A qualitative study of patient-centered goal-setting in geriatric rehabilitation: patient and professional perspectives
A qualitative study of patient-centered goal-setting in geriatric rehabilitation: patient and professional perspectives
复制标题
老年康复中以患者为中心的目标设定的定性研究：患者和专业视角
作者：
R. van Seben;Susanne M. Smorenburg;B. Buurman
目的：了解老年患者康复目标随时间变化的特征，探讨专业人员对以患者为中心的目标设定的态度和对康复目标的看法。设计：定性访谈研究。环境：三个老年康复中心。受试者：10名患者（年龄大于或小于80岁），最近接受了住院老年康复治疗，有目的地招募了7名专业人员。方法：半结构化访谈。在住院康复出院后的第三或第四周对患者进行访谈，以反映他们的住院目标，并调查他们在家后的长期目标。进行了专题分析。结果：在住院康复期间，参与者的主要目标是恢复自理活动和回家。出院后，患者未达到其基线功能水平。康复目标似乎随着时间的推移而改变，一旦回到家，患者就制定了更雄心勃勃的康复目标，这些目标与恢复完全独立和能够进行活动有关。虽然专业人士认为与患者一起设定目标很重要，但他们也指出，老年人往往要么无法制定目标，要么设定不现实的目标。此外，专业人士指出，目标必须与出院标准有关，例如进行基本的自我保健活动，康复围绕着让患者为出院做好准备。结论：在住院康复过程中，患者目标与回家相关。出院后，患者有远大的目标，这与他们的病前功能水平有关。康复服务应区分病人住院期间的重要目标和出院后的重要目标。
Objective: To characterize how rehabilitation goals of older patients change over time and to explore professionals’ attitudes toward patient-centered goal-setting and their perspectives on rehabilitation goals. Design: Qualitative interview study. Setting: Three geriatric rehabilitation centers. Subjects: Ten patients (aged ⩾ 80), who had recently received inpatient geriatric rehabilitation, and seven professionals were purposively recruited. Methods: Semi-structured interviews. Patients were interviewed in the third or fourth week after discharge from inpatient rehabilitation, to reflect on their inpatient goals and to investigate long-term goals now that they were at home. A thematic analysis was performed. Results: During inpatient rehabilitation, participants’ main goals were regaining independence in self-care activities and going home. Post-discharge, patients were not at their baseline functioning level. Rehabilitation goals appeared to shift over time, and once at home, patients formulated more ambitious rehabilitation goals that were related to regaining full independence and being able to perform activities. Although professionals thought goal-setting together with the patient is important, they also stated that older individuals often are either unable to formulate goals or they set unrealistic ones. In addition, professionals indicated that goals have to be related to discharge criteria, such as performing basic self-care activities, and rehabilitation revolves around getting patients ready for discharge. Conclusion: During inpatient rehabilitation, patient goals are related to going home. After discharge, patients have ambitious goals, related to their premorbid functioning level. Rehabilitation services should distinguish between goals that are important while patients are inpatient and goals that are important after discharge.
影响因子：
120.7
作者：
Kansagara, Devan;Englander, Honora;Salanitro, Amanda;Kagen, David;Theobald, Cecelia;Freeman, Michele;Kripalani, Sunil
通讯作者：
Kripalani, Sunil