Client-Centred Rehabilitation - Arthritis Community Research ...

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43 Table 2: Client Level Indicators of Client –Centred Care CONCEPT DEFINITION INDICATORS Client participation in decisionmaking & goal setting The client defines the need, defines important goals and outcomes, sets the priorities in partnership with health professionals. Programs are individualized to the particular clients’ needs and condition. • goals are set at levels of ICIDH-2. • choice available re: treatment options. • use of tools such as goal attainment scaling and COPM • single items from Picker or CAHPS (q33,q34) Client-centred education Evaluation of outcomes from client’s perspective Education and information are crucial to informed client participation in decisionmaking and goal setting. Information should be appropriate, timely and according to the client’s wishes. Client is at the center of the educational process and defines educational needs. Client-centred education encourages: • Autonomy • Client participation • Planning with client • Empowerment • Active client • Independence Evaluation of outcomes incorporates expectations of the client and considers the importance of performance areas to the client. Interventions need to be evaluated using outcomes that tap multiple dimensions. e.g. move beyond traditional measures of impairment and disability to include participation in mobility, personal maintenance, social relationships, home life, education, work, economic life. Further, the clients should evaluate their own progress towards the achievement of these goals • client receives feedback after evaluation. • no “dead time” – educational material provided at first contact • check for understanding of educational material • receives written instructions/home program. • understands the risks and benefits and all evidence-based options for treatment are explored. • includes prevention strategies. • WASCANA • outcomes measured at all levels of ICIDH-2. • clients evaluate goal achievement e.g. goal attainment scaling (GAS) and Canadian Occupational Performance Measure (COPM)[participation level goals] • items added to WASCANA
44 Family involvement Family involvement is critical to clientcentred care. The family is defined broadly to include anyone the client recognizes as a significant relative, friend, or companion regardless of biological or legal relationships. Families need emotional support, ongoing help with caregiving and information about the client’s condition and treatment. It is up to the client to define extent to which family is involved (social context is considered). • WASCANA • describe ways that families are incorporated into the process Emotional support Flexibility Clients should feel their emotional needs and concerns are being addressed, that their wishes and decisions are being respected and that they are treated with dignity. Effective emotional support conveys a sense of genuine caring and concern for the client’s needs. It includes expressing a positive affect, acknowledging the client’s feelings, and providing useful information. Services need to be flexible in terms of how, where, when and what type of service is provided • WASCANA • items from Picker • give examples of strategies to address emotional support (e.g. support groups, buddy systems, follow-up phone calls) • receives timely assessment and treatment (waiting lists). • choice available of where treatment offered, time of day • language is appropriate in terms of culture and reading level. • services are culturally sensitive
Page 1 and 2: ARTHRITIS COMMUNITY RESEARCH & EVAL
Page 3 and 4: 2 Table of Contents Executive Summa
Page 5 and 6: 4 Executive Summary Objectives ♦
Page 7 and 8: 6 Chapter 1: Background 1.1 Arthrit
Page 9 and 10: Articles considered relevant from t
Page 11 and 12: applicable to our conceptualization
Page 13 and 14: likert-type scale) 16 barriers to c
Page 15 and 16: 1990), checklists of physician=s an
Page 17 and 18: communication," giving insight into
Page 19 and 20: A national survey of acute care hos
Page 21 and 22: Although GAS usually involves devel
Page 23 and 24: Much of the work to date at the sys
Page 25 and 26: 3.1.2 Setting The SCI, ABI, MS, Hip
Page 27 and 28: 26 Table 1: Demographics for Focus
Page 29 and 30: 28 expertise. Rehab specialists don
Page 31 and 32: 30 ARTH #2 Preparation for life in
Page 33 and 34: 32 had been involved in goal settin
Page 35 and 36: 34 “.... But in terms of professi
Page 37 and 38: 36 readmission were important to ou
Page 39 and 40: 38 abrupt and left them feeling iso
Page 41 and 42: 40 Chapter 4: Components of Client-
Page 43: 42 continuum are aware of the roles
Page 47 and 48: 46 Table 3: System Level Indicators
Page 49 and 50: 48 In summary, there is no single m
Page 51 and 52: 50 ♦ Experimental designs evaluat
Page 53 and 54: 52 Carroll, L., Sullivan, F.M., & C
Page 55 and 56: 54 Guinn, R.M. (1993). Operational
Page 57 and 58: 56 Malec, J.F., Smigielski, J.S., &
Page 59 and 60: 58 Turnbull, J. (1998). Evaluating
Page 61 and 62: Validity: Chan and Lee (1997): Cont
Page 63 and 64: Law M, Polatajko H, Pollock N, McCo
Page 65 and 66: Advantages of GAS GAS is beneficial
Page 67 and 68: Picker survey data indicates proble
Page 69 and 70: Survey Program Survey Frequency: mo
Page 71 and 72: among different sub-populations (ch

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