Implementation of medical rehabilitation for children with severe disabilities, arranged by the Social Insurance Institution of Finland, is based on collaboration of the family with several professionals and organizations providing the necessary services. Therefore, it sets special challenges for service provision. Parents' experiences of shared agency and participation during children's rehabilitation process were analyzed in relation to the following research questions: what factors, describing the planning and implementation of rehabilitation, were associated with (a) the parents' satisfaction with planning, (b) the correspondence between the plans and the needs of the child, and (c) the correspondence between the received rehabilitation and the needs and wishes of the child and the parents. A questionnaire survey for the children's parents (n=496) included items on rehabilitation planning and implementation of services. The results were analyzed using cross-tabulations and logistic regression analyses. Taking into account of the parents' and children's preferences in rehabilitation and active participation of the rehabilitation counselor and the therapist were positively associated with parents' satisfaction with planning and the correspondence between the plan and the needs. The rehabilitation process was considered as more successful if the information received was sufficient, the parents were heard in all phases of the process, and the child was motivated to participate. Several stakeholders have responsibilities in medical rehabilitation for individuals with severe disabilities. Parents' experience of good rehabilitation planning in healthcare requires shared agency; that is, rehabilitation professionals listening to the family's preferences in decision making. Parents' experience with a successful rehabilitation process is dependent on information sharing, becoming heard, and collaboration in all phases of the process.

Medical rehabilitation arranged by the Social Insurance Institution of Finland is provided for children with severe disabilities. The study aimed to find out which service characteristics were associated with perceived outcomes of rehabilitation. Parents whose children had participated in rehabilitation (n = 496) responded to a mail questionnaire that included questions on service characteristics and possible outcomes. Based on factor analysis, four outcome variables were formed. Logistic regression analysis was used to identify the particular service characteristics that were associated with the perceived outcomes. The family's participation in rehabilitation planning and the child's willingness to participate in rehabilitation activities were associated with good outcomes. Having a contact person for the rehabilitation process predicted child and family empowerment outcomes. The results emphasize the significance of establishing a good partnership between the professionals and the family; of developing the contents of the rehabilitation program, so that they motivate the child, and of organizing service coordinators for each family.

This qualitative study examines the facilitators and challenges of integrating Experts by Experience (EbyE) activity in mental health services in the public sector from the perspective of mental health professionals and trained EbyE. The research data consist of four focus group interviews conducted in one hospital district in Finland. In the hospital district, EbyE activity is an established working model in mental health services. The professional focus groups had 9, and the EbyE focus groups had 13 participants. The data were analysed using abductive content analysis. The experiences of professionals and EbyE emphasised the successful integration of EbyE activity. The identified facilitators of integration included an organisational culture that values EbyE activity, facilitating operating structures, and extensive implementation and utilization of EbyE activities. Despite successful integration, certain challenges were described with regard to actors and practices. The findings indicate that the hospital district has overcome many of the obstacles to the integration identified in previous studies. The findings highlight the role of effectively implemented, organised EbyE activity.

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Sopeutumisvalmennus on kuntoutusmuoto, jonka avulla pyritään tukemaan kuntoutujaa vamman tai pitkäaikaisen sairauden hallinnassa. Tutkimuksen tavoitteena oli selvittää sopeutumisvalmennukseen saapuvien aikuisten kuntoutujien elämäntilannetta, sairauskäsityksiä, hallinnan tunnetta, terveyteen liittyvää valtaistumista ja sopeutumisvalmennukseen kohdistuvia odotuksia. Kurssimuotoja oli kolme: syöpää, fibromyalgiaa ja diabetesta sairastavien kurssit. Neljän kuntoutuslaitoksen toteuttamille kursseille osallistui vuosina 2014–15 toteutetun tiedonkeruun aikana 581 kuntoutujaa, joista 377 (65 %) antoi kirjallisen suostumuksen osallistua tutkimukseen ja vastasi alkukyselylomakkeeseen. Kurssiryhmät erosivat sairauskäsitystensä suhteen toisistaan. Kuntoutujien elämäntilanne, sosiaalinen ja institutionaalinen luottamus sekä sairauden rajoitukset olivat yhteydessä hallinnan tunteeseen. Sopeutumisvalmennukseen kohdistuvat odotukset muodostivat neljä ulottuvuutta: palvelutietoja, sairautta ja sen hoitoa koskevia tietoja, psykososiaalista asiantuntijatukea sekä vertaistukea koskevat odotukset. Odotukset vaihtelivat kurssiryhmittäin. Sairauskäsityksiin liittyvät sairauden oireet, huolestuneisuus, tunnereaktiot ja käsitys hoidon vaikutuksista ja omista vaikutusmahdollisuuksista selittivät odotusten vaihtelua. Tietoihin ja psykososiaaliseen asiantuntija-apuun kohdistuvien odotusten todennäköisyyttä lisäsi terveyteen liittyvän valtaistumisen osalta tiedollisen hallinnan vähäisyys, kun taas vertaistukeen liittyvien odotusten todennäköisyyttä lisäsi vahva tiedollinen ja psykososiaalinen hallinta. Abstract Illness perceptions, empowerment and rehabilitation expectations of persons attending psychosocial rehabilitation Adaptation training is a form of psychosocial rehabilitation that aims to empower the client in coping with his or her illness or disability. The aim of the study was to examine the life situation, sense of mastery, illness perceptions, health-related empowerment and rehabilitation needs and expectations of clients attending adaptation training courses for adults with cancer, fibromyalgia or diabetes. In 2014–15, 581 clients attended these courses in four rehabilitation centers; 377 of them gave their informed consent to participate the study and answered the questionnaire at the beginning of the course. The three groups differed according to their illness perceptions and rehabilitation expectations, but there was also much variance between group members. Life situation, perceived disability, and social and institutional trust were associated with sense of mastery. Rehabilitation expectations were grouped into four main dimensions, i.e., information about services and support, information about the illness and treatment and rehabilitation options, psychosocial professional support, and peer support. Illness perceptions, i.e. perceived symptoms, worry, emotional reactions, experienced outcomes of treatment, and perceptions of one’s own possibilities to influence the illness were associated with different dimensions. Health-related empowerment was also connected with expectations. Expectations for information and professional help were stronger in those with weak informational mastery, whereas expectations for peer support were stronger with those whose informational and psychosocial mastery was better than average.