The patient's view of recovery: an emerging tool for empowerment through self-knowledge.
OBJECTIVE
To introduce Recovery Preference Exploration (RPE) as a new technique for studying the personal significance of being able to perform one type of functional activity over others. To determine if patients' concepts of function reflect the ADL, sphincter management, mobility and cognition (ASMC) domains established through the factor analyses of observed patient performance.


METHODS
RPE involves an adapted card sort procedure. Patients sorted 18 cards each listing a single functional skill such as eating, walking, and memory into subjectively meaningful groups of activities based on how they see those skills relating to one another in their daily lives. They then ordered the groups from most to least important. Recovery preferences were explored for 32 patients with disabilities resulting from neurological or other conditions undergoing inpatient rehabilitation in the USA.


RESULTS
The abilities to eat, bathe and toilet were the activities most frequently placed in the most valued pile. At times, the patient's card sorts mirrored the ASMC domains. At other times, patients grouped activities that tended to occur in a particular place or that were linked through cause and effect. Patients' narrative explanations reflected the uniqueness of their personal circumstances.


CONCLUSIONS
RPE uncovers the life contexts that underlie patients' subjective beliefs about the meaning of being able to perform various types of activities. RPE might be applied in clinical practice and research to explore the idiosyncratic aspects of disability.
Stineman
Margaret G
MG
Department of Physical Medicine and Rehabilitation, University of Pennsylvania, USA. mstinema@mail.med.upenn.edu
Kurz
Ashley E
AE
Kelleher
Deirdre
D
Kennedy
Bonnie L
BL
D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D000368:Aged; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012047:Rehabilitation Centers; D012648:Self Care; D020377:Self Efficacy