Recovery From Disablement: What Functional Abilities Do Rehabilitation Professionals Value the Most?

Abstract

Rist PM, Freas DW, Maislin G, Stineman MG. Recovery from disablement: what functional abilities do rehabilitation professionals value the most? Objective To determine whether rehabilitation clinicians representing different therapeutic disciplines would choose to recover from profound disability differently. Design Applying recovery preference exploration as a data-collection tool, clinicians imagined recovery from complete disability in each of the 18 activities assessed on the FIM instrument. We hypothesized that recovery-choice pathways would vary among the disciplines because of differences in training and practice focus. We compared each clinician's preference for imagined recovery of the ability to perform each FIM activity relative to the other 17. Item-level preferences were explored by discipline. The mean absolute difference (MAD) in the medians of the 18 FIM recovery preference values between each of the disciplines was used to quantify overall differences. Setting Inpatient rehabilitation unit within a larger tertiary care urban hospital of an academic medical center. Participants Ninety-three clinicians actively providing care to patients in an inpatient rehabilitation setting classified into 5 groups anticipated to have similar types of practices: physicians and medical students (physician group), nurses, occupational and recreational therapists (occupational therapy [OT] group), physical therapists (physical therapy [PT] group), and neuropsychologists and social workers (psychology group). Interventions Not applicable. Main Outcome Measures Relative recovery preferences in 18 FIM activities. Results The MAD value between the 2 groups with the least similar recovery values (physician and psychology groups) was 1.78 times larger than the MAD value between the 2 groups with the most similar recovery values (PT and OT groups). Conclusions There were subtle differences in recovery choice pathways that may logically relate to differences in the cognitive processes used in clinical decision making among the therapeutic discipline groups.