Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation

Levack, William; Weatherall, Mark; Hay-Smith, E. Jean C.; Dean, Sarah; McPherson, Kathryn; Siegert, Richard J.

doi:10.1002/14651858.cd009727.pub2

Cited by 163 publications

(265 citation statements)

References 161 publications

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“…Importantly, the goals that are pursued in CAPABLE are person-directed and selected in partnership with either the RN or the OT rather than together. Because of the complexity of evaluating goal-setting and the importance of understanding it as a granular process, 15 we exclusively focus on OT-specific goal-setting.…”

Section: Methodsmentioning

confidence: 99%

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Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults

Waldersen

Wolff

Roberts

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Objective To describe functional goals and factors associated with goal attainment among low-income older adults with disabilities living in the community. Design Secondary analysis from two studies of CAPABLE. Functional goals were coded using the International Classification of Functioning, Disability, and Health (ICF) framework. The percentage of goals attained at five months follow-up was computed within each ICF domain. Multivariate logistic regression was used to identify factors associated with goal attainment. Setting Participants’ homes in Baltimore, Maryland Participants CAPABLE participants (n=226) Interventions A five-month, home-based, person-directed, structured program delivered by an inter-professional team: occupational therapist (OT), registered nurse (RN), and handyman. Main Outcome Measure(s) Process of OT goal setting and attainment at the final OT visit. Results Participants identified 728 functional goals (average of 3.2 per participant), most commonly related to transferring (22.0%, n=160 goals), changing or maintaining body position (21.4%, n=156 goals), and stairclimbing (13.0%, n= 95 goals). Participants attained 73.5% (n=535) of goals. Goal attainment was highest for stairclimbing (86.3%), transferring (85.6%), and self-care (84.6%); walking goals were less likely attained (54.0%). Goal attainment was not associated with age, gender, education, depressive symptoms, function, or health-related quality of life but was less likely among participants who had severe pain compared to those without pain (aOR: 0.38, 95% CI: 0.17, 0.86). When participant readiness to change (RTC) score increases by one point on the four-point scale, goal attainment was 62% more likely (aOR 1.62; 95% CI: 1.14–2.29). Conclusion Home-based collaborative goal-setting between older adults and OTs is feasible and particularly effective when individuals are ready or willing to adopt new strategies to achieve identified goals.

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Section: Methodsmentioning

confidence: 99%

“…A recent Cochrane review concluded that goal setting in rehabilitation improves quality of life and self-efficacy, although the strength of the findings was limited by the quality of available evidence. 15 …”

Section: Introductionmentioning

confidence: 99%

Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults

Waldersen

Wolff

Roberts

et al. 2017

Archives of Physical Medicine and Rehabilitation

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“…The evidence for the effectiveness of teamwork within healthcare is relatively limited 4,6,7 because teamwork is often not identified as the feature being investigated. Nonetheless there is some evidence.…”

Section: Team Workmentioning

confidence: 99%

Rehabilitation – a new approach. Part three: the implications of the theories

Wade¹

2015

Clin Rehabil

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The last editorial suggested that rehabilitation needed to involve the patient in learning, and depended upon a group of professionals to identify what actions might help the patient, and to undertake or arrange the necessary actions. In many cases there will be both a wide variety of actions needed from a reasonably large number of people and organisations, and the process is likely to be extended over weeks, months or occasionally years. This editorial shows that these features characterise the rehabilitation process as complex and therefore it needs to be managed by a trans-disciplinary team. Some of the characteristics of teamwork are discussed. This leads to a discussion of teams in rehabilitation, showing that there are currently many different types of teams organised around different areas of interest and that a patient might need access to several specialised teams. It is then argued that the complexity of team coordination is best resolved by formal rehabilitation planning meetings, held early in a patient's involvement with rehabilitation; this should increase effectiveness and efficiency. Finally the editorial argues that rehabilitation would be improved by having rehabilitation teams that mirror the existing medical specialities, ensuring that all patients thereby have easy and early access to rehabilitation planning.

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“…Goals are internal representations of desired states, something that a patient is working towards . The selection of goals (ie, goal setting) improves motivation and adds patient engagement in order to achieve individual selected outcome parameters . Recently, Werbrouck et al performed a systematic review towards interventions to promote patient empowerment.…”

Section: Introductionmentioning

confidence: 99%

“…11 The selection of goals (ie, goal setting) improves motivation and adds patient engagement in order to achieve individual selected outcome parameters. 12 Recently, Werbrouck et al 13 performed a systematic review towards interventions to promote patient empowerment. Patient empowerment refers to a person's inherent capacity to be responsible for his/her own life, and entails a complex experience of personal change.…”

Section: Introductionmentioning

confidence: 99%

Goal Identification Before Spinal Cord Stimulation: A Qualitative Exploration in Potential Candidates

et al. 2019

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Introduction Due to the difficulties encountered in the treatment process of patients with chronic pain, it is of utmost importance to involve patients themselves in their rehabilitation trajectory. Patient engagement can be obtained by motivating patients to select their own treatment goals. We hypothesize that applying goal setting, as a form of patient empowerment, in potential candidates for spinal cord stimulation (SCS) may further improve the outcome of SCS. As a first step in creating patient empowerment, patients' goals that they aim to achieve with SCS will be explored. Methods Fifteen patients suffering from failed back/neck surgery syndrome and scheduled for SCS were interviewed in depth. All interviews were audio recorded and analyzed using in vivo coding. Afterwards, the International Classification of Functioning, Disability and Health framework was used to structure the responses of patients. Results In the domain of bodily functions, all patients mentioned pain reduction, and 1 patient wanted to regain his previous sleep pattern. In the domain of activities, walking, sitting, driving a car, bending down, and picking up were the highest ranked goals. Regaining a social life was the highest ranked goal for participation. Eleven patients wanted to regain a feeling of happiness, and 5 patients wanted to focus on avoiding depression. Conclusion The interviews revealed a broad spectrum of individual patients' goals, highlighting the need of individually targeted rehabilitation trajectories in the field of neuromodulation. Goal identification could entail the first step towards individualized medicine in the SCS trajectory.

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Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation

Cited by 163 publications

References 161 publications

Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults

Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults

Rehabilitation – a new approach. Part three: the implications of the theories

Goal Identification Before Spinal Cord Stimulation: A Qualitative Exploration in Potential Candidates

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