title: Client-centred ADL intervention after stroke: Occupational therapists' experiences.
abstract: BACKGROUND
  This study was conducted in the context of a randomized controlled trial evaluating the effect of a client-centred activities in daily living intervention (CADL). The aim of the CADL was to enable agency in daily activities and participation in everyday life among persons with stroke.
  
  
  OBJECTIVE
  This qualitative, longitudinal study aimed to describe how occupational therapists (OTs) applied the CADL in their clinical practice by studying their experiences and reflections concerning their interaction with the clients with stroke.
  
  
  METHODS
  Six OTs who conducted the CADL were followed through interviews and observations on four separate occasions over one year. Data were analysed using a grounded theory approach.
  
  
  RESULTS
  Sharing was the core category showing how the OTs helped their clients to achieve agency in daily activities. Through sharing the situation the OTs strove to obtain an empathetic understanding of the clients' lived experience throughout the whole intervention process in order to enable the clients' ownership of their daily activities.
  
  
  CONCLUSIONS
  The continuity of sharing seems to be the key for a gradual increase in agency. The approach of sharing should preferably be applied by all members of the interprofessional team, including the client and significant others.
authors.affiliation: a Department of Neurobiology, Care Sciences and Society , Karolinska Institutet , Stockholm , Sweden ;
authors.forename: Maria
authors.initials: M
authors.lastname: Ranner
authors.affiliation: a Department of Neurobiology, Care Sciences and Society , Karolinska Institutet , Stockholm , Sweden ;|b Department of Neurology , Karolinska University Hospital , Stockholm , Sweden ;
authors.forename: Lena
authors.initials: L
authors.lastname: von Koch
authors.affiliation: a Department of Neurobiology, Care Sciences and Society , Karolinska Institutet , Stockholm , Sweden ;
authors.forename: Susanne
authors.initials: S
authors.lastname: Guidetti
authors.affiliation: a Department of Neurobiology, Care Sciences and Society , Karolinska Institutet , Stockholm , Sweden ;|c Department of Occupational Therapy , Karolinska University Hospital , Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Tham
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D066296:Grounded Theory; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods / Q000523:psychology*; D018802:Patient-Centered Care; D011369:Professional-Patient Relations; D000071939:Stroke Rehabilitation
keywords: Clinical reasoning; goal-setting; person-centred care; qualitative method; shared decisions; stroke rehabilitation; therapeutic strategies