Reprise des loisirs et des activités sociales à domicile après un AVC : quel accompagnement de l’ergothérapeute en équipe mobile de réadaptation-réinsertion ?

Abstract : Introduction: Evidence-based data show that coming back home after a stroke takes a great psychological toll on patients.Their lives have changed and they are facing difficulties in their daily life activities. The occupational therapist has a major role in supporting them so that they are able to go back to their meaningful activities, especially concerning leisure, in order to maintain their sense of identity. In France, mobile stroke units have recently been deployed in several regions to support patients at home, and include occupational therapists to tackle these occupational issues. This study aimed to understand the practice of occupational therapists in mobile stroke units in order to help patients resume their leisure activities. Method: A qualitative approach was used: nine occupational therapists were interviewed. Verbatim records were analysedusing the Iramuteq® software. They were also analysed regarding the theories of mourning, of care, and the model of human occupation. Results: Interviewed occupational therapists systematically questioned the patient’s leisure activities, but did not always provide support to help the patients resume these activities. Situational exercises and tools such as typical day diaries were often used. Quoted obstacles included the patient’s cognitive impairments, limitations in mobility, cost and lack of organisations to liaise with. For occupational therapists, time was the main difficulty, preventing them from tackling these issues. Discussion: Temporality seems to be important on different levels, including the moment when the patient is helped after their stroke, the number of home visits, their duration, and the overall period of time over which these sessions are spread. A partnership with other professionals appears essential to ensure results on the long term. Occupational therapists do not always identify their interventions as enabling a person to resume their leisure activities. This could be linked with the current shift in professional identity foroccupational therapists, and the emergence of occupational science in practices. This qualitative study could be extended with a quantitative longitudinal study following the interventions of occupational therapists in mobile stroke units.
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https://dumas.ccsd.cnrs.fr/dumas-02023821
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Submitted on : Monday, February 18, 2019 - 4:53:53 PM
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Anne-Cécile Larricq. Reprise des loisirs et des activités sociales à domicile après un AVC : quel accompagnement de l’ergothérapeute en équipe mobile de réadaptation-réinsertion ?. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02023821⟩

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