Quality of Care in Geriatric Rehabilitation: Clients' Perceptions, ADL Dependence, and Subjective Well-being in a One-year Perspective
Abstract
World-wide, the development of community-based geriatric rehabilitation has received increased attention. In Sweden, national reforms during the 1990s aimed at improved quality of geriatric rehabilitation. This paper focuses clients' perceptions of the rehabilitation process, dependence in activities of daily living (ADL), and subjective well-being in a one-year perspective. A study-specific questionnaire, a revised version of the ADL Staircase, and the Göteborg Quality of Life Instrument were administered, in 1996 ( N = 278) and 1997 ( N = 233). Even if 77% of the clients were content as regards rehabilitation quality, in 1997 contentment diminished among clients in sheltered housing facilities. Most clients also reported a diminished contentment with the training provided during the period investigated. Most clients were dependent in ADL, but in sub-groups independence in some activities diminished over the study period. In contrast, in some aspects sub-groups scored their subjective well-being lower on the second measurement than on the first. The investigation of clients' perceptions of quality of care is a multifaceted matter, and the results of this study were partly ambiguous. Still, since valid descriptions of variables at target for rehabilitation is one important key to the continuous process of quality development, this study produced information valuable for further studies following geriatric rehabilitation processes over time. The implementation of this study could be applicable in similar settings.