Brukermedvirkning - rehabilitering - slagpasienter : fysioterapeuters erfaringer fra samhandling med eldre slagpasienter

Abstract

This master’s thesis concentrates on patient-participation in rehabilitation of elderly stroke patients, and it is a qualitative study based on in-depth interviews with three experienced physiotherapists. The objective of this study is to illuminate the patient-participation of elderly stroke patients. It is also an aim to stimulate into reflections on problems within this field of practice and thus contribute to an increased consciousness and understanding of the communication with this particular group of patients. As a background for the main subject I have outlined some theory on rehabilitation and patient-participation. My theoretical perspectives focus on attitudes and approach in communication, and are mainly based on theories of social philosophy.

The interviewees` experiences are presented by citations with my comments closely linked to the text. The descriptions bring to attention factors influencing the communication, and they also highlight the challenges this field of practice is facing. The three physiotherapists seem conscious of the importance of patient-participation, but they do, however, express difficulties in carrying it through in their busy everyday practice with its limiting framework. A lot of the elderly patients greatly respect authority figures, and they wish to leave their decisions related to rehabilitation and future to professionals and families. The physiotherapists often make decisions on behalf of the patients, and they are also conscious that the way different alternatives are presented to the patients, may limit their options. The therapists reflect on the possibility of their approaches towards patients being controversial in order to make the patients accept certain alternatives in case of disagreement.

The discussion focuses on the physiotherapists` attitudes and approaches in communication with patients, and I have chosen some of the above mentioned problems which appeared especially interesting for further discussion. By discussing these topics in light of the theoretical perspectives I have tried to view the physiotherapists’ experiences from other viewpoints, and also attempted to open up for further reflections on clinical practice. In my opinion, an increased consciousness and reflection on these topics eventually may benefit the patients.

Key words: Stroke patients, rehabilitation, patient-participation, communication, attitudes, approaches, consciousness, reflections.