McPherson Kathryn M, Kayes Nicola, Weatherall Mark
National Research Centre for Stroke, Applied Neuroscience and Neurorehabilitation and Health and Rehabilitation Research Centre, School of Rehabilitation and Occupation Studies, Auckland, New Zealand.
Clin Rehabil. 2009 Apr;23(4):296-309. doi: 10.1177/0269215509102980.
To determine the acceptability and clinical application of two recently developed goal-setting interventions (Goal Management Training and Identity Oriented Goal Training) in people with traumatic brain injury.
A three parallel group, randomized controlled pilot study.
Inpatient and community rehabilitation facilities.
Thirty-four people with moderate to severe traumatic brain injury (Goal Management Training, n = 12; Identity Oriented Goal Training, n = 10; usual care, n = 12) and their rehabilitation clinicians.
For both Goal Management Training and Identity Oriented Goal Training participants met face to face with their key worker weekly over a period of 6-8 weeks, during which time the key worker worked to engage them in goal setting and goal performance using the strategy prescribed by their group allocation. Usual care was provided to the other participants.
Largely qualitative using observation, individual interviews and focus groups. Participants also completed a Goal Attainment Scale at baseline, post intervention and at three months follow-up.
Both approaches were acceptable to the majority of participants with many reporting improved mood and goal attainment. Clinicians found working in a different way with patients both challenging and rewarding, with both experimental approaches enhancing a focus on the person's own goals. Identity Oriented Goal Training seemed particularly helpful in engaging people in the goal-setting process while Goal Management Training appeared particularly helpful in providing a structured framework for error prevention in attempting goal performance.
These theoretically informed approaches to goal setting showed promise but were time intensive and at times difficult for practitioners to utilize.
确定两种最近开发的目标设定干预措施（目标管理训练和身份导向目标训练）在创伤性脑损伤患者中的可接受性和临床应用情况。
一项三平行组随机对照试验性研究。
住院和社区康复机构。
34名中重度创伤性脑损伤患者（目标管理训练组，n = 12；身份导向目标训练组，n = 10；常规治疗组，n = 12）及其康复治疗师。
目标管理训练组和身份导向目标训练组的参与者在6 - 8周内每周与他们的关键工作人员面对面交流，在此期间，关键工作人员按照其分组分配所规定的策略，促使他们参与目标设定和目标执行。为其他参与者提供常规治疗。
主要采用观察、个体访谈和焦点小组等定性方法。参与者还在基线、干预后和三个月随访时完成了目标达成量表。
两种方法对大多数参与者来说都是可以接受的，许多人报告情绪改善且目标达成情况良好。治疗师发现以不同方式与患者合作既具有挑战性又有收获，两种实验方法都增强了对患者自身目标的关注。身份导向目标训练在促使人们参与目标设定过程方面似乎特别有帮助，而目标管理训练在为目标执行中的错误预防提供结构化框架方面似乎特别有帮助。
这些基于理论的目标设定方法显示出前景，但耗时较长，且有时从业者难以运用。
