Users' Perspectives on the Organization of Rehabilitation Services – A Focus Group Study of User Organization Representatives in Norway

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES Health Expectations Pub Date : 2024-12-25 DOI:10.1111/hex.70139

Helene Lundgaard Søberg, Per Koren Solvang, Nada Andelic, Cecilie Røe, Marit Kirkevold

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Abstract

Background

User organizations for people with disabilities in Norway work for social equality and participation, and quality of health services for people with disabilities, chronic illnesses and reduced functional capacity. Consideration of the experiences from user representatives is necessary when determining the quality and appropriateness of the rehabilitation services. Rehabilitation services constitute the provision and delivery of intangible products to maintain or improve functioning in individual patients or patient groups. Rehabilitation services can be characterized at the policy (macro), organizational (meso) and individual (micro) levels.

Objectives

To explore user representatives' perspectives on rehabilitation service provision and organization and how they experience the influence they exert.

Methods

Focus group interviews with 14 representatives nominated from 11 user organizations in Norway conducted in 2021. Two online focus groups using a semi-structured interview guide were conducted. Data analysis was performed according to Braun and Clarke's thematic data analysis.

Results

Six core themes were developed when analyzing the participants' experiences and opinions regarding rehabilitation services. The themes were inter-connected and addressed perspectives on Access to services, Integration of care, Rehabilitation team, Person centeredness, System and governance and Modes of user representation and contribution.

Conclusion

The user representatives revealed tension and complexity influencing the provision and organization of rehabilitation services from individual access to health policy and regulation. Empowering user representatives through training was important to fight tokenism. Filling the role of a user representative at the meso level requires the integration of personal and peer experiences at the micro level, and knowledge of health policy regulations at the macro level.

Patient or Public Contribution

The Norwegian Federation of Organisations of Persons with Disabilities recruited user representatives in this study. The user representatives participated in the assessment and discussion of the results of the study. The results were presented for discussion to the User panel at the Research Centre for Habilitation and Rehabilitation Models & Services (CHARM) at the University of Oslo.

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使用者对康复服务组织的看法-挪威使用者组织代表的焦点小组研究。

背景：挪威残疾人用户组织致力于促进社会平等和参与，以及为残疾人、慢性病患者和功能减退者提供高质量的保健服务。在确定康复服务的质量和适当性时，必须考虑用户代表的经验。康复服务包括提供和交付无形产品，以维持或改善患者个人或患者群体的功能。康复服务可分为政策（宏观）、组织（中观）和个人（微观）三个层次。目的：探讨使用者代表对康复服务提供和组织的看法，以及他们如何体验他们所施加的影响。方法：于2021年对挪威11个用户组织提名的14名代表进行焦点小组访谈。使用半结构化访谈指南进行了两个在线焦点小组。数据分析参照Braun和Clarke的专题数据分析。结果：通过分析参与者对康复服务的体验和意见，形成了六个核心主题。这些主题相互关联，涉及以下方面的观点：获得服务、综合护理、康复团队、以人为本、系统和治理以及用户代表和贡献模式。结论：用户代表揭示了从个人获得卫生政策和法规影响康复服务提供和组织的紧张和复杂性。通过培训赋予用户代表权力对于打击象征性主义很重要。在中观层面发挥用户代表的作用，需要在微观层面整合个人和同行经验，在宏观层面整合卫生政策法规知识。患者或公众贡献：挪威残疾人组织联合会在这项研究中招募了用户代表。用户代表参加了对研究结果的评估和讨论。研究结果已提交给奥斯陆大学康复和康复模式与服务研究中心的用户小组讨论。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.