Healthcare Professionals' Perspectives on Barriers and Facilitators in Care and Rehabilitation of Adults with Myasthenia Gravis in Neurological Departments in Denmark.

Abstract

Introduction: Myasthenia gravis (MG) is a rare, chronic autoimmune disease that causes various fluctuating symptoms. Healthcare professionals at neurological departments often focus on treating MG with the risk of overlooking other aspects of daily living. Rehabilitation seeks to enable people with disabilities to become as independent as possible in everyday activities. This study aims to explore how healthcare professionals at neurological departments perceive barriers and facilitators in care and rehabilitation of adults with MG in Denmark to target future rehabilitation initiatives.

Methods/materials: A qualitative design using individual interviews with healthcare professionals employed at neurological departments was performed. The qualitative interpretive description methodology aimed at informing clinical practice and the critical psychology framework by Klaus Holzkamp guided the study. Ten participants were included.

Results: The results showed how "Supporting patient understanding and navigation through personalized care", "Navigating responsibility and resources in clinical practice", and "Organizational structures impacting on professional quality of care" were important areas for the healthcare professionals when considering barriers and facilitators to rehabilitation for their patients. The first two areas were the center of the participants' clinical practice, and surrounding and impacting on this center was the participants' perception of their ability to navigate responsibilities and resources in their clinical practice. The third area had significant impact on the quality of care, allocation of resources, and structural changes within the specialized healthcare services.

Conclusion: Healthcare professionals at neurological departments experience multiple facilitators and barriers to the rehabilitation of adults with MG. Their agency potential is deeply rooted in the relational, organizational, and structural settings that they engage in. Their ability to support adults with MG in coping with their condition depends on expertise, flexibility, continuity, and interdisciplinary collaboration both in and outside their organization. It is pivotal that organizational structures support these conditions. If not, it may have negative consequences for the patients' agency potential, rehabilitation, and health.