title: The client-centred approach as experienced by male neurological rehabilitation clients in occupational therapy. A qualitative study based on a grounded theory tradition.
abstract: Purpose To explore the perspectives of male clients in a neurological rehabilitation setting with regard to the occupational therapy they have received and the client-centred approach. Method This study involved a qualitative research design based on the grounded theory tradition. Individual in-depth interviews were used to collect data. Data were analysed using a constant comparative method. Seven male participants from an inpatient neurological setting were included using a theoretical sampling technique. Results Three themes emerged to describe the approach of the therapists to client-centred practice: (a) a shared biomedical focus as the start of the rehabilitation process, (b) the un-simultaneous shift from a biomedical towards a psycho-social focus and (c) formal versus informal nature of gathering client information. Conclusion A client-centred approach entails a shift from the therapist focussing on recovery from the short-term neurological issues towards the long-term consequences of the disease. According to the client, this shift in reasoning must occur at a specific and highly subjective moment during the rehabilitation process. Identifying this moment could strengthen the client-centred approach. Implications for Rehabilitation Client-centred practice entails a shift from recovering the short-term neurological issues towards the long-term psycho-social consequences of the disease. To be effective in client-centred practice, the clients expect from the professional to be an authority with regard to biomedical issues and to be partner with regard to psycho-social issues. Client-centred practice is most likely to be successful when client is susceptible to discuss his psycho-social issues and finding this moment is a challenge for the professional. Using formal methods for goal setting do not necessarily cover all the information needed for a client-centred therapy programme. Rather, using informal methods could lead to a more valid image of the client.
authors: a Department of Rehabilitation Sciences and Physiotherapy , Occupational Therapy Program, Ghent University , Ghent , Belgium ;|d Department of Occupational Therapy , Artevelde University College , Ghent , Belgium.
authors: Dominique
authors: D
authors: Van de Velde
authors: b Department of Family Medicine and Primary Health Care , Ghent University , Ghent , Belgium ;
authors: Ignaas
authors: I
authors: Devisch
authors: c Department of Gerontology and Frailty in Ageing (FRIA) Research Group , Vrije Universiteit Brussel , Belgium ;|d Department of Occupational Therapy , Artevelde University College , Ghent , Belgium.
authors: Patricia
authors: P
authors: De Vriendt
mesh_terms: D000328:Adult; D066296:Grounded Theory; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000523:psychology / Q000534:rehabilitation; D000066530:Neurological Rehabilitation / Q000379:methods / Q000523:psychology; D009788:Occupational Therapy / Q000379:methods*; D057240:Patient Preference; D018802:Patient-Centered Care / Q000379:methods*; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012047:Rehabilitation Centers
keywords: Client-centred practice; neurological rehabilitation; qualitative research