Differences in the occupational therapy goals of clients and therapists affect the outcomes of patients in subacute rehabilitation wards: a case-control study.
Yuki Saito, Kounosuke Tomori, Hirofumi Nagayama and 2 others
PMID 31417214WHAT IT FOUND
Clients whose goals matched their therapist's had higher motor function at discharge.
However, total independence scores were not significantly different. Clients who felt they received a clear explanation of goals had higher total function scores, regardless of whether the goals actually matched.
Key findings
01Motor FIM scores at discharge were significantly higher in the matched goal group (82.7) than in the unmatched group (74.3).
02Total FIM scores at discharge and home discharge rates did not differ significantly between matched and unmatched goal groups.
03Clients' perception of receiving an explanation about goals was a significant predictor of higher total FIM scores at discharge, whereas goal matching was not.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was a retrospective case-control study, not a randomized trial, so pre-existing differences between the matched and unmatched groups could have influenced the results. The study excluded clients with aphasia or significant cognitive impairment, so the findings may not apply to patients with communication or cognitive difficulties. Goal matching was determined by a post-hoc review of interview responses, which may not reflect the complexity of real-world goal setting. The sample size was small (100 clients) and drawn from a convenience sample of therapists.
Declared interests
The research was supported by a Kakenhi Grant from the Japanese Society for the Promotion of Science. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that simply writing down identical goals for the chart improves patient function. The study found that clients who felt they received a clear explanation of the goals had better outcomes, suggesting the quality of the conversation and understanding matters more than the alignment of the written text.