Promoting Patient Wellbeing in Rehabilitation by Rona Harcus @RonaAHPed, Occupational Therapist, NHS Orkney #AHPCFS2022 @NESnmahp

Whilst working in rehabilitation I have been honoured to work with many inspiring people who have bravely accepted their condition and worked hard to achieve personal goals, despite many challenges.  Often people source personal strength and support from those around them to cope well with this experience.  Sadly, many people struggle and can experience poor wellbeing, which can impact on their rehabilitation.  Often as AHP’s we work with people who struggle to engage in therapy, have difficulty setting goals, feel dissatisfied and do not wish to return home.   These behaviours are often associated with poor mental health and can have a negative impact upon recovery and timely discharge.    With service pressures, ensuring people get the right support at the right time can be a challenge.  It leads me to wonder, do we truly understand what is at the root cause of these behaviours? Are we supporting these people adequately?

‘As an AHP I feel we often fail to understand these people and provide them with the adequate support.  It is imperative we gain a better understand of their lived experience, before seeking solutions to how we improve outcomes for them’

AHP Career Fellowship

When the opportunity to apply for an AHP Career Fellowship arose, I saw this as the ideal opportunity to take some time out of my busy workload to explore and promote the wellbeing of people engaging in rehabilitation.   As my colleague observes similar issues in the community rehabilitation service, we decided to work together on this project and co-lead a Career Fellowship.

In our Fellowship project we aim to:

– Explore the concept of patient wellbeing by gathering patient stories and lived experience of rehabilitation journeys.  

-Engage with Staff to explore their thoughts and feelings on patient wellbeing and raise awareness of the value of promoting patient wellbeing

-Research best practice, guidelines and policy

-Share findings with the Team and facilitate the creation of a development plan and referral pathway to promote patient wellbeing

Power of Language & Terminology

Sharing this Fellowship project and journey with my Colleague has been invaluable.   As the project has progressed we have faced several unforeseen challenges, which we have worked through together.  One such example is language.  As we embarked on the project we initially used the term ‘mental wellbeing’ to describe the concept we wished to explore.   It was only when inviting our first participant to interview that we realised that this term could pose a problem.  Upon reading the information sheet, our participant saw the word ‘mental wellbeing’ and declined to proceed, stating ‘she didn’t have mental health problems and it would not be relevant to her’.   It was at this point that we realised the power of language and the importance of getting our terminology right.  Whilst reflecting and exploring this and meeting with key members of the Team, we also became aware that behaviours often exhibited were also linked with spiritual distress, a concept we had not yet considered.  

It was at this point that we chose to use the term ‘wellbeing’, use The World Health Organisation’s (WHO) definition of health and wellbeing, and agree upon a visual model to help define the concept of wellbeing to participants and staff.   

Model of Wellbeing

Stopping what we were doing, to reflect upon and respond to these findings did delay our project and created anxiety that we would not meet our deadlines.   However, we have realised that ‘it was of more importance to clearly define the concept we wish to explore and get the terminology right before proceeding, if we were to be successful in achieving our project aims’.

Next Stage

The next stage of our Fellowship is to engage with staff and meet with participants to gather their lived experience.   Now that we have a more holistic understanding of what constitutes health and wellbeing we feel more confident articulating the concept we seek to explore.    We are hopeful that by exploring peoples’ experience of rehabilitation it will enhance our understanding of their wellbeing at this time and enable us to compile a development plan and referral pathway, based on evidence and lived experience, to promote wellbeing and ensure ‘the right support at the right time’.

Rona Harcus

Occupational Therapist & AHP Career Fellow Cohort 3 –  NHS Orkney    @RonaAHPed                                                                             March 2022


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