Patient centered goal-setting in a subacute rehabilitation setting
Patient centered goal-setting in a subacute rehabilitation setting
复制标题
DOI：
10.3109/09638280903036605
复制
发表时间：
2010-01-01
影响因子：
2.2
通讯作者：
Haines, Terrence
中科院分区：
文献类型：
--
作者：
Leach, Emma;Cornwell, Petrea;Haines, Terrence
法对澳大利亚一家医院老年评估和康复科的治疗师进行了定性的半结构化电子邮件采访。治疗师被要求回答有关确定的中风康复患者的问题。确定了三种目标设定方法：治疗师控制，治疗师领导和患者为中心。目标主要针对ICF的损伤程度和活动限制。以患者为中心的目标设定方法的障碍在很大程度上超过了促进者。为克服这些障碍提供了潜在的成功解决方案。患者无法充分参与目标设定过程，这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在活动和参与水平上感知患者目标的垫脚石。以患者为中心的方法的障碍可以通过教育患者和家庭关于伤害的性质和治疗师与患者之间的沟通的修改来克服。
Method. 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.Results. 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.Conclusions. 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.