Advantages and Disadvantages of the Home Setting for Therapy: Views of Patients and Therapists

A qualitative study was undertaken to explore patients' views and perceptions of a home-delivered therapy service. Fifteen subjects with hemiplegia were recruited from one health district, 10 women and 5 men. All subjects had experienced at least three consecutive sessions of both home-delivered therapy and hospital-based therapy in the preceding 18 months. A semi-structured interview was undertaken with each subject. Transcribed data were analysed using the grounded theory approach (Glaser and Strauss 1967). Five main themes were identified: ‘Convenience’, ‘Therapeutic environment’, ‘Social contact’, ‘Control’ and ‘Grateful recipient?’ Two discussion groups were held with six therapists after the data collection phase to explore their perceptions of the themes emerging from the interviews. The subjects identified convenience and being comfortable within the home as two significant advantages of home therapy. The therapists highlighted the greater relevancy of the home environment for intervention and goal setting. The disadvantages identified by the subjects included the lack of equipment and floor space and the demotivating effect of the home setting. The therapists identified the difficulty of determining control within a therapy session. The study demonstrated that the assumptions about the advantages and disadvantages of community-based rehabilitation services made by service providers are not necessarily experienced by the users of such services.

[1]  S. Ebrahim,et al.  Patients' satisfaction with stroke services , 1994 .

[2]  R. Shayon.  Open to criticism , 1971 .

[3]  G. C. Pascoe,et al.  Patient satisfaction in primary health care: a literature review and analysis. , 1983, Evaluation and program planning.

[4]  I. Reinvang,et al.  Acquiring and maintaining self-care skills after stroke. The predictive value of apraxia. , 1985, Scandinavian journal of rehabilitation medicine.

[5]  M. Johnston,et al.  Perceived control of recovery from physical disability: measurement and prediction. , 1989, The British journal of clinical psychology.

[6]  R. Andersen,et al.  Health care in the U.S. : equitable for whom? , 1980 .

[7]  C. Velozo,et al.  Using the assessment of motor and process skills to compare occupational performance between clinic and home settings. , 1994, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[8]  M. Avis,et al.  Incorporating patients' voices in the audit process. , 1997, Quality in health care : QHC.

[9]  K. Wilson,et al.  Consumer satisfaction with a rehabilitation mobile outreach program. , 1995, Archives of physical medicine and rehabilitation.

[10]  N. Lincoln,et al.  A randomised controlled trial of domiciliary and hospital-based rehabilitation for stroke patients after discharge from hospital. , 1993, Journal of neurology, neurosurgery, and psychiatry.

[11]  A. Stewart,et al.  The measurement and meaning of patient satisfaction. , 1978, Health & medical care services review.

[12]  M Tamm,et al.  What does a home mean and when does it cease to be a home? Home as a setting for rehabilitation and care. , 1999, Disability and rehabilitation.

[13]  Bjørneby Er,et al.  Acquiring and maintaining self-care skills after stroke. The predictive value of apraxia , 2018, Journal of Rehabilitation Medicine.

[14]  Frazer Fw.  Domiciliary physiotherapy--cost and benefit. , 1981 .

[15]  A. Strauss,et al.  Basics of Qualitative Research , 1992 .

[16]  S. Michie,et al.  Happy ever after. , 1994, The Health service journal.

[17]  Gary Lafferty,et al.  Community-based alternatives to hospital rehabilitation services: a review of the evidence and suggestions for approaching future evaluations , 1996 .