Patient inclusion in goal setting during early inpatient rehabilitation after acquired brain injury

Dalton, Catherine M.; Farrell, Rachel; Souza, Annette De; Wujanto, Evelyn; McKenna-Slade, Ann; Thompson, Sharmen; Liu, Clarence; Greenwood, Richard

doi:10.1177/0269215511405230

Cited by 48 publications

(27 citation statements)

References 19 publications

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“…disease, significant others may not yet acknowledge how much the situation has changed after stroke. They may also lack the skills required to fully understand the situation of the patient's functioning (Dalton et al, 2012). However, we did not expect to find such low agreement rates between patients and their significant others.…”

Section: Discussionmentioning

confidence: 78%

Differences between rehabilitation team, rehabilitants, and significant others in opinions on functioning of subacute stroke survivors

Saltychev

Tarvonen-Schröder

Bärlund

et al. 2014

International Journal of Rehabilitation Research

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To assess quantitative differences between rehabilitation team, rehabilitants, and significant others in opinions on functioning of subacute stroke survivors. During inpatient interdisciplinary neurorehabilitation, the interdisciplinary team, nurses, rehabilitants, and significant others reported their opinions on the functioning of consecutive 62 rehabilitants. Data were gathered using the structured form based on the International Classification of Functioning, Disability and Health (ICF) Brief Core Set for Stroke. Agreement between observers on the presence and severity of restrictions in functioning was analyzed. The strongest agreement between different observers on all studied ICF categories was achieved between the interdisciplinary team and nurses (weighted squared κ=0.7-0.9). The weakest agreement was detected between the team and rehabilitants (weighted squared κ=0.1-0.6). Support by family was found to be an important facilitating factor of functioning by all observers. Limitations in cognitive activity were identified less frequently than other restrictions. Opinions on restrictions in functioning may differ between the interdisciplinary team, rehabilitants, and significant others. These differences can be assessed quantitatively and documented using the ICF Core Set for Stroke. This potential observer-dependent discrepancy should be taken into account during the process of neurorehabilitation.

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Section: Discussionmentioning

confidence: 78%

Differences between rehabilitation team, rehabilitants, and significant others in opinions on functioning of subacute stroke survivors

Saltychev

Tarvonen-Schröder

Bärlund

et al. 2014

International Journal of Rehabilitation Research

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“…That is, rehabilitation in ABI can be a process over several years, and each person's rehabilitation needs to be adapted to his/her current situation, offering the proper type of intervention at the right stage in the process. Moreover, goals should be coordinated together with the person [4,8].…”

Section: Acquired Brain Injury (Abi) Includes Traumatic Brain Injuriementioning

confidence: 99%

The group rehabilitation helped me adjust to a new life: Experiences shared by persons with an acquired brain injury

2013

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The group rehabilitation helped me adjust to a new life: Experiences shared by persons with an acquired brain injury.Månsson Lexell, Eva; Alkhed, Ann-Kristin; Olsson, Kerstin General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain women with an acquired brain injury who had participated in an out-patient group rehabilitation programme were performed. Data was analysed with qualitative content analysis.Findings: The findings formed the theme "The group rehabilitation helped me adjust to a new life" that revealed experiences related to the content and outcome of the programme, as well as the process they went through during the programme. The participants described how the rehabilitation gave them the tools they needed to change their everyday lives, especially in relation to improved knowledge, and learning new routines and habits. They perceived their rehabilitation as a long-term, individual, but also collaborative process, where professionals as well as family and friends had crucial roles. Conclusion:Learning how persons with acquired brain injury experience participation in a group rehabilitation program can help to unravel parts of the 'black box of rehabilitation', and can support professionals to better understand the effective components of such programmes.3

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“…Approaches to goal setting have been described within rehabilitation [8-10] and self-management interventions [11,12]. Practice recommendations have been developed to guide writing Specific, Measurable, Achievable, Realistic/Relevant and Timed (SMART) goals [13] and ways to optimise involvement of people with communication difficulties in the process described [14,15].…”

Section: Introductionmentioning

confidence: 99%

Implementing a framework for goal setting in community based stroke rehabilitation: a process evaluation

Scobbie

McLean

Dixon

et al. 2013

BMC Health Serv Res

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BackgroundGoal setting is considered ‘best practice’ in stroke rehabilitation; however, there is no consensus regarding the key components of goal setting interventions or how they should be optimally delivered in practice. We developed a theory-based goal setting and action planning framework (G-AP) to guide goal setting practice. G-AP has 4 stages: goal negotiation, goal setting, action planning & coping planning and appraisal & feedback. All stages are recorded in a patient-held record. In this study we examined the implementation, acceptability and perceived benefits of G-AP in one community rehabilitation team with people recovering from stroke.MethodsG-AP was implemented for 6 months with 23 stroke patients. In-depth interviews with 8 patients and 8 health professionals were analysed thematically to investigate views of its implementation, acceptability and perceived benefits. Case notes of interviewed patients were analysed descriptively to assess the fidelity of G-AP implementation.ResultsG-AP was mostly implemented according to protocol with deviations noted at the planning and appraisal and feedback stages. Each stage was felt to make a useful contribution to the overall process; however, in practice, goal negotiation and goal setting merged into one stage and the appraisal and feedback stage included an explicit decision making component. Only two issues were raised regarding G-APs acceptability: (i) health professionals were concerned about the impact of goal non-attainment on patient’s well-being (patients did not share their concerns), and (ii) some patients and health professionals found the patient-held record unhelpful. G-AP was felt to have a positive impact on patient goal attainment and professional goal setting practice. Collaborative partnerships between health professionals and patients were apparent throughout the process.ConclusionsG-AP has been perceived as both beneficial and broadly acceptable in one community rehabilitation team; however, implementation of novel aspects of the framework was inconsistent. The regulatory function of goal non-attainment and the importance of creating flexible partnerships with patients have been highlighted. Further development of the G-AP framework, training package and patient held record is required to address the specific issues highlighted by this process evaluation. Further evaluation of G-AP is required across diverse community rehabilitation settings.

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Patient inclusion in goal setting during early inpatient rehabilitation after acquired brain injury

Cited by 48 publications

References 19 publications

Differences between rehabilitation team, rehabilitants, and significant others in opinions on functioning of subacute stroke survivors

Differences between rehabilitation team, rehabilitants, and significant others in opinions on functioning of subacute stroke survivors

The group rehabilitation helped me adjust to a new life: Experiences shared by persons with an acquired brain injury

Implementing a framework for goal setting in community based stroke rehabilitation: a process evaluation

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