THU0703-HPR A SANCTUARY FROM EVERYDAY LIFE: A QUALITATIVE STUDY OF THE EXPERIENCE OF IN-PATIENT MULTIDISCIPLINARY REHABILITATION, FOR PATIENTS WITH RHEUMATIC DISEASES

Abstract

Background In Denmark, patients with rheumatic diseases can receive inpatient multidisciplinary rehabilitation at a hospital for rheumatic diseases or at rehabilitation centers. Quantitative studies indicate that it is difficult to detect a general and lasting effect of 1-4 weeks of inpatient multidisciplinary rehabilitation, but few studies have explored patients’ experience of in-patient multidisciplinary rheumatology rehabilitation. Objectives To explore how patients, experience the process and personal impact of an inpatient rehabilitation stay. Methods An exploratory qualitative phenomenological-hermeneutic study was planned. Adult rheumatic patients admitted for a two-week inpatient rehabilitation stay were invited to participate. Individual semi-structured interviews were conducted in the patients’ home shortly after discharge or at the ward one of the last days of admission. The interviews were audio recorded and transcribed verbatim. The analysis was inspired by Paul Ricour’s interpretative philosophy (1). Results Fifteen interviews were conducted, 11(73%) female, age 28-89. The analysis derived a core theme,”A sanctuary”, reflecting that the patients experienced to have sufficient time and mental resources to provide self-care. In addition, the analysis derived five subthemes: 1) “Being seen, heard and acknowledged as an equal and whole person”. To feel acknowledged was vital for the patients’ experience of quality and benefit. 2) “Professional care and compassion”, which were considered by the patients as the most fundamental contextual factors to facilitate their self-care. 3) “Social relations and interactions between patients”, reflecting the patients experience of feeling recognized by other patients and to experience common understanding. 4) “An individually planned rehabilitation stay, but challenges regarding shared decision making”. The patients felt the rehabilitation was individually planned, but with room for improvement in relation to awareness of shared decision-making. 5) “Rehabilitation as a personal process but problems with transferability to everyday life”. The patients experienced the rehabilitation stay as a part of a personal rehabilitation process, but expressed concerns about whether they were able to transfer new learning and habits to everyday life. Conclusion Patients with rheumatic diseases experience in-patient rehabilitation as a sanctuary, with rehabilitation at three levels; through multidisciplinary rehabilitation interventions at the hospital; through recognition from the multidisciplinary staff and through recognition, social relationships and interactions with fellow patients. There is a need for improved coordination of rehabilitation across primary and secondary health care, in order to ease transferal to the patients’ everyday life.