Burton, CR, Horne, M orcid.org/0000-0002-6153-8547, Woodward-Nutt, K et al. (2 more authors) (2015) What is rehabilitation potential? Development of a theoretical model through the accounts of healthcare professionals working in stroke rehabilitation services. Disability and Rehabilitation, 37 (21). pp. 1955-1960. ISSN 0963-8288
Abstract
Introduction: Multi-disciplinary team members predict each patient’s rehabilitation potential to maximise best use of resources. A lack of underpinning theory about rehabilitation potential makes it difficult to apply this concept in clinical practice. This study theorises about rehabilitation potential drawing on everyday decision-making by Health Care Professionals (HCPs) working in stroke rehabilitation services. Methods: A clinical scenario, checked for face validity, was used in two focus groups to explore meaning and practice around rehabilitation potential. Participants were 12 HCPs working across the stroke pathway. Groups were cofacilitated, audio-recorded and fully transcribed. Analysis paid attention to data grounded in first-hand experience, convergence within and across groups and constructed a conceptual overview of HCPs’ judgements about rehabilitation potential. Results: Rehabilitation potential is predicted by observations of ‘‘carry-over’’ and functional gain and managed differently across recovery trajectories. HCPs’ responses to rehabilitation potential judgements include prioritising workload, working around the system and balancing optimism and realism. Impacts for patients are streaming of rehabilitation intensity, rationing access to rehabilitation and a shifting emphasis between management and active rehabilitation. For staff, the emotional burden of judging rehabilitation potential is significant. Current service organisation restricts opportunities for feedback on the accuracy of previous judgements. Conclusion: Patients should have the opportunity to demonstrate rehabilitation potential by participation in therapy. As therapy resources are limited and responses to therapy may be contextdependent, early decisions about a lack of potential should not limit longer-term opportunities for rehabilitation. Services should develop strategies to enhance the quality of judgements through feedback to HCPs of longer-term patient outcomes.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Editors: |
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Copyright, Publisher and Additional Information: | This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 12 December 2014, available online: http://doi.org/10.3109/09638288.2014.991454 |
Keywords: | Clinical judgement, decision-making, qualitative, rehabilitation potential, resource allocation, stroke rehabilitation |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Nursing Adult (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 01 Sep 2016 16:16 |
Last Modified: | 17 Jan 2018 16:23 |
Published Version: | http://doi.org/10.3109/09638288.2014.991454 |
Status: | Published |
Publisher: | Taylor & Francis |
Identification Number: | 10.3109/09638288.2014.991454 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:101190 |