Goal attainment, adjustment and disengagement in the first year after stroke: A qualitative study

Abstract

Understanding stroke survivor responses to attainable and unattainable goals is important so that rehabilitation staff can optimally support ongoing recovery and adaption. In this qualitative study, we aimed to investigate (i) stroke survivor's experiences of goal attainment, adjustment and disengagement in the first year after stroke and (ii) whether the Goal setting and Action Planning (G-AP) framework supported different pathways to goal attainment. In-depth interviews were conducted with eighteen stroke survivors' to explore their experiences and views. Interview data were transcribed verbatim and analysed using a Framework approach to examine themes within and between participants. Stroke survivors reported that attaining personal goals enabled them to resume important activities, reclaim a sense of self and enhance emotional wellbeing. Experiences of goal-related setbacks and failure facilitated understanding and acceptance of limitations and informed adjustment of, or disengagement from, unattainable goals. Use of the GAP framework supported stroke survivors to (i) identify personal goals, (ii) initiate and sustain goal pursuit, (iii) gauge progress and (iv) make informed decisions about continued goal pursuit, adjustment or disengagement. Stroke survivor recovery involves attainment of original and adjusted or alternative goals. The GAP framework can support these different pathways to goal attainment.

Facilitators and “deal breakers”: a mixed methods study investigating implementation of the Goal setting and action planning (G-AP) framework in community rehabilitation teams

“…Eighteen stroke survivors consented to their case notes being reviewed. Demographic details of stroke survivors are reported elsewhere [24].…”

“…And, what are the barriers and facilitators to G-AP implementation in practice? Stroke survivors' experiences of G-AP implementation were also investigated and are reported elsewhere [24].…”

Co-creating Digital Stories With UK-Based Stroke Survivors With the Aim of Synthesizing Collective Lessons From Individual Experiences of Interacting With Healthcare Professionals

“…Healthcare staff have reported conservatively managing expectations in regards to recovery to avoid disappointment in stroke survivors if goals cannot be met ( 90 ). However, Scobbie et al ( 91 ) suggest that rehabilitation staff should support the personal goals set by stroke survivors but to prepare for and anticipate potential failure in meeting their personal goals. By doing so, healthcare can begin to frame long-term adjustment post-stroke as a fluent and changing pathway, where stroke survivors' recovery aims, and their understanding of the way their acquired disabilities have impacted their lives, adapts over time.…”

Multidisciplinary goal attainment measure (MGAM): A review of stroke client goal-based outcomes within a community rehabilitation setting in Brisbane, Queensland, Australia

“…Despite these favorable results, it is important to note that the MGAM, like the GAS and COPM [23], was designed primarily as a goal setting outcome measure. As such, the MGAM does not give insight into the complexities around goal attainment such as client's motivation to participate, personal contextual factors, co-morbidities, neurological recovery as well service delivery limitations.…”