Abstract
BackgroundReablement services are rehabilitation for older people living at home, being person-centered in information, mapping and the goal-setting conversation. The purpose of this study was to gain knowledge about conversation processes and patient influence in formulating the patients’ goals. There are two research questions: How do conversation theme, structure and processes appear in interactions aiming to decide goals of home-based reablement rehabilitation for the elderly? How professionals’ communication skills do influence on patients' participation in conversation about everyday life and goals of home-based reablement?MethodsA qualitative field study explored eight cases of naturally occurring conversations between patients and healthcare professionals in a rehabilitation team. Patients were aged 67–90 years old. The reablement team consisted of an occupational therapist, physiotherapist, nurse and care workers. Data was collected by audio recording the conversations. Transcribed text was analyzed for conversational theme and communication patterns as they emerged within main themes.ResultsPatient participation differed with various professional leadership and communication in the information, mapping and goalsetting process. In the data material in its entirety, conversations consisted mainly of three parts where each part dealt with one of the three main topics. The first part was “Introduction to the program.” The main part of the talk was about mapping (“Varying patient participation when discussing everyday life”), while the last part was about goal setting (“Goals of rehabilitation”).ConclusionsHome-based reablement requires communication skills to encourage user participation, and mapping of resources and needs, leading to the formulation of objectives. Professional health workers must master integrating two intentions: goal-oriented and person-centered communication that requires communication skills and leadership ability in communication, promoting patient influence and goal-setting. Quality of such conversations is complex, and requires the ability to apply integrated knowledge, skills and attitudes appropriate to communication situations.
Highlights
Introduction to the programPatients often got a very brief introduction about both the conversation purposes and what the rehabilitation would entail
Home-based reablement for older persons Different denominations exist about rehabilitation for older people living at home; for example, reablement [4,5,6]
Informants and recruitment The head administrator of a home-based reablement rehabilitation project assisted with the provision of information and selection of participants
Summary
Introduction to the programPatients often got a very brief introduction about both the conversation purposes and what the rehabilitation would entail. As an example from an introduction sequence, a dialogue where there were two staff members present took place as follows: Staff member 1: We have received an application from you, stating that you are applying for home nursing, practical assistance in the home. Reablement services are rehabilitation for older people living at home, being person-centered in information, mapping and the goal-setting conversation. How professionals’ communication skills do influence on patients' participation in conversation about everyday life and goals of home-based reablement?. The focus of this study is elderly patients’ influence in conversations with healthcare professionals about performance in everyday living and goals for home-based rehabilitation. Some research has shown uncertain outcomes [5], while other research has shown that reablement has led to a need for reduced home care [10]
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