Client-Centred Rehabilitation - Arthritis Community Research ...

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people. The whole world knowing
how full your leg bag was or
whatever. The institutional
experience that I’ve experienced just
says don’t even bother trying to hang
on to some dignity…. You just quit
trying to keep it going anymore and
accept that in this place I’m
somewhere less than a full adult.”
SCI #2
Although staff could be important sources of
support and motivation for clients, clients in
all the focus groups discussed the issue of
depression and how staff did not deal with
their patients/clients being depressed. This
was identified as a common situation for
clients where they did not receive adequate
emotional support from staff.
“Very common with people with
arthritis and it’s something a lot of
the doctors don’t address. It’s
actually just here. In the States, more
so. They’re very quick to notice the
depression in arthritis people. Where
here, they don’t even know you’re
depressed most of the time” ARTH
#1
Many participants attributed the staff’s lack
of acknowledgement of depression to a lack
of knowledge and training in dealing with
clients’ emotional states.
“Depression is a major part of this
syndrome and none of us have gone
through it without some cycle of
depression and its not often talked
about. It’s what they....getting in a
bad mood or down. I’ve had my
down days and whatever you know
you really notice that I was
depressed and again it was later that
you recognized what was happening
to me that I went out and got some of
my own help. It helped in that issue.
It’s not something that the staff were
prepared... they knew it... but it
wasn’t something that they
intervened with.” SCI #3
A few clients raised the issue of staffing as
part of the challenge of providing clientcentred
care. They stressed the importance
of the staff having enough time to work with
the individual client and not feeling rushed
because there was a time limit in their
interaction. Concerns about staff working
too long of hours and being short staffed
were also discussed. Increased staff
turnaround was also a concern for inpatient
clients because it takes a while to adjust to
new staff.
“They haven’t the time…at least
they think they haven’t.” PTPART
#3
“You’re just hoping that you’ll get a
good nurse or somebody for at least
2 or 3 days and you feel comfortable
and you feel a lot more at ease. If
you get somebody new and then you
have to know them and have to go
through whole motions of what you
need, this and that, what do you like
and all that other stuff” SCI #3
System Level Issues
Access
Issues of access into a rehabilitation
program were not so great with these groups
because our inclusion criteria stipulated that
participants had to have completed a course
of rehabilitation. Our sample therefore does
not include people who may need
rehabilitation but have not received it.
However, issues of continuing access and