title: The rehabilitation plan can support clients' active engagement and facilitate the process of change - experiences from people with late effects of polio participating in a rehabilitation programme.
abstract: OBJECTIVE
  To explore how the rehabilitation plan influences the rehabilitation process and its outcome in people with late effects of polio participating in an individualised goal-oriented interdisciplinary rehabilitation programme.
  
  
  METHODS
  Four women and two men with late effects of polio were interviewed before rehabilitation, at discharge, and at follow-up. Data were analysed according to the constant comparative method of grounded theory.
  
  
  RESULTS
  The participants' experiences formed one core category: "The same starting point but different rehabilitation processes". Before rehabilitation, all participants experienced a similar starting point: Naïve understanding of rehabilitation. During rehabilitation, two separate processes followed. Four participants experienced their rehabilitation as being a mutually shared process that led to a process of change. They were actively engaged, using the rehabilitation plan, and working towards goals targeting a broad perspective of daily activities. The remaining two participants experienced their rehabilitation as a staff-directed process, with limited use of the rehabilitation plan, focusing on goals mainly related to body functions and self-care, not leading to any substantial changes.
  
  
  CONCLUSIONS
  When clients experience that they develop a mutually shared rehabilitation process, based on a rehabilitation plan, they became more engaged in their rehabilitation and gained a better understanding of their participation during the process. Knowledge of the differences in how clients use the rehabilitation plan during the rehabilitation process can support their active engagement during rehabilitation. This, in turn, can promote a more holistic view among clients and professionals during the rehabilitation for people with late effects of polio. Implications for Rehabilitation Clients who experience a rehabilitation that is mutually shared with professionals, have a better understanding of their engagement during the rehabilitation process. When clients and professionals use the rehabilitation plan as a mutual tool, clients become more actively engaged in their rehabilitation process. A structured rehabilitation plan can serve as a map, and support clients' process of change during the rehabilitation process, also after the rehabilitation period is completed.
authors.affiliation: a Department of Neurology and Rehabilitation Medicine , Skåne University Hospital , Lund-Malmö , Sweden .|b Department of Health Sciences , Lund University , Lund , Sweden , and.
authors.forename: Eva Månsson
authors.initials: EM
authors.lastname: Lexell
authors.affiliation: a Department of Neurology and Rehabilitation Medicine , Skåne University Hospital , Lund-Malmö , Sweden .|b Department of Health Sciences , Lund University , Lund , Sweden , and.
authors.forename: Jan
authors.initials: J
authors.lastname: Lexell
authors.affiliation: c Department of Health Sciences , Division of Occupational Therapy, Luleå University of Technology , Luleå , Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Larsson-Lund
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D064702:International Classification of Functioning, Disability and Health; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning / Q000592:standards*; D010358:Patient Participation; D016262:Postpoliomyelitis Syndrome / Q000534:rehabilitation*; D012648:Self Care; D013548:Sweden
keywords: Adaptation; disability and health; international classification of functioning; patient care planning; post-poliomyelitis syndrome; rehabilitation