Stevens Anita, Köke Albère, van der Weijden Trudy, Beurskens Anna
a Faculty of Health , Zuyd University of Applied Sciences , Heerlen , The Netherlands.
b Department of Family Medicine , Maastricht University, CAPHRI School for Public Health and Primary Care , Maastricht , The Netherlands.
Disabil Rehabil. 2018 Aug;40(17):2048-2055. doi: 10.1080/09638288.2017.1325943. Epub 2017 May 13.
To deliver client-centered care, physiotherapists need to identify the patients' individual treatment goals. However, practical tools for involving patients in goal setting are lacking. The purpose of this study was to improve the frequently used Patient-Specific Complaints instrument in Dutch physiotherapy, and to develop it into a feasible method to improve physiotherapy goal setting.
An iterative user-centered design was conducted in co-creation with the physiotherapists and patients, in three phases. Their needs and preferences were identified by means of group meetings and questionnaires. The new method was tested in several field tests in physiotherapy practices.
Four main objectives for improvement were formulated: clear instructions for the administration procedure, targeted use across the physiotherapy process, client-activating communication skills, and a client-centered attitude of the physiotherapist. A theoretical goal-setting framework and elements of shared decision making were integrated into the new-called, Patient-Specific Goal-setting method, together with a practical training course.
The user-centered approach resulted in a goal-setting method that is fully integrated in the physiotherapy process. The new goal-setting method contributes to a more structured approach to goal setting and enables patient participation and goal-oriented physiotherapy. Before large-scale implementation, its feasibility in physiotherapy practice needs to be investigated. Implications for rehabilitation Involving patients and physiotherapists in the development and testing of a goal-setting method, increases the likelihood of its feasibility in practice. The integration of a goal-setting method into the physiotherapy process offers the opportunity to focus more fully on the patient's goals. Patients should be informed about the aim of every step of the goal-setting process in order to increase their awareness and involvement. Training physiotherapists to use a patient-specific method for goal setting is crucial for a correct application.
为提供以患者为中心的护理，物理治疗师需要确定患者的个体治疗目标。然而，目前缺乏让患者参与目标设定的实用工具。本研究的目的是改进荷兰物理治疗中常用的针对患者特定问题的工具，并将其开发成一种可行的方法来改善物理治疗目标设定。
与物理治疗师和患者共同进行了一个迭代的以用户为中心的设计，分三个阶段。通过小组会议和问卷调查确定了他们的需求和偏好。新方法在多个物理治疗实践的现场测试中进行了检验。
制定了四个主要改进目标：管理程序的清晰说明、在整个物理治疗过程中的针对性使用、激发患者积极性的沟通技巧以及物理治疗师以患者为中心的态度。一个理论性的目标设定框架和共同决策的要素被整合到新的患者特定目标设定方法中，同时还有一个实用培训课程。
以用户为中心的方法产生了一种完全融入物理治疗过程的目标设定方法。新的目标设定方法有助于采用更结构化的目标设定方法，并使患者能够参与以及进行以目标为导向 的物理治疗。在大规模实施之前，需要研究其在物理治疗实践中的可行性。对康复的启示让患者和物理治疗师参与目标设定方法的开发和测试，增加了其在实践中可行的可能性。将目标设定方法整合到物理治疗过程中提供了更充分关注患者目标的机会。应告知患者目标设定过程每一步的目的，以提高他们的认识和参与度。培训物理治疗师使用针对患者的目标设定方法对于正确应用至关重要。
