Client-Centred Rehabilitation - Arthritis Community Research ...

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In summary, there is no single measure of
the extent to which a particular rehabilitation
program is client-centred. Instead, a
multifaceted approach is required that
incorporates a number of indicators at the
level of the client/ professional and the
system. Many of the client level indicators
from the client’s perspective are tapped by
the WASCANA, however this measure in
and of itself does not capture the extent to
which a particular program is client-centred.
In addition, evidence as to the presence of
other components of client-centred care is
needed.
4.3 Implications for the
Rehabilitation Reference Group
Framework
Our findings provide support for many of
the directions put forward in “Managing the
Seams: Making the Rehabilitation System
Work for People” (Provincial Rehabilitation
Reference Group, MOHLTC, 2000).
1) “Rehabilitation services must aim to meet
the needs of individuals at the three levels of
client need (impairment, activity limitation
and participation).” [p. 22, Provincial
Rehabilitation Reference Group, MOHLTC,
2000]. Our findings suggest that
rehabilitation services mainly address two
levels of client need (impairment and
activity limitation) but that the participation
level of client need is not being addressed
adequately. Steps must be taken to ensure
that rehabilitation services better prepare
clients for community living. This will
require:
♦ education of rehabilitation
professionals with respect to
participation level interventions
♦ training of physicians and allied
health care providers with respect to
the meaning and practice of clientcentred
care – both at the
undergraduate level and for
practicing clinicians
♦ linkages between various
components of the system (e.g.
hospital based rehab services and
community based service providers).
♦ research to identify best practices
with respect to participation level
interventions.
♦ increased public awareness of
community programming to meet
ongoing client needs for community
involvement
2) “For many years, services partners such
as the Canadian Paraplegic Association, The
Arthritis Society, and the Heart and Stroke
Foundation have played pivotal roles within
the rehabilitation system (providing peer
support and counseling, volunteer led
programs, information and service
coordination) but their roles have not been
recognized as being integral to the larger
system” (p. 22, Provincial Rehabilitation
Reference Group, MOHLTC, 2000). Our
findings strongly support this point.
♦ The role of community service
providers and disease specific
organizations needs to be recognized
and augmented and linkages to
formal rehabilitation programs
enhanced.
♦ There is a need for programs and
services that provide on-going
emotional support for clients. These
do not necessarily need to be
professional-driven but could be
provided through support groups,
peers, and mentoring. The Arthritis
Society and its client services