Perception des cliniciens, gestionnaires et usagers à l’égard des interventions de groupe offertes pendant la réadaptation en déficience physique
Introduction: The demand for physical rehabilitation services in auditory, language, motor or visual impairment is growing. Concerned about the access and the efficiency of the services, rehabilitation settings are called upon to increasingly offer group interventions. Objectives: The first objective of this study is to examine the facilitators and barriers to the implementation of group interventions in rehabilitation. The second objective is to explore the perception of clinicians, managers and patients of issues related to quality of care, costs and the achievement of goals during those interventions. Methodology: A multiple case study design was used. Clinicians and managers from five rehabilitation centres in the Montreal area were consulted using an online questionnaire (n = 162) and focus groups. Individual interviews were conducted with patients who participated in group interventions. Descriptive and quantitative statistics were performed for the results of the questionnaire. The qualitative data were grouped by themes and triangulated with the results of the questionnaire. Results: Key facilitators include patient’s interest, potential for influence among participants, and recognition of the value of these interventions. The main obstacles are schedule management, time required for reasonning and planning the interventions and having a critical mass of patients which is sometimes insufficient to form groups. Regarding the second objective, group interventions are perceived as safe. They should be offered for profit rather than for financial reasons and be linked to the achievement of patient goals. They must also be offered as a complement to individual interventions. Conclusion: Group interventions provide many benefits. A better understanding of the perceptions of key actors will facilitate their implementation as well as their sustainability. Recommendations are proposed to help managers and clinicians plan services and at thus maximize benefits for patients.
Rehabilitation Physical rehabilitation Physical impairment Group interventions Facilitators and barriers Quality of care Accessibility Costs Safety Effectiveness