Division of Speech Pathology, The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia,
Disabil Rehabil. 2010;32(2):159-72. doi: 10.3109/09638280903036605.
The purpose of this research is to describe current practices in goal-setting within a subacute rehabilitation setting from the perspective of therapists representing the disciplines of occupational therapy, speech pathology and physiotherapy.
Qualitative semi-structured email interviews were conducted with therapists from the Geriatric Assessment and Rehabilitation Unit of an Australian hospital. Therapists were required to respond to questioning with reference to identified rehabilitation patients with stroke.
Three approaches to goal-setting were identified: therapist controlled, therapist led and patient centred. Goals aimed at the ICF levels of impairment and activity limitations were predominant. Barriers to a patient centered goal-setting approach largely outweighed facilitators. Potential successful resolutions were offered to overcome these barriers.
The inability of patients to participate fully in the goal-setting process largely determines the approach taken by therapists. This influences the level of patient centeredness incorporated into the goal-setting process. Goals expressed at the level of impairment, by therapists, may be stepping stones to perceived patient goals at the levels of activity and participation. Barriers to a patient centered approach can be overcome through education of the patient and family regarding the nature of the injury and modification of communication between therapist and patient.
本研究旨在从职业治疗师、言语病理学家和物理治疗师的角度描述亚急性康复环境中目标设定的当前实践。
对澳大利亚一家医院老年评估和康复病房的治疗师进行了定性半结构化电子邮件访谈。要求治疗师参考已确定的中风康复患者的情况回答问题。
确定了三种目标设定方法：治疗师控制、治疗师主导和以患者为中心。以 ICF 损伤和活动受限水平为目标的目标占主导地位。以患者为中心的目标设定方法的障碍远远超过了促进因素。提出了潜在的成功解决方案来克服这些障碍。
患者无法充分参与目标设定过程在很大程度上决定了治疗师所采取的方法。这会影响目标设定过程中纳入的以患者为中心的程度。治疗师在损伤水平上表达的目标可能是患者在活动和参与水平上感知目标的踏脚石。通过对患者和家属进行有关损伤性质的教育以及调整治疗师和患者之间的沟通，可以克服以患者为中心方法的障碍。
