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Patients’ views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury—A qualitative interview‐based study

INTRODUCTION: Involving patients in decision making is a legal requirement in many countries, associated with better rehabilitation outcomes, but not easily accomplished during initial inpatient rehabilitation after severe trauma. Providing medical treatment according to the principles of shared dec...

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Autores principales: Scheel‐Sailer, Anke, Post, Marcel W., Michel, Franz, Weidmann‐Hügle, Tatjana, Baumann Hölzle, Ruth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5600242/
https://www.ncbi.nlm.nih.gov/pubmed/28338280
http://dx.doi.org/10.1111/hex.12559
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author Scheel‐Sailer, Anke
Post, Marcel W.
Michel, Franz
Weidmann‐Hügle, Tatjana
Baumann Hölzle, Ruth
author_facet Scheel‐Sailer, Anke
Post, Marcel W.
Michel, Franz
Weidmann‐Hügle, Tatjana
Baumann Hölzle, Ruth
author_sort Scheel‐Sailer, Anke
collection PubMed
description INTRODUCTION: Involving patients in decision making is a legal requirement in many countries, associated with better rehabilitation outcomes, but not easily accomplished during initial inpatient rehabilitation after severe trauma. Providing medical treatment according to the principles of shared decision making is challenging as a point in case for persons with spinal cord injury (SCI). OBJECTIVES: The aim of this study was to retrospectively explore the patients’ views on their participation in decision making during their first inpatient rehabilitation after onset of SCI, in order to optimize treatment concepts. METHODS: A total of 22 participants with SCI were interviewed in‐depth using a semi‐structured interview scheme between 6 months and 35 years post‐onset. Interviews were transcribed verbatim and analysed with the Mayring method for qualitative content analysis. RESULTS: Participants experienced a substantially reduced ability to participate in decision making during the early phase after SCI. They perceived physical, psychological and environmental factors to have impacted upon this ability. Patients mentioned regaining their ability to make decisions was an important goal during their first rehabilitation. Receiving adequate information in an understandable and personalized way was a prerequisite to achieve this goal. Other important factors included medical and psychological condition, personal engagement, time and dialogue with peers. CONCLUSION: During the initial rehabilitation of patients with SCI, professionals need to deal with the discrepancy between the obligation to respect a patient's autonomy and their diminished ability for decision making.
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spelling pubmed-56002422017-10-01 Patients’ views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury—A qualitative interview‐based study Scheel‐Sailer, Anke Post, Marcel W. Michel, Franz Weidmann‐Hügle, Tatjana Baumann Hölzle, Ruth Health Expect Original Research Papers INTRODUCTION: Involving patients in decision making is a legal requirement in many countries, associated with better rehabilitation outcomes, but not easily accomplished during initial inpatient rehabilitation after severe trauma. Providing medical treatment according to the principles of shared decision making is challenging as a point in case for persons with spinal cord injury (SCI). OBJECTIVES: The aim of this study was to retrospectively explore the patients’ views on their participation in decision making during their first inpatient rehabilitation after onset of SCI, in order to optimize treatment concepts. METHODS: A total of 22 participants with SCI were interviewed in‐depth using a semi‐structured interview scheme between 6 months and 35 years post‐onset. Interviews were transcribed verbatim and analysed with the Mayring method for qualitative content analysis. RESULTS: Participants experienced a substantially reduced ability to participate in decision making during the early phase after SCI. They perceived physical, psychological and environmental factors to have impacted upon this ability. Patients mentioned regaining their ability to make decisions was an important goal during their first rehabilitation. Receiving adequate information in an understandable and personalized way was a prerequisite to achieve this goal. Other important factors included medical and psychological condition, personal engagement, time and dialogue with peers. CONCLUSION: During the initial rehabilitation of patients with SCI, professionals need to deal with the discrepancy between the obligation to respect a patient's autonomy and their diminished ability for decision making. John Wiley and Sons Inc. 2017-03-24 2017-10 /pmc/articles/PMC5600242/ /pubmed/28338280 http://dx.doi.org/10.1111/hex.12559 Text en © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research Papers
Scheel‐Sailer, Anke
Post, Marcel W.
Michel, Franz
Weidmann‐Hügle, Tatjana
Baumann Hölzle, Ruth
Patients’ views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury—A qualitative interview‐based study
title Patients’ views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury—A qualitative interview‐based study
title_full Patients’ views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury—A qualitative interview‐based study
title_fullStr Patients’ views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury—A qualitative interview‐based study
title_full_unstemmed Patients’ views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury—A qualitative interview‐based study
title_short Patients’ views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury—A qualitative interview‐based study
title_sort patients’ views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury—a qualitative interview‐based study
topic Original Research Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5600242/
https://www.ncbi.nlm.nih.gov/pubmed/28338280
http://dx.doi.org/10.1111/hex.12559
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