What is the experience of providing, receiving and using short-term loan equipment?
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The question at the heart of this thesis is “What is the experience of providing, receiving and using short-term loan equipment?” The study sought to explore the lived experience of occupational therapists and patients with short-term disabilities with short-term loan equipment (assistive devices). While much is known about the use and non-use of such equipment, little is known about the experience of the process of providing, receiving and using the equipment in the New Zealand context. The methodology of hermeneutic phenomenology, informed by the writings of Heidegger [1889-1976], Gadamer [1900-2002] and van Manen [1942- ] was selected because of the emphasis on lived experience, and an interpretation of equipment as technology. The term ‘patient’ has been used throughout for those participants who used occupational therapy services because it implies a special duty of care towards the person. Five occupational therapists and eight adult patients from the acute wards of a busy metropolitan hospital were interviewed. Their experiences of how the equipment came to be chosen, its delivery to their home and how they used it until it was time to return it were explored. Anecdotes from the transcribed interviews became the research text. Dwelling with the texts, referring back to literature and calling on my own experiences with short-term loan equipment gave me the chance to listen to the spoken and unspoken words of the participants. The thesis concludes that patients highly value the short-term loan equipment provided for use at home following discharge from hospital. Nevertheless there are several courses of actions that are possible that will improve the service further. The study findings are presented under two overarching themes: what did work for patients and occupational therapists, and what did not work for patients and therapists. Openness to each other, time to understand each other, and having confidence in each other worked for patients and therapists; whereas a lack of a connection between patient and therapist, an inflexible system, and occupational therapists’ practice dictated by the employer’s goals contributed to the system not working. The thesis finishes with an explanation of the strengths and weaknesses of the study and notes seven implications for occupational therapy practice: 1) taking time to get to know and understand patients’ disability needs; 2) leap ahead and consider patients’ potential long-term disability needs while addressing the short-term needs; 3) follow-up after discharge to check that the equipment is meeting the patients’ disability needs; 4) use digital technology to see patients’ home environment; 5) use the text function on mobile phones as a communication device with patients; 6) improve written and verbal communication with patients while they are on the ward to inform them of the staff who work with them and their roles, contact details, the short-term loan equipment process, and what to do if the equipment does not work for them; 7) protect and preserve expert occupational therapy practice for where it will have the greatest impact for patients.