liu.seSearch for publications in DiVA
Change search
ReferencesLink to record
Permanent link

Direct link
The rehabilitation process for the geriatric stroke patient: an exploratory study of goal setting and intervention
Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
Linköping University, Department of Medicine and Health Sciences, Physiotherapy. Linköping University, Faculty of Arts and Sciences. (Landstinget i Östergötland; Centre for Public Health Sciences; Centre for Public Health Sciences; Folkhälsovetenskapligt centrum; Folkhälsovetenskapligt centrum)
Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
1999 (English)In: Disability and Rehabilitation, ISSN 0963-8288 (print) 1464-5165 (online), Vol. 21, no 2, 80-87 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim was to describe and analyse the rehabilitation process of the geriatric stroke patient from two perspectives; the treatment goals expressed by the staff and the patient and the treatment interventions chosen by the physiotherapist and occupational therapist. A secondary aim was to test whether the process, treatment goals and interventions could be classified according to the International Classification of Impairments, Disabilities and Handicaps (ICIDH).

Method: Qualitative interviews were performed with patients and personnel; diaries were used to register treatment interventions. The 30 interviews were categorized according to the goals expressed by physiotherapists, occupational therapists, physicians and patients. The diaries (n= 22) were analysed to describe how treatment interventions were connected in time, at what levels (impairment, disability and handicap) the interventions were directed, and finally, whether certain decisions were made in order to change the rehabilitation process.

Results: The patients talked more about attaining their prestroke status than about their goals. The therapists set goals according to functional level, whereas the doctors expressed themselves in general terms. Three patterns of rehabilitation processes were found: one with clearly identified decision points, one with a set programme which was not changed through the process, and one where the goal was changed according to changes in medical status.

Conclusions: The patient does not participate in the goalsetting process, and the vaguely expressed goals are not measurable. The rehabilitation process and reason for discharge demonstrate different patterns. Treatment interventions, if related to the ICIDH, give a clear picture of the process, though certain interventions do not fit in the classification.

Place, publisher, year, edition, pages
1999. Vol. 21, no 2, 80-87 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-14363DOI: 10.1080/096382899298016OAI: diva2:23337
Available from: 2007-03-23 Created: 2007-03-23 Last updated: 2009-08-21
In thesis
1. Client participation in the rehabilitation process
Open this publication in new window or tab >>Client participation in the rehabilitation process
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis evaluates the rehabilitation process with respect to client participation. The Swedish version of a client-centred structure, the Canadian Occupational Performance Measure (COPM), is evaluated from the perspectives of the clients, the occupational therapists and the members of a rehabilitation team. Data have been collected through diaries, the COPM, assessments of ability to perform activities of daily living, mobility, self-assessments of pain and health, interviews with clients, interviews with staff, and focus groups interviews.

The results show that a structured method is needed in order to improve clients’ active participation in goal formulation.

The Swedish version of the COPM has high responsiveness to change over time. The use of the COPM improved client participation in the goal-formulation process, according to the results from a study with experiment and control groups. The clients perceived that treatment goals were identified, they were able to recall the goals and felt that they were active participants. They also perceived they had a higher ability to manage after the rehabilitation period was completed compared to clients in the control group.

The clinical utility of the Swedish version of the COPM was confirmed in focus-group interviews with occupational therapists. The occupational therapists perceived the COPM as helpful in the goal-setting process and planning of treatment interventions. Even though problems are identified, they are directly related to, and formulated as, goals. Clients receive feedback on improvement over time. The COPM ensures a client-centred approach, facilitates communication within the rehabilitation team, and encourages therapists in their professional role. Therapists need knowledge about the theoretical foundation of the instrument and have to develop a personal interview technique.

When the COPM is used in a team setting, it provides the team with broader information on what is purposeful occupation to the client. The focus is on occupational performance rather than function. According to team members the use of the COPM as a team tool increased client participation, was a good outcome measure, resulted in distinct goals, and focused on goals that were meaningful to the client.

Implementation of a client-centred approach is facilitated when a structured method is used, but this is not enough. Involvement and motivation from all team members are required, as well as support during the introduction and implementation period. Support from management, knowledge about the underlying theory, time for discussions and reflections as well as opportunities to develop a personal interview technique are pointed out as important factors for a successful implementation.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2002. 70 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 722
Occupational therapy, Client-centred practice,, Participation, Rehabilitation, Goal formulation, Outcome
National Category
Occupational Therapy
urn:nbn:se:liu:diva-8594 (URN)91-7373-167-6 (ISBN)
Public defence
2002-04-05, Berzeliussalen, Campus US, Linköpings Universitet, Linköping, 09:00 (English)
On the day of the defence date the status on article V was Submitted.Available from: 2007-03-23 Created: 2007-03-23 Last updated: 2012-01-25Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textLink to Ph.D. Thesis

Search in DiVA

By author/editor
Wressle, EwaÖberg, BirgittaHenriksson, Chris
By organisation
Department of Social and Welfare StudiesFaculty of Health SciencesDepartment of Geriatric MedicinePhysiotherapyFaculty of Arts and Sciences
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 648 hits
ReferencesLink to record
Permanent link

Direct link