Family role in in-patient rehabilitation: the cases of England and Turkey

Abstract

Purpose

This article explores the differences between experiences of family role in in-patient rehabilitation in Turkey and England.

Background

The literature predominantly assumes family presence in rehabilitation as positive, because it draws upon Western cases, where care is delivered fully by professionals, and patients may feel isolated during hospital stays. Analyses of other contexts provide a more nuanced view.

Method

This qualitative research included in-depth interviews (Turkey: 42, England: 18) with people with disabilities (n = 39), their families (n = 8) and hospital staff (n = 13); hospital ethnography (Turkey), focus groups (England: 3 groups involving 4 doctors, 5 nurses, 6 therapists), and participant-observation (England: 5 families). Thematic analysis highlights experiences of family involvement across different contexts.

Results

Families are differently integrated in rehabilitation in England and Turkey. In England, where family presence is regulated and relatively limited, people with disabilities feel more isolated and see family as a major form of support. In Turkey, where family presence is unregulated and intense, they enjoy family as an agent of intra-hospital socialising, but find it disabling when it implies a loss of privacy and individuality.

Conclusion

Family involvement in rehabilitation should support social interaction but allow people with disabilities to remain independent.

Implications for rehabilitation

• Family involvement in rehabilitation can be both enabling and disabling.

• Existing literature draws upon rehabilitation practices, where family presence is limited and perceived as positive. An analysis of cases, where families are integral to the health care system (e.g., Turkey), can provide a nuanced view of family integration, which can be both enabling and disabling.

• Rehabilitation processes and health professionals need to integrate families in ways that will enrich social interaction, but still allow people with disabilities to retain their independence.

Keywords:

• Family
• disability
• in-patient rehabilitation
• England
• Turkey

Acknowledgements

The authors would like to dedicate this paper to the memory of Yunus Akıncıoğlu: an inspiring disability activist, who experienced in-patient rehabilitation in Turkey and passed away during the preparation stage of this paper. The authors also thank the patients, their families, the hospital staff and the five experts in the field for their valuable time and information sharing, as well as Kate Lee for her generous and continuous support.

Disclosure statement

The authors report no declarations of interest.

Additional information

Funding

The UK part of this project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement (701075).