A qualitative investigation into the patient-centered goal-setting practices of allied health clinicians working in rehabilitation

Cameron, Lisa J.; Somerville, Lisa; Naismith, Catherine E; Watterson, Dina; Maric, Valentina; Lannin, Natasha A.

doi:10.1177/0269215517752488

Cited by 57 publications

(51 citation statements)

References 26 publications

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“…This also resonates with other published evidence describing a continuum of goal setting approaches, from 'patient-led' at one end to 'health professional' led at the other, along which person-centered goal setting was possible. 23,45,46 Cameron et al, 46 in their ethnographic study, highlighted active and reflective listening by practitioners as being crucial to achieving the level of collaboration required for successful patient-centred goal setting, recognizing that most patients have the ability to direct goal setting conversations when supported.…”

Section: Person-centered Goal Setting Is Possible But Often Does Not mentioning

confidence: 99%

“…A positive and engaging therapeutic relationship seemed to foster more of the same, whereas a relationship where practitioner and stroke survivor goals were not aligned led to discontentment, resignation and sometimes to the stroke survivors keeping their own goals secret. Cameron et al 46 found practitioners had greater influence on the goals developed than patients, highlighting practitioner self-awareness as a key factor in the success of goal setting. However, they also reported a perceptual-practice gap where practitioners may overestimate the extent to which their goal setting was person-centred.…”

Section: Practitioners Shape the Context Of Goal Setting (Level 2 Heamentioning

confidence: 99%

“…Areas of difference included a greater focus from participants on the vagueness of rehabilitation, 41 and the need for greater inclusion of family members in goal setting (with reference to stroke survivors with aphasia). 39,46…”

Section: Excluded Studies (Level 2 Heading)mentioning

confidence: 99%

See 2 more Smart Citations

Experiences of stroke survivors, their families and unpaid carers in goal setting within stroke rehabilitation: a systematic review of qualitative evidence

Lloyd

Bannigan

Sugavanam

et al. 2018

JBI Database of Systematic Reviews and Implementation Reports

104

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Person-centered goal setting within stroke rehabilitation is both possible and rewarding but often does not occur. Goal setting contributes to the post-stroke rehabilitation experience and can be positively or negatively influenced by practitioners. Maintaining hope and a sense of forward momentum in recovery after stroke is perceived by stroke survivors as important and could be supported using goal setting that is tailored to the individual's needs and preferences. Future research should focus on refining individualized methods of goal setting in stroke rehabilitation and the role of the practitioner in this, including what skills are needed and how they can be acquired. The identified gaps in the literature about family members' and unpaid carers' experiences, and the role of goal setting in self-management, warrant further research.

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Section: Person-centered Goal Setting Is Possible But Often Does Not mentioning

confidence: 99%

Section: Practitioners Shape the Context Of Goal Setting (Level 2 Heamentioning

confidence: 99%

See 1 more Smart Citation

Experiences of stroke survivors, their families and unpaid carers in goal setting within stroke rehabilitation: a systematic review of qualitative evidence

Lloyd

Bannigan

Sugavanam

et al. 2018

JBI Database of Systematic Reviews and Implementation Reports

104

View full text Add to dashboard Cite

show abstract

“…The client-centred approach is highlighted in occupational therapy models (6,7) and recommended for rehabilitation after stroke in order to achieve a successful rehabilitation outcome. To increase the clients' involvement in the rehabilitation process it is important to collaborate with the client, and to focus on the needs and wishes of the client (8)(9)(10). Being able to participate in meaningful activities can promote health and life satisfaction for people with long-term conditions such as stroke, and is often expressed as the overall goal in rehabilitation (11,12).…”

mentioning

confidence: 99%

Factors affecting outcome in participation one year after stroke: A secondary analysis of a randomized controlled trial

Gustavsson¹,

Guidetti²,

Eriksson³

et al. 2019

J Rehabil Med

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LAY ABSTRACTThis secondary analysis of a previous study evaluated the effects of enhanced client-centred intervention after stroke. The aim was to explore factors that could impact the client's participation in everyday life after stroke. The factors explored were the characteristics of the client (their age, sex, stroke severity, and level of participation in everyday life before the stroke); the context in which the rehabilitation took place (at hospital or in the client's home) and rehabilitation approach (receiving rehabilitation with an enhanced client-centred approach or not). In order to increase participation in everyday life for people after stroke it appears to be important to employ an enhanced client-centred rehabilitation approach, particularly when working within inpatient rehabilitation and with people with moderate or severe stroke.Objective: To explore the importance of client characteristics (age, sex, stroke severity and participation before stroke), rehabilitation context (in-patient or client's home) and approach (enhanced clientcenteredness or not) on participation in every day life after stroke. Methods: A secondary analysis of data on 237 participants from a previous randomized controlled trial evaluating an enhanced client-centred intervention after stroke. Plausible associations between client characteristics, context and rehabilitation approach, and a positive outcome regarding participation were explored. Three different outcome measures for participation were used: Stroke Impact Scale 3.0, domain participation; Frenchay Activities Index; and Occupational Gaps Questionnaire. Results: For all participants there was a significant association between mild stroke and a positive outcome using the Frenchay Activities Index. Among participants who had not received the enhanced client-centred approach, there was a significant association between mild stroke and a positive outcome using the Stroke Impact Scale. The context of rehabilitation, i.e. receiving home rehabilitation, was also associated with a positive outcome in the Frenchay Activities Index for the control group. Conclusion: In order to increase participation in every day life for people after stroke it appears to be important to use an enhanced client-centred approach, particularly when working within in-patient rehabilitation and with people with moderate or severe stroke.

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“…28. Lisa J Cameron et al, 2018 et al ., “A qualitative investigation into the patient-centred goal-setting practices of allied health clinicians working in rehabilitation,” Clin Rehabil 32, no. 6 (Jun 2018),…”

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confidence: 99%

The singular patient in patient-centred care: physiotherapists’ accounts of treatment of patients with chronic muscle pain

et al. 2019

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A patient-centred approach has gained increasing interest in medicine and other health sciences. Whereas there are discussions about the meaning of a patient-centred approach and what the concept entails, little is known about how the patient as a person is understood in patient-centred care. This article investigates understandings of the patient as a self in patient-centred care through physiotherapy of patients with chronic muscle pain. The material consists of interviews with five Norwegian physiotherapists working in a rehabilitation clinic. Drawing on Kristeva’s discussion of subjectivity in medical discourse, the study highlights two different treatment storylines that were closely entwined. One storyline focuses on open singular healing processes in which the treatment was based on openness to a search for meaning and sharing. In this storyline, the “person“ at the centre of care was not essentialised in terms of biological mechanisms, but rather considered as a vulnerable, irrational and moving self. By contrast, the second storyline focused on goal-oriented interventions aimed at restoring the patient to health. Here, the person in the centre of the treatment was shaped according to model narratives about “the successful patient”; the empowered, rational, choosing and self-managing individual. As such, the findings revealed two conflicting concepts of the individual patient inherent in patient-centred care. On the one hand, the patient is seen as being a person in constant movement, and on the other, they are captured by more standardised terms designed to focus on a more stable notion of outcome of illness. Therefore, our study suggests that the therapists’ will to recognise the individual in patient-centred care had a counterpart involving a marginalisation of the singular.

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A qualitative investigation into the patient-centered goal-setting practices of allied health clinicians working in rehabilitation

Cited by 57 publications

References 26 publications

Experiences of stroke survivors, their families and unpaid carers in goal setting within stroke rehabilitation: a systematic review of qualitative evidence

Experiences of stroke survivors, their families and unpaid carers in goal setting within stroke rehabilitation: a systematic review of qualitative evidence

Factors affecting outcome in participation one year after stroke: A secondary analysis of a randomized controlled trial

The singular patient in patient-centred care: physiotherapists’ accounts of treatment of patients with chronic muscle pain

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