Transitioning from hospitals to the community: perspectives of rehabilitation patients with neurological disorders and their service providers.
To identify the contextual factors that influence community participation in rehabilitation outpatients from the perspectives of patients and their service providers.



Five focus groups with rehabilitation outpatients (n = 22) and three focus groups with occupational and physical therapists (n = 17) were conducted. Two independent coders thematically analyzed the transcribed data.



Patients and their providers identified three common personal factors (personal interests, personal values, and finances) and four major categories of environmental factors (products and technology; support and relationships; attitudes; and services, systems, and policies) that have great influence on patients' participation in the community. Additionally, some patients perceived the impacts of fear of falling and climate on their participation, whereas some service providers reported that age, adaptability, and successful experiences could determine the patients' participation in the community.



This study synthesized and contrasted perspectives from both rehabilitation outpatients and their service providers to identify the contextual factors that enable or restrict patients from participating in the community. Both patients and service providers identified numerous personal and environmental factors associated with participation, thus highlighting areas that can be addressed in rehabilitation outpatient programs and considered in policy development. Implications for Rehabilitation Community participation is an outcome of dynamic interactions among multiple factors and is highly environmentally and culturally sensitive. Both personal and environmental factors have substantial impacts on rehabilitation patients' participation outcomes. Rehabilitation practitioners and policy-makers need to incorporate perspectives from both patients and providers when developing interventions targeting to improve patients' community participation.
a Department of Physical Medicine and Rehabilitation , Taipei Medical University Hospital , Taipei , Taiwan.|b School of Medicine , College of Medicine, Taipei Medical University , Taipei , Taiwan.
Sung-Hui
SH
Tseng
c Graduate Institute of Injury Prevention and Control , College of Public Health and Nutrition, Taipei Medical University , Taipei , Taiwan.
Feng-Hang
FH
Chang
D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003256:Community Participation / Q000379:methods / Q000523:psychology; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000523:psychology / Q000534:rehabilitation; D010045:Outpatients; D010358:Patient Participation / Q000379:methods / Q000523:psychology; D011369:Professional-Patient Relations; D012649:Self Concept; D013624:Taiwan; D000069341:Transitional Care / Q000458:organization & administration*; D016896:Treatment Outcome
Community participation; central nervous system diseases; outpatients; qualitative research; rehabilitation