Disability meanings according to patients and clinicians: imagined recovery choice pathways
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The purpose of this study was to explore how the meaning of disability varies between patients with acute-onset activity limitations and clinicians, and between males and females.
Seventy-nine patients undergoing inpatient rehabilitation and 93 practicing rehabilitation clinicians in the USA developed personal recovery choice pathways through recovery preference exploration (RPE). Imagining complete dependence in 18 activities as diverse as eating and expression, each individual determined an optimal sequence of recovery. This sequence was used to determine the relative value of each activity compared with the other 17. Three comparisons were made by calculating the mean absolute difference (MAD) in median utilities, including patients versus clinicians, male versus female patients, and male versus female clinicians. The MAD shows the relative magnitude of disparity between each pair.
The MAD value between patients and clinicians was 3.4 times larger and 4.8 times larger than the MAD values between male and female patients and male and female clinicians, respectively.
The much larger difference in recovery preferences between patients and clinicians compared with differences between genders suggests that life contexts of being a patient with disabilities versus a clinician are more potent determinants of activity limitation perspectives than being a man or woman.
KeywordsActivities of daily living Decision making Patient-centered care Patient care team Quality of life
Recovery preference exploration
Mean absolute difference
International classification of functioning, disability, and health
World Health Organization
Quality of life
Functional Independence Measure
Schedule for the Evaluation of Individual Quality of Life
Canadian Occupational Performance Measure
This research was supported in part by the National Institutes of Health grant R21 HD045881 from the National Institute of Child Health and Human Development. The opinions of the authors are not necessarily those of the supporting agencies.
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