Engaging patients with moderate to severe acquired brain injury in goal setting

D’Cruz, Kate; Unsworth, Carolyn; Roberts, Karen; Morarty, Jacqui; Turner-Stokes, Lynne; Wellington-Boyd, Anna; Matchado, Joanne; Lannin, Natasha A.

doi:10.12968/ijtr.2016.23.1.20

Cited by 21 publications

(17 citation statements)

References 33 publications

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“…Other qualitative studies have used direct observation of practice to examine the application of goal setting in clinical settings (D'Cruz et al, 2016;Levack et al, 2011). For example, Levack et al examined interdisciplinary team goal setting with nine inpatients with stroke and found that the goal setting process privileged goals of higher clinical priority, which meant at times providing client-centred care was difficult (Levack et al).…”

Section: Introductionmentioning

confidence: 99%

“…For example, Levack et al . examined interdisciplinary team goal setting with nine inpatients with stroke and found that the goal setting process privileged goals of higher clinical priority, which meant at times providing client‐centred care was difficult (Levack et al .). In an observational study of practice with 22 inpatients with ABI, D'Cruz et al . found that in order to engage clients in goal setting, practitioners explored the experience of injury and hospitalisation, built trusting relationships through reflective listening, responded to individual needs and used a collaborative process to elicit goals. However, in some cases despite setting client‐centred goals, discharge priorities were the focus of intervention (D'Cruz et al .).…”

Section: Introductionmentioning

confidence: 99%

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Refining a clinical practice framework to engage clients with brain injury in goal setting

Prescott

Fleming

Doig

2019

Aus Occup Therapy J

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Background/aim: Client-centred goal setting is fundamental to occupational therapy practice and has been increasingly embraced by all rehabilitation practioners. Goal setting in clinical practice is a highly individualised process and may be more challenging with people with acquired brain injury. However, research examining practice is limited. We developed the Client-Centred Goal Setting Practice Framework to explain how client-centred goals are developed in brain injury rehabilitation. This framework was based on interview data and may reflect practitioner's theoretical knowledge rather than goal setting processes used in routine practice. The aims of this study were to explore the application of the framework to every-day practice, examine the extent to which goal setting was client-centred and refine the framework. Methods: A mixed methods approach was employed. Participants were community dwelling clients with ABI and their practitioners, drawn from a hospital outpatient service and community private practices. The communication exchange between practitioners and clients during routine goal setting was audio-recorded, transcribed verbatim and analysed using framework analysis. Quantitative measures evaluated the client-centredness of goals. Results: A total of 65 goal setting sessions with 36 clients and 17 practitioners (n = 8 occupational therapists) were analysed. The three goal setting phases of the framework and associated processes and strategies were represented. The 'establishing trust' process was interwoven throughout all phases and an additional strategy, 'social connection' was identified. Conclusion: The framework provides preliminary evidence about the core processes and strategies which uses establishing trust to engage clients with ABI in goal setting, and may be a useful tool to guide client-centred goal setting practice in similar services.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Refining a clinical practice framework to engage clients with brain injury in goal setting

Prescott

Fleming

Doig

2019

Aus Occup Therapy J

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“…Although not unique to TLS programmes, studies in our review found that goal setting be collaborative, with trust developed between all parties. Consistent with the broader research on engagement in goal-setting after brain injury, the TLS studies also found that the process of goal setting enables successful active engagement in rehabilitation for both residents and families (Guertson, 2008;D'Cruz et al, 2016;Duchnick et al, 2015;McColl et al, 1999). Therefore, there is a need for TLS programmes to support residents and families to be actively engaged in goal setting.…”

Section: Discussionmentioning

confidence: 63%

What is Known About Transitional Living Services for Adults With an Acquired Brain Injury? A Scoping Review

et al. 2017

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Transitional living service (TLS) programmes for adults with an acquired brain injury are considered an important part of rehabilitation. However, considerable variability exists in the design and structure of these services, with limited research to guide the development of a programme based on best evidence. A scoping literature review was completed to answer the question ‘What is known about TLS programmes for adults with an acquired brain injury?’ Four electronic databases were systematically searched, followed by a grey literature search (from 1996 to 2015). 3183 articles were screened and 13 articles were included in the final review. Themes that emerged from the literature include the types of residents using TLS programmes, the subjective experience of residents and staff, intervention approaches, programme staffing, and programme outcomes. The research reviewed supports the use of TLS programmes to maximise functional independence and community integration of individuals with an acquired brain injury. Clinical practise recommendations were developed to help support implementation of TLS programmes based on best evidence, these included: to use multiple outcome measures, implement collaborative goal setting, support generalisation of skills learnt in the TLS to the home environment and for eligibility criteria for these programmes to include individuals across all phases of recovery.

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“…Research which provides insight into how to set goals is needed as this study did not measure the effect that other cognitive impairments had on participation in goal setting. Given that self-awareness impairment has been identified as a factor which may influence client perception of their level of engagement in goal setting (D'Cruz et al, 2016), further research is required to better understand how impaired self-awareness impacts on the development of client-centred goals.…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

Goal statements in brain injury rehabilitation: A cohort study of client-centredness and relationship with goal outcome

et al. 2019

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Background:Currently, there is increasing recognition of the need to use a client-centred approach to goal setting in rehabilitation. However, there is limited research to guide practice with community-dwelling clients with acquired brain injury. An understanding of the characteristics of client-centred goals and the extent to which client-centeredness influences goal outcomes is required.Objective:To examine the relationships between the client-centredness of goals and their characteristics, content, recall and outcomes of client-centred goals in brain injury rehabilitation.Methods:A prospective cohort design study was employed. Participants were 45 clients with brain injury receiving outpatient rehabilitation, who completed measures of client-centredness after goal setting. Each goal was classified according to whether it was specific, measurable, non-jargonistic, and participation-focussed, included a timeframe and was recalled by participants.Results:Participants set 223 goals with 20 clinicians from multiple disciplines. Levels of client-centredness did not differ according to the characteristics, content and recall of goals, with the exception of goal specificity (p < 0.01). Client-centredness was significantly and positively correlated with goal outcomes (p < 0.05).Conclusions:The use of client-centred goals is recommended for improved rehabilitation outcomes. Applying goal documentation criteria does not necessarily mean that goals will be client-centred, and highly specific goal statements may not reflect what is important and meaningful to clients.

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Engaging patients with moderate to severe acquired brain injury in goal setting

Cited by 21 publications

References 33 publications

Refining a clinical practice framework to engage clients with brain injury in goal setting

Refining a clinical practice framework to engage clients with brain injury in goal setting

What is Known About Transitional Living Services for Adults With an Acquired Brain Injury? A Scoping Review

Goal statements in brain injury rehabilitation: A cohort study of client-centredness and relationship with goal outcome

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