Smit Ewout B, Bouwstra Hylco, van der Wouden Johannes C, Wattel Lizette M, Hertogh Cees M P M
Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, Room H465, 1081 BT, Amsterdam, The Netherlands.
Eur Geriatr Med. 2018;9(1):71-76. doi: 10.1007/s41999-017-0011-5. Epub 2017 Dec 21.
Patient-centred goal setting is regarded as a beneficial intervention for geriatric rehabilitation. Nevertheless, its known laborious implementation in clinical practice remains an ongoing challenge. To improve implementation of patient-centred goal setting, the integration of goal setting with standardized measures has been proposed. Our objective of the current study was to explore the feasibility of Collaborative Functional Goal Setting (CFGS), i.e., using standardized functional measures to set and evaluate functional goals during geriatric rehabilitation.
Three medical professionals working in two geriatric rehabilitation wards were trained in CFGS and interviewed at the end of the study. We aimed at including 20 patients who underwent the CFGS intervention and could participate in open interviews. Both interviews of the professionals and patients were qualitatively analyzed.
Eight patients were included in the study, five of which could be interviewed. Both patients and professionals expressed a need for patient-centred goal setting. Patients indicated that goals were mainly set by the professional and that a rehabilitation plan was either not presented or its content was not clear to them. In contrast, the professionals regarded CFGS as patient-centred and potentially helpful in facilitating the goal-setting process. Nevertheless, the professionals indicated having difficulty with the implementation of the intervention.
In the current study, we demonstrated that patient-centred goal setting supported by functional measurements was not feasible in its present form which confirms the evidence from the literature that is difficult to perform patient-centred goal setting in clinical practice.
以患者为中心的目标设定被视为老年康复的一项有益干预措施。然而，其在临床实践中实施起来费力，仍是一个持续存在的挑战。为了改进以患者为中心的目标设定的实施，有人提出将目标设定与标准化测量相结合。本研究的目的是探讨协作功能目标设定（CFGS）的可行性，即在老年康复期间使用标准化功能测量来设定和评估功能目标。
在两个老年康复病房工作的三名医学专业人员接受了CFGS培训，并在研究结束时接受了访谈。我们的目标是纳入20名接受CFGS干预且能够参加开放式访谈的患者。对专业人员和患者的访谈都进行了定性分析。
该研究纳入了8名患者，其中5名患者能够接受访谈。患者和专业人员都表示需要以患者为中心的目标设定。患者指出目标主要由专业人员设定，并且康复计划要么未提供，要么其内容对他们来说不清楚。相比之下，专业人员认为CFGS是以患者为中心的，并且可能有助于促进目标设定过程。然而，专业人员表示在实施该干预措施时存在困难。
在本研究中，我们证明了目前形式下由功能测量支持的以患者为中心的目标设定不可行，这证实了文献中的证据，即在临床实践中难以进行以患者为中心的目标设定。
