Part 1 of this study examined the range of objectives that must be included in a personal rehabilitation plan, in order to ensure compatibility with clients' goals, values and aspirations. In Part 2, examination is made of the importance of identifying when objectives have been reached and what characteristics these objectives should have for it to be possible to recognise that they have been achieved. This is placed in the context of accountability and the use of outcome measures. Spinal cord injury is again used for illustration. Consideration is given to the possible barriers to active patient participation in the rehabilitation process.
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References
1.
Department of National Health and Welfare and Canadian Association of Occupational Therapists. Guidelines for the client centred practice of occupational therapy. Ottawa: Department of National Health and Welfare, 1983.
2.
Department of National Health and Welfare and Canadian Association of Occupational Therapists. Towards outcome measures in occupational therapy. Ottawa: Department of National Health and Welfare, 1987.
3.
KirchmanMMLoomisB. A longitudinal study assessing the quality of occupational therapy. Am J Occup Ther1980; 34(9): 582–86.
4.
BanjaJD. Rehabilitation and empowerment. Arch Rhys Med Rehabil1990; 71: 614–15.
5.
WoodburyB. Psychological adjustment to spinal cord injury: A literature review (1950–1977). Rehabil Psychol1978; 25(3): 119–34.
6.
World Health Organisation. International classification of impairments, disabilities and handicaps: A manual of classification relating to the consequences of disease. Geneva: WHO, 1980.
7.
American Spinal Injury Association. Standards for neurological and functional classification of spinal cord injury. Chicago: ASIA, revised 1992.
8.
WhiteneckGG. Outcome analysis in spinal cord injury rehabilitation. In: FuhrerMJ, ed. Rehabilitation outcomes: Analysis and measurement. Baltimore: Brookes, 1987.
9.
MahoneyFIBarthelDW. Functional evaluation: The Barthel index. Md State Med J1965; 14: 61–65.
10.
GreshamGLabiMDittmarSHicksJJoyceSStehlikM. The Quadriplegia Index of Function. Paraplegia1986; 24: 38–44.
11.
GrangerCVHamiltonBBKeithRAZieleznyMSherwinFS. Advances in functional assessment for medical rehabilitation. Topics Geriatr Rehabil1986; 1(3): 59–74.
12.
WhiteneckGG. A functional independence measure trial in SCI model systems. Proc Am Spinal Injury Assoc1988; 14: 48.
13.
LawMBaptisteSMcCollMAOpzoomerAPolatajkoHPollockN. The Canadian Occupational Performance Measure: An outcome measure for occupational therapy. Can J Occup Ther1990; 57(2): 82–87.
14.
LawMBaptisteSCarswell-OpzoomerAMcCollMAPolatajkoHPollockN. Canadian Occupational Performance Measure. Toronto: Canadian Association of Occupational Therapists, 1991.
15.
Wood-DauphineeSKuchlerT. Quality of life as a rehabilitation outcome: Are we missing the boat?Can J Rehabil1992; 6(1): 3–12.
16.
TrieschmannRB. Spinal cord injuries: Psychological, social and vocational rehabilitation. 2nd ed.New York: Demos, 1988: 28, 38–39.
17.
YerxaEJ. Occupational therapy's role in creating a future climate of caring. Am J Occup Ther1980; 34: 529–34.
18.
OliverMZarbGSilverJMooreMSalisburyV. Walking into darkness: The experience of spinal cord injury. Basingstoke: Macmillan, 1988: 80.
19.
PolatajkoHJ. Naming and framing occupational therapy: A lecture dedicated to the life of Nancy B. Can J Occup Ther1992; 59(4): 189–200.
20.
SeligmanM. Helplessness: On depression, development and death. San Francisco: W H Freeman, 1975.
21.
KanellosMC. Enhancing vocational outcomes of spinal cord injured persons: The occupational therapist's role. Am J Occup Ther1985; 39(11): 726–33.
22.
RotterJB. Generalised expectancies for internal versus external control of reinforcement. Psychol Monogr1966; 80: 1–28.
23.
JohnstonMGilbertPPartridgeCCollinsJ. Changing perceived control in patients with physical disabilities: An intervention study with patients receiving rehabilitation. Br J Clin Psychol1992; 31(1): 89–94.
24.
AlbrechtGHigginsP. Rehabilitation success: The interrelationships of multiple criteria. J Health Social Behav1977; 18: 36–45.
25.
JordanSAWellbornWRKovnikJSaltzeinR. Understanding and treating motivational difficulties in ventilator dependent SCI patients. Paraplegia1991; 29(7): 431–42.
26.
PentlandWKrupaTLynchSClarkC. Community integration for persons with disabilities: Working together to make it happen. Can J Occup Ther1992; 59(3): 127–30.
27.
HammellK. WhalleySpinal cord injury rehabilitation. London: Chapman and Hall, in press.
