Use of an iPad App (Aid for Decision-making in Occupational Choice) for Collaborative Goal Setting in Interprofessional Rehabilitation: Qualitative Descriptive Study (Preprint)

Abstract

BACKGROUND Goal setting is a key part of the rehabilitation process. The use of technology and electronic tools such as smartphone applications (apps) and websites has been suggested as a way of improving the engagement of users in meaningful goal-setting and facilitating shared decision-making between patients and health professionals. OBJECTIVE To describe experiences of health professionals and patients in the use of the English language version of the iPad app Aid for Decision-making in Occupational Choice (ADOC) to facilitate collaborative goal setting in rehabilitation. METHODS We recruited participants from three acute and post-acute care rehabilitation wards in both public and private organizations in New Zealand. Participants were registered allied health professionals including physiotherapists, occupational therapists, and speech-language therapists, who engage in goal setting as part of their normal work, and their adult patients. We collected data via semi-structured interviews to gather information about the experiences of the participants in the use of ADOC for goal setting. Data were analyzed with thematic analysis. RESULTS Eight health professionals and eight patients participated in the study. Six main themes emerged from the data: a) Changing patients’ perspective on what is possible; b) Changing health professionals’ perspective on what is important; c) Facilitating shared decision-making; d) Lack of guides for users; e) Logistic and organizational barriers; and f) App related and technical issues. CONCLUSIONS Health professionals and patients found ADOC to be a valuable tool when setting shared rehabilitation goals. The use of ADOC promoted a patient-centered approach that empowered patients to engage in collaborative goal setting. The technological limitations of the app that negatively impacted experiences can be addressed in the future implementation of ADOC in rehabilitation settings. CLINICALTRIAL The trial was retrospectively registered and allocated to the Australian New Zealand Clinal Trial Registry (ACTRN) number ACTRN12620001328965.