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以患者为中心的目标设定:康复目标设定干预中干预成分及积极参与水平的系统评价

Person-Centered Goal Setting: A Systematic Review of Intervention Components and Level of Active Engagement in Rehabilitation Goal-Setting Interventions.

作者信息

Kang Eunyoung, Kim Moon Young, Lipsey Kim L, Foster Erin R

机构信息

Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO.

Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO.

出版信息

Arch Phys Med Rehabil. 2022 Jan;103(1):121-130.e3. doi: 10.1016/j.apmr.2021.06.025. Epub 2021 Aug 8.

Abstract

OBJECTIVE

This systematic review aims to examine (1) what components are used in current person-centered goal-setting interventions for adults with health conditions in rehabilitation and (2) the extent to which the engagement of people in their rehabilitation goal setting is encouraged.

DATA SOURCES

PubMed/MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature, Scopus, and Web of Science from inception to November 2020.

STUDY SELECTION

Primary inclusion criteria were peer-reviewed articles that evaluated person-centered goal-setting interventions for adults with health conditions in rehabilitation. Two independent reviewers screened 28,294 records, and 22 articles met inclusion criteria.

DATA EXTRACTION

Two reviewers independently completed data extraction and quality assessment using the Physiotherapy Evidence Database (PEDRo) scale based on the original authors' descriptions, reports, and protocol publications. Any discrepancies were resolved by consensus or in consultation with another senior reviewer.

DATA SYNTHESIS

Using narrative synthesis, we found that current person-centered goal setting has variability in their inclusion of intervention components. A considerable number of components are underimplemented in current practice, with formulation of coping plan and follow-up being most commonly left out. The active engagement of people does appear to be promoted within the components that are included in the interventions. Nine studies were high-quality defined as a total PEDro scale score of 6 or above.

CONCLUSIONS

Although current person-centered goal setting encourages the active engagement of people, many of these interventions lack components considered important for supporting goal achievement and optimal outcomes. Future practice may be improved by incorporating a comprehensive set of goal-setting components and encouraging the active engagement of people throughout the entire goal-setting process. Together, these practices may facilitate the achievement of meaningful rehabilitation goals and improve rehabilitation outcomes for adults with health conditions.

摘要

目的

本系统评价旨在探讨:(1)目前针对康复期成年健康状况患者的以患者为中心的目标设定干预措施中使用了哪些组成部分;(2)在多大程度上鼓励人们参与其康复目标设定。

数据来源

截至2020年11月的PubMed/MEDLINE、Embase、护理及相关健康文献累积索引、Scopus和科学网。

研究选择

主要纳入标准为经同行评审的文章,这些文章评估了针对康复期成年健康状况患者的以患者为中心的目标设定干预措施。两名独立评审员筛选了28294条记录,22篇文章符合纳入标准。

数据提取

两名评审员根据原始作者的描述、报告和方案出版物,使用物理治疗证据数据库(PEDRo)量表独立完成数据提取和质量评估。任何差异均通过协商一致或与另一位高级评审员协商解决。

数据综合

采用叙述性综合分析,我们发现目前以患者为中心的目标设定在干预组成部分的纳入方面存在差异。在当前实践中,相当数量的组成部分未得到充分实施,应对计划的制定和随访最常被遗漏。在干预措施所包含的组成部分中,确实似乎促进了人们的积极参与。九项研究质量较高,定义为PEDRo量表总得分6分及以上。

结论

尽管目前以患者为中心的目标设定鼓励人们积极参与,但许多此类干预措施缺乏被认为对支持目标实现和最佳结果很重要的组成部分。通过纳入一套全面的目标设定组成部分并鼓励人们在整个目标设定过程中积极参与,未来的实践可能会得到改善。这些做法共同可能有助于实现有意义的康复目标,并改善成年健康状况患者的康复结果。

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