Article

PURPOSE: To explore how therapy in a home and day hospital setting impacts on
rehabilitation processes and outcomes from the perspective of the patients, their
significant others and their treating occupational therapists. METHOD: Fourteen
participants with severe traumatic brain injury received a one-to-one,
goal-directed, client-centred outpatient occupational therapy programme (a) in
their home for 6 weeks and (b) in a day hospital clinic for 6 weeks. The
experience of rehabilitation in both settings was explored using semi-structured
interviews with the participants, their significant others and their treating
occupational therapists. RESULTS: Participants and their significant others
described the two environments as disparate with home-based therapy perceived as
more relaxing, normal, satisfying and effective. The approach to therapy at home
was commonly described as 'real-life' whereas the therapy approach in day
hospital was characterised as 'simulation of real life tasks' and 'remedial
exercises'. Participants' experience of therapy relationships at home was
characterised as 'friendship', in which the therapist was a 'visitor', whereas in
the hospital, participants were characterised as 'patients' and therapists as
'bosses' and 'teachers'. CONCLUSION: The experience of home-based therapy was
perceived as more convenient, positive and preferred by patients and their family
members. Therapists described more therapeutic benefits and the ability to work
more effectively on activity and participation level goals in the client's real-life environment.

Langue : ANGLAIS