Occupational therapy leadership: promoting an autonomy-supportive environment based on self-determination theory, to improve patient outcomes in acute and post-acute stroke rehabilitation
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Abstract
A major dilemma that is being addressed in the current project is the
discrepancies between healthcare system's expectations for a rapid and successful
rehabilitation process and patients after having a stroke ability to meet these expectations
while striving to adapt to the calamitous event in their life. Emphasizing a more
biomedical approach and under implementation of psychosocial approaches, poor
acknowledging of patients' basic psychological needs lead to poor motivation, therapeutic
disengagement and may lead to a rehabilitation failure.
To cope with this gap in the process of stroke rehabilitation, an educational
program aiming for occupational therapists working with patients after having a stroke in
their acute and post-acute rehabilitation phases was constructed. The program guides
practitioners for effective communication with their patients, building a needs-supportive
environment and addressing their patients' basic psychological needs in light of the selfdetermination
theory, theories of adaptation from occupational therapy perspectives and
considering occupational justice and the ICF model. A clinical reasoning, step-by-step
problem solving is introduced using adaptation of known models and innovated models
for interventions that were created for this purpose.
Program delivery through a series of 4-webinar modules is illustrated with their
learning objectives, assignments and discussions. The program evaluation and
implementation are expected to be the initiator of a change in the health and rehabilitation
climate and in Israel.
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Attribution-NonCommercial-NoDerivatives 4.0 International