It is widely acknowledged within rehabilitation services for people with Acquired Brain Injury, that there is considerable variation in the degree of engagement, and that this has the potential to affect outcomes. While it is recognised that subjective beliefs are an important factor in engagement, little is known about how clients perceive their experience, what expectations they have in relation to recovery and rehabilitation, and how their perceptions impact on engagement with rehabilitation. This research aimed to explore clients' perspectives and increase knowledge of clients' expectations of recovery and rehabilitation, prior to beginning community based rehabilitation; and to develop a theoretical explanation, upon which improvements in service delivery and practice can be based. The research aims were explored through a qualitative methodology, using a symbolic interactionist theoretical perspective to grounded theory, to facilitate the process of theory generation (Glaser & Strauss 1967, Charmaz 2006). Twenty-one people were interviewed prior to being seen by community rehabilitation services, including people with communication and cognitive impairments The central theme that emerged was hoping-despairing, with five further main categories: making sense of what has happened, moving forward, what can I do?, trusting/doubting others, and accepting. An explanatory framework was developed and a model was proposed, by which belief in self/others and belief in recovery interact to generate hope and readiness to engage. A focus group consisting of specialist rehabilitation therapists was conducted, to compare the expectations of clients and therapists. The findings suggest that expectations and beliefs at this stage in the rehabilitation pathway influence the degree of engagement with rehabilitation services, and that this has implications for clinical intervention. While the context of qualitative research is critical in interpreting findings, it is felt that there are wide implications for ABI services and other areas of health care.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:647045 |
| Date | January 2015 |
| Creators | Gravell, Rosemary |
| Contributors | Brumfitt, Shelagh ; Body, Richard |
| Publisher | University of Sheffield |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://etheses.whiterose.ac.uk/8987/ |
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