POS0047-HPR GOALS AND ACTION PLANS ACROSS TIME AND PLACE IN PERSON-CENTRED REHABILITATION - A QUALITATIVE STUDY EXPLORING THE IMPORTANCE OF CONTEXT

Abstract

BackgroundPerson-centeredness is increasingly addressed in relation to rehabilitation interventions (1). Collaborative goal setting and action plans are key elements in person-centered rehabilitation (2). There is a lack of knowledge about how person-centered goals and action plans developed during inpatient rehabilitation are experienced by the patients after discharge.ObjectivesThis aim of the study was to explore how rheumatic patients experience the relevance of goals and action plans after discharge from an inpatient rehabilitation stay.MethodsIndividual narrative interviews were conducted with eight patients with a rheumatic disease three to five weeks after discharge from a two-week inpatient rehabilitation stay. A convenience sampling strategy was applied. In order to the exploratory nature of the study, we strived for variety in diagnoses, age and gender (3). One male and seven female patients participated, aged between 40 and 60 years. Six of the participants were active at the labor market and two were retired. Data collection, analysis and interpretation of data were performed within a phenomenological-hermeneutic framework inspired by Paul Ricoeur’s interpretative philosophy (4).ResultsThe analysis derived one core theme: ‘The relevance of goals and action plans is contextual’ and three subthemes: ‘The hospitalization - a protected bubble’, ‘Being at home - a harsh reality’, and ‘Need for support after discharge’. The participants expressed that during the admission there was time and peace to exercise and to take a rest. They were relieved from everyday duties, and received support from the interdisciplinary team in how to exercise and during conversations where they focused on management of their symptoms and illness. Back home after discharge, the participants experienced how their everyday life differed from the hospital context. They found it challenging to work further with goals and actions plans in their everyday life. They described in particular challenges with incorporation of new habits in everyday life, challenges they were not prepared for. On challenging days with pain and fatigue, the participants missed having someone to talk to. The participants suggested involvement of their relatives to support action plans and called for follow-up support to enable them to continue working to achieve their goals and action plans after discharge. They suggested support by telephone calls from a nurse from the hospital after one, two or three months after discharge to ask how they felt. They believed that it would be motivating and could support the outcomes of the admission.ConclusionGoals and actions plans are relevant for rheumatic patients, but must be adapted to the patient’s everyday life. There is a need to plan during the hospitalization how goal and action plans can be transferred to the rheumatic patient’s everyday life after discharge from a rehabilitation stay. Likewise, there is a need for follow-up support after discharge to support the patients to pursue their goals and cope with challenges in everyday life.