Date of Award

2014

Degree Type

Thesis

Degree Name

Doctor of Philosophy

School

School of Nursing & Midwifery

Faculty

Faculty of Health, Engineering and Science

First Advisor

Dr Anne Wilkinson

Second Advisor

Dr Gilly Smith

Third Advisor

Dr Claudette Kelly

Abstract

Stroke is one of the more disabling conditions which may result in the inability for survivors to care for themselves independently. Stroke survivors benefit most when they receive early onset assessment, treatment, and rehabilitation. Increasingly, stroke care in Canadian hospitals relies on an interdisciplinary rehabilitation team approach to provide immediate rehabilitation services and to make decisions about discharge destination for stroke survivors. Currently, there is little research on how interdisciplinary rehabilitation teams decide upon rehabilitation placements for stroke survivors or how individuals on the team, stroke survivors, or their families participate in and contribute to this decision. This research studied the culture of the interdisciplinary rehabilitation team to understand the specific client, clinical, and family situations considered by team members and how that information was communicated and evaluated by them during their decision-making.

To address the research question, the researcher undertook an ethnographic study of a health care team on a stroke unit of a Canadian hospital. Based on observations of the interdisciplinary rehabilitation team and interviews with team members, the study found that decisions about post-hospital discharge destination were conditioned by variables related to the social, economic, and policy context; interactions among members of the team; and the condition of stroke survivors or their families and their ability and willingness to contribute to home care.

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