Goal-setting in geriatric rehabilitation: a systematic review and meta-analysis

Abstract

Objective:To explore the effect of goal-setting on physical functioning, quality of life and duration of rehabilitation in geriatric rehabilitation compared to care as usual.Data sources:Medline, Embase, CINAHL, PsycINFO and the Cochrane Library were searched from initiation to October 2018.Methods:We included randomized controlled trials (RCTs), controlled before–after studies and studies using historic controls of older patients (mean age ⩾55 years) receiving rehabilitation for acquired disabilities. Our primary outcome was physical functioning; secondary outcomes were quality of life and rehabilitation duration. Cochrane guidelines were used to assess the risk of bias of the studies and extract data. Only RCT data were pooled using standardized mean difference (SMD).Results:We included 14 studies consisting of a total of 1915 participants with a mean age ranging from 55 to 83 years. Ten out of the 14 studies had a randomized controlled design, 7 of which could be pooled for the primary outcome. The risk of bias was judged high in several domains in all included studies. The meta-analysis showed no statistically significant differences between goal-setting and care as usual for physical functioning (SMD −0.11 (−0.32 to 0.10)), quality of life (SMD 0.09 (−0.56 to 0.75)) and rehabilitation duration (MD 13.46 days (−2.46 to 29.38)).Conclusion:We found low-quality evidence that goal-setting does not result in better physical functioning compared to care as usual in geriatric rehabilitation. For quality of life and duration of rehabilitation, we could not exclude a clinically relevant effect.

Goal planning in person-centred care supports older adults receiving case management to attain their health-related goals

“…Next to the scoring instrument debate, little evidence exists about the feasibility [18] and effects of goal setting with frail older adults [19]. Within this population, very heterogeneous needs and goals can exist [20].…”

Effects of Nurse-Led Intervention Programs Based on Goal Attainment Theory: A Systematic Review and Meta-Analysis

“…The goal-setting and health contract program had a small effect size of 0.35. The effect size from a previous study [51] on physical functioning and quality of life was small and significant at 0.11 and 0.09, respectively. As both studies reported small effect sizes, further meta-analysis on these programs is warranted.…”

Cognitive Biases in Chronic Illness and Their Impact on Patients' Commitment

“…Goal setting is a fundamental component of any care plan (Vaughn et al, 2016). Goal setting allows patients to identify the short-and long-term objectives to achieve, taking into account the patient's needs and lifestyle (Wade, 2009;Levack et al, 2015;Smit et al, 2019). Biases and, in particular, the tendency to focus on the negative factors may lead the patients to formulate goals to avoid the negative symptoms (e.g., pain), instead of pursuing the long-term personal growth objectives (e.g., "I will not participate in the intervention because it's tiring: I just need to rest").…”