Stevens Anita, Moser Albine, Köke Albère, van der Weijden Trudy, Beurskens Anna
Zuyd University of Applied Sciences, Faculty of Health, Heerlen, The Netherlands; Maastricht University, CAPHRI School for Public Health and Primary Care, Dept of Family Medicine, Maastricht, The Netherlands.
Zuyd University of Applied Sciences, Faculty of Health, Heerlen, The Netherlands; Maastricht University, CAPHRI School for Public Health and Primary Care, Dept of Family Medicine, Maastricht, The Netherlands.
Musculoskelet Sci Pract. 2017 Feb;27:23-31. doi: 10.1016/j.msksp.2016.12.005. Epub 2016 Dec 11.
Physiotherapists are encouraged to set goals together with their patients to deliver client-centred care. In practice however, this goal-setting process is poorly specified, with limited patient involvement. The Patient-Specific Complaints instrument (PSC) can support the goal-setting process. Despite its being frequently used by Dutch physiotherapists, its actual role in goal setting is unknown. The objective was to examine physiotherapy goal-setting and the use of the PSC within this process, as well as the physiotherapists' perception of the usefulness of the PSC.
Consultations between physiotherapists and patients were observed and physiotherapists were interviewed. Data were analysed by directed content analysis, using a goal-setting framework as the coding scheme whose phases include: goal negotiation, goal setting, planning, and appraisal and feedback.
The patients' problems were comprehensively explored, with the PSC focussing on activity problems. Goal-setting and planning phases were poorly specified and mainly physiotherapist-led. The physiotherapists appreciated the PSC for patient involvement during goal negotiation and evaluation. Its perceived usefulness for goal setting and planning ranged from useful for tailoring goals to the patient's needs to not useful at all. One major reason to use it was meeting external audit obligations.
There are some discrepancies between how physiotherapists use the PSC and how they perceived its usefulness. Physiotherapists did use the PSC in a goal-setting process, though often as a standalone tool without integration in the whole physiotherapy process, and with limited patient involvement. In this way, its full potential for goal setting is not utilized.
鼓励物理治疗师与患者共同设定目标，以提供以患者为中心的护理。然而在实际操作中，这个目标设定过程缺乏明确的规范，患者参与度有限。特定患者投诉工具（PSC）可以支持目标设定过程。尽管荷兰物理治疗师经常使用该工具，但其在目标设定中的实际作用尚不清楚。目的是研究物理治疗目标设定以及该工具在此过程中的使用情况，以及物理治疗师对该工具有用性的看法。
观察物理治疗师与患者之间的会诊，并对物理治疗师进行访谈。采用定向内容分析法对数据进行分析，使用目标设定框架作为编码方案，其阶段包括：目标协商、目标设定、计划以及评估与反馈。
全面探讨了患者的问题，PSC聚焦于活动问题。目标设定和计划阶段缺乏明确规范，主要由物理治疗师主导。物理治疗师赞赏PSC在目标协商和评估过程中促进了患者参与。其在目标设定和计划方面的有用性被认为从有助于根据患者需求调整目标到完全无用不等。使用它的一个主要原因是满足外部审计义务。
物理治疗师使用PSC的方式与其对其有用性的认知之间存在一些差异。物理治疗师在目标设定过程中确实使用了PSC，但通常作为一个独立工具，未融入整个物理治疗过程，且患者参与度有限。通过这种方式，其在目标设定方面的全部潜力未得到利用。
