outcomes: (1) desire to return to
normal, (2) initial anticipation of brief recovery, (3) trust of therapist, (4)
cannot stop living, and (5) feelings of ambivalence. Challenges included living
with the desire to move back into life. Multiple factors affected patient
adherence: cost of treatment, patient-provider relation (difference between
therapist and patient understanding on what is important for treatment), and
patients expecting the treating therapists to be an expert and fix their problem.
CONCLUSIONS: Patient adherence to UE rehabilitation presents many challenges.
Patients view themselves as laypersons and seek the knowledge of a dedicated
therapist who they trust to spend time with them to understand what they value as
important and clarify their injury, collaboratively make goals, and explain the
intervention to get them in essence, back into life, in the minimal required
time. When categorized according to the World Health Organization's
multidimensional adherence model, domains identified in this model include social
and economic, health care team and system, condition-related, therapy-related,
and patient-related dimensions. Assessing factors identified to improve
efficiency and effectiveness of clinical management can enhance patient
adherence.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS