The University of Southampton
University of Southampton Institutional Repository

Discharge from physiotherapy following stroke: the management of disappointment

Discharge from physiotherapy following stroke: the management of disappointment
Discharge from physiotherapy following stroke: the management of disappointment
Stroke tends to result in a range of disabilities which have been shown to benefit from rehabilitation, in particular physiotherapy. Patients tend to have high expectations of the extent of recovery they can achieve through physiotherapy, and subsequently view discharge from physiotherapy before they have achieved that degree of recovery as disappointing and distressing. Current literature suggest that explicit discussion between physiotherapists and patients of the anticipated extent of recovery tends to be avoided during the programme of physiotherapy treatment, making discharge from physiotherapy the point at which potentially differing expectations might be expected to be confronted. This paper explores how the process of discharge is managed and experienced by patients and physiotherapists. It draws on Craib's (1994) ideas about how disappointment is managed in modern society. A qualitative longitudinal study was conducted with 16 stroke patients and their physiotherapists. These data comprise interview and observational material. The study found that the discharge of stroke patients from physiotherapy is not a point when patients' expectations and optimism about recovery are confronted. The notion of natural recovery that was raised with patients by physiotherapists at discharge and the information physiotherapists gave about exercise post-discharge had the effect of maintaining patients' high expectations and hopes about recovery. This has implications for the process of adaptation and adjustment that the patient eventually goes through in order to accommodate their altered abilities and identity. We argue that a number of factors contribute to the denial of disappointment within this interaction and that services need to be developed in ways that enable physiotherapists to engage with the possibility of disappointment about stroke outcome with patients, thereby making a positive contribution to the process of adaptation and adjustment that stroke survivors experience following discharge.
patient, stroke, disabilities, disability, rehabilitation, outcome, survivors
0277-9536
1263 - 1273
Wiles, Rose
5bdc597b-716c-4f60-9f45-631ecca25571
Ashburn, Ann
818b9ce8-f025-429e-9532-43ee4fd5f991
Payne, Sheila
d7c97f41-ec69-4157-9339-ca07c521fbcc
Murphy, Caroline
6f95b133-c7a6-4852-96a8-52fe28fbc075
Wiles, Rose
5bdc597b-716c-4f60-9f45-631ecca25571
Ashburn, Ann
818b9ce8-f025-429e-9532-43ee4fd5f991
Payne, Sheila
d7c97f41-ec69-4157-9339-ca07c521fbcc
Murphy, Caroline
6f95b133-c7a6-4852-96a8-52fe28fbc075

Wiles, Rose, Ashburn, Ann, Payne, Sheila and Murphy, Caroline (2004) Discharge from physiotherapy following stroke: the management of disappointment. Social Science & Medicine, 59 (6), 1263 - 1273. (doi:10.1016/j.socscimed.2003.12.022).

Record type: Article

Abstract

Stroke tends to result in a range of disabilities which have been shown to benefit from rehabilitation, in particular physiotherapy. Patients tend to have high expectations of the extent of recovery they can achieve through physiotherapy, and subsequently view discharge from physiotherapy before they have achieved that degree of recovery as disappointing and distressing. Current literature suggest that explicit discussion between physiotherapists and patients of the anticipated extent of recovery tends to be avoided during the programme of physiotherapy treatment, making discharge from physiotherapy the point at which potentially differing expectations might be expected to be confronted. This paper explores how the process of discharge is managed and experienced by patients and physiotherapists. It draws on Craib's (1994) ideas about how disappointment is managed in modern society. A qualitative longitudinal study was conducted with 16 stroke patients and their physiotherapists. These data comprise interview and observational material. The study found that the discharge of stroke patients from physiotherapy is not a point when patients' expectations and optimism about recovery are confronted. The notion of natural recovery that was raised with patients by physiotherapists at discharge and the information physiotherapists gave about exercise post-discharge had the effect of maintaining patients' high expectations and hopes about recovery. This has implications for the process of adaptation and adjustment that the patient eventually goes through in order to accommodate their altered abilities and identity. We argue that a number of factors contribute to the denial of disappointment within this interaction and that services need to be developed in ways that enable physiotherapists to engage with the possibility of disappointment about stroke outcome with patients, thereby making a positive contribution to the process of adaptation and adjustment that stroke survivors experience following discharge.

This record has no associated files available for download.

More information

Published date: 1 September 2004
Keywords: patient, stroke, disabilities, disability, rehabilitation, outcome, survivors

Identifiers

Local EPrints ID: 18105
URI: http://eprints.soton.ac.uk/id/eprint/18105
ISSN: 0277-9536
PURE UUID: 0db7008d-f3bf-47f4-bb7a-8a9c4ccc6647

Catalogue record

Date deposited: 27 Oct 2005
Last modified: 15 Mar 2024 06:02

Export record

Altmetrics

Contributors

Author: Rose Wiles
Author: Ann Ashburn
Author: Sheila Payne
Author: Caroline Murphy

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×