Importance of a patient-centred approach inensuring quality of post-fracture rehabilitation for working aged people: Aqualitative study of therapists' andpatients' perspectives.

Abstract

Quality in rehabilitation is important for recovery and return to work for people at working age, who sustain fractures, but there is limited information about what constitutes quality in rehabilitation. To identify factors that therapists and patients define as quality in the rehabilitation process for working population after simple or multiple fractures. The study is a qualitative study based on grounded theory approach with semi-structured interviews conducted individually or in focus groups. Seven patients with fractures, 15 physiotherapists and eight occupational therapists from hospitals, municipalities and private practice were included in the study. Grounded theory was used to analyze data and develop a theory about quality in the rehabilitation process. Partnership was identified as the core category with continuity of rehabilitation and patient-centred approach as its dimensions. Themes in the patient-centred approach were Biopsychosocial understanding and Professionalism. The patient's perceived control enhanced when the therapist addressed the whole situation, especially return to work. Therapist's individual considerations and patient's involvement in decisions about the therapeutic methods had the same effect. Quality in rehabilitation was enhanced in all its dimensions namely structure, process and outcome when therapists used the patient-centred approach and addressed the patient's overall situation.