Lh. Chang et Br. Hasselkus, OCCUPATIONAL THERAPISTS EXPECTATIONS IN REHABILITATION FOLLOWING STROKE - SOURCES OF SATISFACTION AND DISSATISFACTION, The American journal of occupational therapy, 52(8), 1998, pp. 629-637
Objective. The purpose of this study was to gain understanding of the
satisfactions and dissatisfactions in the work of occupational therapi
sts with clients after stroke. Method. Data consisted of narrative des
criptions by 32 therapists of especially satisfying and dissatisfying
experiences in practice. Phenomenology and grounded theory strategies
were used for the study design and data analysis. Results. ''Expectati
on'' emerged as the core meaning of occupational therapy in stroke reh
abilitation. Strong satisfaction was expressed when therapist-informan
ts believed that they had fulfilled their expectations for clients to
achieve the following: (a) maximum neuromuscular and functional recove
ry in affected upper extremities; (b) independence in daily activities
; and (c) return to living in the community. Major sources of informan
ts' dissatisfactions were reaching the ''plateau'' stage of neurologic
al recovery, disagreement between therapist expectations and client an
d family member expectations and working with clients perceived as pea
rly motivated. Conclusion. American ideologies about the value of hard
work, independence, and self-sufficiency appear to strongly shape the
rapists' expectations, satisfaction, and dissatisfaction in stroke reh
abilitation. For occupational therapists, a tension may exist between
the idealism of their therapeutic expectations and the realities of st
roke recovery as it is experienced within the context of clients' ongo
ing lives.