Objective: To map out from the literature the nature, extent and effects of application of patient-centred goal setting in stroke rehabilitation practice.Design: Systematic review.Data sources: A search was conducted in the Cochrane (Wiley), AMED, Medline (EBSCO), Embase, Sports discuss, Medline (Ovid) and CINAHL databases. Secondary search based on references from the preliminary search was undertaken.Review methods: Quantitative and qualitative studies that included aspects of patient-centredness and goal setting in stroke patients from 1980 to June 2010 were collected. Studies were scrutinized for relevance and quality based on published methodology. The findings were synthesized by aggregating the themes from the qualitative studies and relating them to relevant findings from the quantitative studies.Results: Eighteen qualitative and eight quantitative and one mixed method study conducted in stroke rehabilitation services ranging from acute to community rehabilitation were included. Themes that emerge...

http://journals.sagepub.com/doi/pdf/10.1177/0269215510394467

A systematic review and synthesis of the quantitative and qualitative evidence behind patient-centred goal setting in stroke rehabilitation

Objective: To determine the evidence regarding the effectiveness of goal planning in clinical rehabilitation.Design: Systematic review.Method: MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, American College of Physicians (ACP) Journal Club, and the Database of Abstracts of Reviews of Effects (DARE) were searched for randomized controlled trials on the therapeutic effectiveness of goal planning in the rehabilitation of adults with acquired disability. Studies were categorized by patient population and the clinical context of the study. Data were analysed using best-research synthesis, based on methodological quality determined by Physiotherapy Evidence Database (PEDro) scale scores.Results: Nineteen studies were included in this review. Study populations in these papers included patients with neurological disorders, psychiatric disorders, musculoskeletal disorders, cardiovascular disorders, respiratory disorders and dietary/...

Is goal planning in rehabilitation effective? A systematic review

Objective: To systematically integrate and appraise the evidence for effects and experiences of goal setting in stroke rehabilitation.Design: Systematic review of quantitative and qualitative studies.Methods: Relevant databases were searched from start of database to 30 April 2011. Studies of any design employing goal setting, reporting stroke-specific data and evaluating its effects and/ or experiences were included.Results: From a total of 53998 hits, 112 full texts were analysed and 17 studies were included, of which seven evaluated effects while ten explored experiences of goal setting. No eligible randomized controlled trials were identified. Most of the included studies had weak to moderate methodological strengths. The design, methods of goal setting and outcome measures differed, making pooling of results difficult. Goal setting appeared to improve recovery, performance and goal achievement, and positively influenced patients’ perceptions of self-care ability and engagement in rehabilitation. Howe...

The effects and experiences of goal setting in stroke rehabilitation - a systematic review.

Objective: To analyse in detail therapists' and patients' communication practices during physiotherapy goal-setting in stroke rehabilitation settings. To deduce explanations for observed practices. To contribute to understanding of the communication challenges entailed in goal-setting.Design: A conversation analytic study of video-recorded treatment sessions.Setting: Physiotherapy ‘gyms’ in four UK hospitals.Subjects: The 74 recorded sessions involved 21 patients (52-86 years, 11 female) and 10 senior physiotherapists. Patients' disabilities varied; none were severely aphasic. Nine of the therapists were female, post qualification experience ranged from 3 to 23 years.Findings: Eight goal-setting episodes were identified. In all but one, therapists supplied the target problems or abilities for which goals were subsequently set. The case in which the patient was asked to propose problems prior to goal-setting is examined in detail. Various interactional difficulties and delays arose both in eliciting the pa...

Communication during goal-setting in physiotherapy treatment sessions

https://link.springer.com/content/pdf/10.1057%2Fjors.1980.65.pdf

The art of problem solving

Background and Purpose. An important part of treatment planning in physical therapy is effective goal setting. The Guide to Physical Therapist Practice recommends that therapists should identify the patient's goals and objectives during the initial examination in order to maximize outcomes. The purpose of this study was to examine whether therapists seek to involve patients in goal setting and, if so, what methods they use. Therapists' attitudes toward participation and patient satisfaction with the examination were also examined. Subjects and Methods. Twenty-two physical therapists audiotaped the initial examination of 73 elderly patients (X=76.4 years of age, SD=7.1, range=65–94). The audiotaped examinations were then scored using the Participation Method Assessment Instrument (PMAI) to determine the frequency of attempts made by therapists to involve patients in goal setting. Therapists and patients completed surveys following the examinations. Results. Therapists' use of participation methods during examinations ranged from a minimum of 1 to a maximum of 19 out of 21 possible items on the PMAI. The therapists stated that they believed that it is important to include patients in goal-setting activities and that outcomes will be improved if patients participate. Patients also indicated that participation is important to them. Discussion and Conclusion. In most cases, the therapists did not fully take advantage of the potential for patient participation in goal setting. Patient and therapist education is needed regarding methods for patient participation during initial goal-setting activities.

Susan M Baker

Papers

Patient Participation in Physical Therapy Goal Setting