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TitleInterprofessional Rehabilitation: A Person-Centred Approach
File Size3.1 MB
Total Pages208
Table of Contents
	Interprofessional Rehabilitation
		About the editors
		About the contributors
Chapter 1: Introdiction
	1.1 What is rehabilitation?
	1.2 Setting boundaries ? or what we don’t mean by rehabilitation
	1.3 Some definitions of rehabilitation
	1.4 Some other issues in defining rehabilitation
		Therapy versus rehabilitation
		Disabling societies
	1.5 The core themes
	1.6 A word about terminology
	1.7 Summary
Chapter 2: A rehabilitation framework:the International Classifi cation of Functioning, Disability and  Health
	2.1 There is a need for a common language of functioning
	2.2 The ICF is both a model and a classification  system
		The ICF as a model
		Components of the ICF model
		The ICF as a classification
	2.3 The origins of the ICF
	2.4 Using the ICF in practice ? ICF core sets,rehabilitation cycle and ICF tools
		ICF core sets
		The rehabilitation cycle and ICF tools
		The ICF assessment sheet
		The ICF categorical profile
		The ICF intervention table
		The ICF evaluation display
	2.5 Can the ICF be used to measure functioning ? both the ‘what’ and the ‘how’? Controversies ? to measure or to classify that is the question
	2.6 Controversies ? classification of ‘participation restrictions’ versus ‘activity limitations’
	2.7 Controversies ? is the ICF a framework for understanding ‘ QoL ’?
	2.8 Future developments of the ICF
	Additional resources
Chapter 3: An interprofessional approach to rehabilitation
	3.1 Introduction and setting the scene
	3.2 Terminology and interprofessional working within rehabilitation
	3.3 Characteristics of good teamwork
		Teams that work well and teams that work less well
		The tensions of working in teams
		Thinking outside the professional box
	3.4 Team membership and roles
		Team leadership
		Specific team roles
	3.5 Processes of teamwork
		Interprofessional team assessment
		Team meetings
		Team evaluation
	3.6 The role of interprofessional education in rehabilitation
	3.7 Collaborative rehabilitation research
	3.8 The future for interprofessional rehabilitation teams
	3.9 Conclusion
	Additional resources
Chapter 4: Processes in rehabilitation
	4.1 Introduction
	4.2 Assessment
	4.3 Goal planning
		What is a rehabilitation goal?
		What is ‘goal setting’ and ‘goal  planning’?
		Application of goal planning to rehabilitation
		Setting long-term goals
		Setting short-term goals
			‘ SMART ’ goals
			Randall and McEwen ’s ‘who, what, how well, by when’ method
			Goal Attainment Scaling  GAS  goals
		Considerations for goal planning
			Purposes of goal planning
			Disrupted life goals
			Impairments of goal pursuit
	4.4 Interventions
		Classifi cation of rehabilitation interventions
		Motivation and adherence
	4.5 Evaluation
	4.6 Discharge planning and transitions from hospital to community
	4.7 Conclusion
	Additional resources
Chapter 5: Outcome measurement in rehabilitation
	5.1 Introduction
		Why do we use outcome measures in rehabilitation?
		What are the important outcomes to measure?
		ICF level of functioning and outcome measurement
		QoL in rehabilitation
		Who decides which outcomes are the important ones?
		What makes a good outcome measure?
	5.2 Psychometrics ? a primer
			Content validity
			Criterion validity
			Construct validity
		Recent advances in  psychometrics
	5.3 Applying outcome measures in clinical  practice
		Using ‘indicators’
		Normative comparison values
		The use of national / international core sets
		Cultural relevance
		Personal impact for patients
	5.4 Conclusion
	Additional resources
Chapter 6: The person in context
	6.1 Introduction
	6.2 Who are the stakeholders in rehabilitation?
	6.3 Key terms
		Person and personhood
		Person- centredness, patient- centredness and personalization
		Personal factors
	6.4 The lived experience of acquired disability
	6.5 Rehabilitation as a personal journey of reconstruction or transformation of the self
	6.6 Understanding rehabilitation as ‘work’and the role of participation
	6.7 Clinical services guiding and supporting personal rehabilitation journeys
	6.8 Placing the person in their family contextand involving families in rehabilitation
	6.9 Ideas for making clinical rehabilitation processes and practices person-centred
		Idea 1: Get to know yourself
		Idea 2: Authentically seek to understand the person who is the patient within the context of their life story
		Idea 3: Take responsibility for building a trusting relationship that enables patients to do the physical and biographical work of rehabilitation
		Idea 4: Consider ways of incorporating into your practice strategies that empower, or ‘activate’ patients
		Idea 5: Acknowledge, value, respect and support the biographical as well as the physical and psychological work of rehabilitation
	6.10 Can we do person-centred rehabilitation?
	Additional resources
Chapter 7: Conclusion: rethinking rehabilitation
	7.1 Introduction
	7.2 The ICF as a theoretical framework and language for rehabilitation
	7.3 Interprofessional teamwork in rehabilitation
	7.4 Processes in rehabilitation: goal settingand its mediators
	7.5 Outcome measurement to evaluate rehabilitation and show it makes a difference
	7.6 The importance of  the individual person in their context and how to do person-centred rehabilitation
	7.7 Using the ICF as a way to map interprofessional rehabilitation
	7.8 Revisiting the  definition of rehabilitation
	7.9 Limitations related to the scope of  this textbook
	7.10 Future directions of interprofessional rehabilitation
	7.11 Conclusion
	Additional resources
Document Text Contents
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Processes in rehabilitation 89

less relevant. If goal planning is undertaken too quickly however, insufficient time

may have been spent on building a rapport with the patient and their family, learning

about their priorities and usual social context, before goals are set. There are no firm

rules about when is best to set initial goals for rehabilitation, but one guideline might

be that the longer and more complex the anticipated rehabilitation programme, the

more time should be spent on building a working relationship with the patient and

their family before confirming the goals of rehabilitation. In these types of service,

pushing patients to set goals for therapy within their first interactions with clinicians,

before they have had time to consider the implication of their newly acquired disabil-

ity, may well be premature and result in superficial, tokenistic goals, rather than goals

that reflect their personal context and world view.

Setting long-term goals

Prior to setting short-term goals and assigning clinical tasks, it is usually a good idea

to establish the patient’s long-term goals. In rehabilitation the phrase ‘long-term goal’

is sometimes used just to refer to any goal that is to be achieved at a more distant point

in time (e.g. after discharge from a service or after a set period such as 4 or more

weeks), with ‘short-term goals’ being the ‘steps’ required to make progress towards

this ‘long-term goal’ (e.g. to be achieved after periods of 2 weeks or less). However,

‘long-terms goals’ can often be qualitatively different from ‘short-term goals’ as well.

For example the phrase ‘long-term goals’ can at times be used to refer to: (1) goals

that emphasize the direction the patient wishes to take with their life, (2) goals that are

stated by the patient without reinterpretation or negotiation by the rehabilitation team,

or (3) goals that are grouped under the ICF category of ‘participation’.

Long-term goals can be identified by simply asking patients questions such as

‘where do you see yourself in 6 months’ time?’ or ‘what do you hope to eventually

achieve from rehabilitation?’ If this open-ended approach is unsuccessful then

prompts under headings such as ‘family’, ‘work’, ‘leisure’, ‘community activities’,

‘social relationships’ and ‘friends’ may provide the starting points for discussion

about these goals. In some situations (for example if the client has cognitive problems)

this discussion will benefit from input from members of their family.

Alternatively, long-term goals can be established by using some method for

identifying a patient’s life goals. Life goals have been defined as ‘the desired states

that people seek to obtain, maintain or avoid’ (Nair, 2003 ). Although a number of

tools are available to evaluate life goals (Conrad et al., 2010 ; Nair, 2003 ), there is one

tool designed specifically for the purpose of facilitating meaningful goal planning in

rehabilitation settings and this is the Rivermead Life Goals Questionnaire (RLGQ).

A copy of this questionnaire has been reproduced in Figure  4.4 .

One important point regarding the RLGQ is that although ‘scores’ can be gener-

ated from its items, it has in no way been promoted as an outcome measure. This is

because it is impossible to say whether changes in scores on individual RLGQ items

represent improvements or deterioration in health outcomes. Also of note, apart from

the original development work that went into the RLGQ (McGrath and Adams, 1999 ),

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