OCCUPATIONAL THERAPISTS EXPECTATIONS IN REHABILITATION FOLLOWING STROKE - SOURCES OF SATISFACTION AND DISSATISFACTION

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.