Contexte : L'autonomie est un concept central tant en bioéthique qu'en réadaptation. La bioéthique a mis l'accent sur l'autonomie en tant qu'auto-gouvernance et sur son application dans la prise de décision en matière de traitement. En plus de discuter de l'autonomie décisionnelle, la réadaptation met aussi l'accent sur l'autonomie en tant qu'indépendance fonctionnelle. Dans la pratique, la prise en charge des patients en perte d'autonomie est une composante importante des soins de réadaptation, mais elle engendre aussi des tensions et des défis. Notre objectif était de mieux comprendre les façons complexes et distinctes dont l'autonomie est comprise et maintenue dans le contexte des soins de réadaptation en examinant comment l'autonomie est abordée dans la littérature sur la réadaptation. Méthodes : Nous avons effectué une étude de la portée des questions d'autonomie dans le contexte de la réadaptation mentale et physique. Notre processus s'est déroulé en trois étapes séquentielles. Nous avons extrait et analysé des informations bibliométriques. Nous avons ensuite examiné comment l'autonomie était définie et conceptualisée. Enfin, nous avons examiné la façon dont les articles traitaient du rôle des professionnels de la santé en réadaptation dans l'autonomie des patients. Résultats : Les articles comprennent 16 rapports empiriques, 17 études de cas et 30 articles théoriques. Les récits conceptuels les plus courants sur l'autonomie s'appuyaient sur le principisme, les analyses fondées sur les droits et les analyses juridiques et les approches relationnelles/sociales. Nous avons identifié quatre grandes approches pour répondre à l'autonomie du patient : le soutien, la promotion, le respect et la promotion. Conclusion : Cet examen aide à clarifier certaines des ambigüités et des distinctions conceptuelles qui sous-tendent les discussions et les pratiques liées à l'autonomie en réadaptation. Il attire également l'attention sur un large éventail d'activités que les professionnels de la santé peuvent entreprendre dans le but de soutenir, de promouvoir, de respecter et de promouvoir l'autonomie des patients dans les soins de réadaptation. Background: Autonomy is a central concept in both bioethics and rehabilitation. Bioethics has emphasized autonomy as selfgovernance and its application in treatment decision-making. In addition to discussing decisional autonomy, rehabilitation also focuses on autonomy as functional independence. In practice, responding to patients with diminished autonomy is an important component of rehabilitation care, but also gives rise to tensions and challenges. Our objective was to better understand the complex and distinctive ways that autonomy is understood and upheld in the context of rehabilitation care by reviewing how autonomy is discussed in the rehabilitation literature. Methods: We conducted a scoping review addressing issues of autonomy in the context of mental and physical rehabilitation. Our process followed three sequential steps. We extracted and analyzed bibliometric information. ...
A PW simulator may be helpful if it supports the practice of activities in specific contexts (such as a bathroom or supermarket), to complement the basic skills training received in the clinic (such as driving forward, backward, turning, and avoiding obstacles). Implications for Rehabilitation New power wheelchair users appreciate practicing on a virtual reality simulator and find the experience useful when the simulated diving activities are realistic and ecologically valid. User-centred development can lead to simulated power wheelchair activities that adequately capture everyday driving challenges experienced in various environmental contexts.
Ethics education is the cornerstone of professional practice, fostering knowledge and respect for core ethical values among healthcare professionals. Ethics is also a subject well-suited for interprofessional education and collaboration. However, there are few initiatives to gather experiences and share resources among ethics educators in rehabilitation. We thus undertook a knowledge exchange project to 1) share knowledge about ethics training across Canadian occupational and physical therapy programs, and 2) build a community of educators dedicated to improving ethics education. The objectives of this paper are to describe this interprofessional knowledge exchange project involving ethics educators (with a diversity of professional and disciplinary backgrounds) from Canadian occupational and physical therapy programs as well as analyze its outcomes based on participants' experiences/perceptions. Two knowledge exchange strategies were employed: an interactive one-day workshop and a wiki platform. An immediate post-workshop questionnaire evaluated the degree to which participants' expectations were met.Structured telephone interviews nine to ten months after the workshop collected participants' perceptions on whether (and if so, how) the project influenced their teaching or led to further interprofessional collaborations. Open-ended questions from the post-workshop questionnaires and individual interviews were analyzed using qualitative methods. Of 40 ethics educators contacted, 23 participated in the workshop and 17 in the follow-up interview. Only 6 participants logged into the wiki from its launch to the end of data collection. Five themes emerged from the qualitative analysis: 1) belonging and networking; 2) sharing and collaborating; 3) changing (or not) ways of teaching ethics; 4) sustaining the network; and 5) envisioning the future of ethics education. The project attained many of its goals, despite encountering some challenges. While the wiki platform proved to be of limited benefit in advancing the project goals, the interactive format and collaborative nature of the one-day workshop were described as rewarding and 3 effective in bringing together occupational therapy and physical therapy educators to meet, network, and share knowledge.
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