Recovery preference exploration: analysis of patient feedback after imagined scenarios

To present a new assessment approach, referred to as recovery preference exploration (RPE), for exploring the personal meaning of functional loss and recovery. RPE determines how people would choose to recover from profound disability if they could control that recovery.

Twenty-six patients with a variety of medical conditions and one or more limitations in the functions being addressed were recruited from an inner-city ambulatory care clinic. The patients imagined recovery from 15 functional limitations, beginning with severe problems in all functions and ending with complete independence. Individual-specific preferences for recovery in each function were calculated relative to the other 14 and were submitted for principal components analyses.

Imagined difficulty in toileting and with depression were most troubling. Principal components analyses identified trade-off choices among domains of physical, psychological, and social functioning. Some people valued physical independence above psychological well-being or social abilities. Others had opposite patterns. Patients' narrative explanations, when triangulated, were consistent with their preferences.

RPE makes visible the highly personal nature of feelings about ability and disability. Our results may help guide the selection of rehabilitation interventions in ambulatory care.