PTOTQualitativeClinical rehabilitation2019

A qualitative study of patient-centered goal-setting in geriatric rehabilitation: patient and professional perspectives.

Rosanne van Seben, Susanne M Smorenburg, Bianca M Buurman

PMID 30103621

WHAT IT FOUND

Older patients in geriatric rehabilitation first aim for self-care and going home, then set more ambitious goals after discharge.

Teams focused on discharge criteria. Long-term goals were often unrecorded.

Key findings

01After discharge, patients set more ambitious goals, including returning to hobbies and leisure activities.

02Professionals focused on discharge-related goals, and long-term patient goals were often not written in rehabilitation plans.

03OTs used the COPM rarely because of time, scoring and perceived difficulty for older patients.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study used a small purposive sample of 10 patients and 7 professionals and did not aim for data saturation. Patients were only included if they had no signs of cognitive impairment and could speak and understand Dutch, so the findings may not apply to people with cognitive impairment or language barriers. All patients were discharged home and had improved during inpatient rehabilitation, so it says little about patients who remain in institutions or who do not improve. Professionals were interviewed from a limited number of team members, so their views may not represent all geriatric rehabilitation teams. Patients were asked after discharge to recall their inpatient goals, which may introduce recall bias. The study did not observe goal-setting meetings or collect other data sources beyond interviews and rehabilitation plans. The setting was three Dutch rehabilitation centers during recent reforms that allowed home visits, so findings may not transfer to other health systems.

Declared interests

The authors declared no potential conflicts of interest and received no financial support.

The easy way to misread this

Do not read this as evidence that patient-centered goal-setting improves rehabilitation outcomes. It describes themes from a small qualitative sample, not a tested intervention or measured effect.

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