Facilitators and barriers to patient-centred goal-setting in rehabilitation: A scoping review.
L Crawford, J Maxwell, H Colquhoun and 5 others
PMID 36017567WHAT IT FOUND
Providers often believe they are patient-centred but remain directive, creating a barrier to goal-setting.
Patients feel unprepared and excluded from the team. The review identifies provider attitudes and lack of time as the primary obstacles, suggesting interventions must target provider beliefs and workflow, not just patient education.
Key findings
01Providers' belief that they are already providing patient-centred care, combined with a preference for being the 'expert', is the most frequently identified barrier to true collaborative goal-setting.
02Organizational constraints, specifically lack of time and high productivity targets, prevent providers from engaging in the authentic dialogue required for patient-centred goal-setting.
03Patients often lack knowledge about their condition and prognosis, which leads them to adopt a passive role and expect providers to set goals for them.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review only included other review studies, so detailed findings from individual primary studies may have been lost. Most evidence was drawn from adult stroke populations and traditional rehabilitation professions, limiting applicability to paediatrics, mental health, or emerging roles like recreational therapy. The methodological quality of the included reviews was not evaluated. Only English-language publications were included. The review protocol was not registered.
Declared interests
The authors declared no potential conflicts of interest. The research received no financial support.
The easy way to misread this
Do not interpret the finding that providers believe they are patient-centred as evidence that they are actually doing so. The review explicitly states that this belief is a barrier because it prevents providers from recognizing the need to change their directive practice.