Is the practice of goal-setting for patients in acute stroke care patient-centred and what factors influence this? A qualitative study

Authors: Rosewilliam, S., Sintler, C., Pandyan, A.D., Skelton, J. and Roskell, C.A.

Journal: Clinical Rehabilitation

Volume: 30

Issue: 5

Pages: 508-519

eISSN: 1477-0873

ISSN: 0269-2155

DOI: 10.1177/0269215515584167

Abstract:

Objective: To explore whether goal-setting for rehabilitation with acute stroke survivors is patient-centred and identify factors which influence the adoption of patient-centredness in goal-setting practice. Setting: Acute stroke unit in a large teaching hospital in England. Participants: Patients with stroke who had no cognitive or significant communication problems and health care professionals who had a significant engagement with an individual patient were approached for participation. Method: Multiple qualitative methods were used. Perceptions and beliefs about patient-centredness, within the context of goal-setting, were collected from patients and corresponding professionals using qualitative semi-structured interviews. Adoption of patient-centred behaviour was triangulated using analysis of patient records and observation of team meetings related to participating patients. Data analysis: Interview transcripts and field notes were coded, clustered under categories and descriptively summarised. Additionally, data from patients' documents were summarised. These summaries were then mapped on to an a-priori frame work of patient-centredness from which further interpretative themes were derived. Results: Seven patients and seven health-care professionals participated. Goal-setting was not consistently patient-centred as evidenced by a) incongruities between patients and professionals in setting, communicating and prioritising of goals and b) dysfunctional therapeutic relationships. The factors that influenced patient-centred goal-setting were both professional and patient beliefs and attributes, work-culture, practice model, limitations in knowledge and systems that disempowered both professionals and patients. Conclusion: It may be possible to infer that current local practice of goal-setting was inadequately patient-centred. Further research is required to identify strategies to overcome these challenges and to develop patient-centred goal-setting methods.

Source: Scopus

Is the practice of goal-setting for patients in acute stroke care patient-centred and what factors influence this? A qualitative study.

Authors: Rosewilliam, S., Sintler, C., Pandyan, A.D., Skelton, J. and Roskell, C.A.

Journal: Clin Rehabil

Volume: 30

Issue: 5

Pages: 508-519

eISSN: 1477-0873

DOI: 10.1177/0269215515584167

Abstract:

OBJECTIVE: To explore whether goal-setting for rehabilitation with acute stroke survivors is patient-centred and identify factors which influence the adoption of patient-centredness in goal-setting practice. SETTING: Acute stroke unit in a large teaching hospital in England. PARTICIPANTS: Patients with stroke who had no cognitive or significant communication problems and health care professionals who had a significant engagement with an individual patient were approached for participation. METHOD: Multiple qualitative methods were used. Perceptions and beliefs about patient-centredness, within the context of goal-setting, were collected from patients and corresponding professionals using qualitative semi-structured interviews. Adoption of patient-centred behaviour was triangulated using analysis of patient records and observation of team meetings related to participating patients. DATA ANALYSIS: Interview transcripts and field notes were coded, clustered under categories and descriptively summarised. Additionally, data from patients' documents were summarised. These summaries were then mapped on to an a-priori frame work of patient-centredness from which further interpretative themes were derived. RESULTS: Seven patients and seven health-care professionals participated. Goal-setting was not consistently patient-centred as evidenced by a) incongruities between patients and professionals in setting, communicating and prioritising of goals and b) dysfunctional therapeutic relationships. The factors that influenced patient-centred goal-setting were both professional and patient beliefs and attributes, work-culture, practice model, limitations in knowledge and systems that disempowered both professionals and patients. CONCLUSION: It may be possible to infer that current local practice of goal-setting was inadequately patient-centred. Further research is required to identify strategies to overcome these challenges and to develop patient-centred goal-setting methods.

Source: PubMed

Is the practice of goal-setting for patients in acute stroke care patient-centred and what factors influence this? A qualitative study

Authors: Rosewilliam, S., Sintler, C., Pandyan, A.D., Skelton, J. and Roskell, C.A.

Journal: CLINICAL REHABILITATION

Volume: 30

Issue: 5

Pages: 508-519

eISSN: 1477-0873

ISSN: 0269-2155

DOI: 10.1177/0269215515584167

Source: Web of Science (Lite)

Is the practice of goal-setting for patients in acute stroke care patient-centred and what factors influence this? A qualitative study.

Authors: Rosewilliam, S., Sintler, C., Pandyan, A.D., Skelton, J. and Roskell, C.A.

Journal: Clinical rehabilitation

Volume: 30

Issue: 5

Pages: 508-519

eISSN: 1477-0873

ISSN: 0269-2155

DOI: 10.1177/0269215515584167

Abstract:

Objective

To explore whether goal-setting for rehabilitation with acute stroke survivors is patient-centred and identify factors which influence the adoption of patient-centredness in goal-setting practice.

Setting

Acute stroke unit in a large teaching hospital in England.

Participants

Patients with stroke who had no cognitive or significant communication problems and health care professionals who had a significant engagement with an individual patient were approached for participation.

Method

Multiple qualitative methods were used. Perceptions and beliefs about patient-centredness, within the context of goal-setting, were collected from patients and corresponding professionals using qualitative semi-structured interviews. Adoption of patient-centred behaviour was triangulated using analysis of patient records and observation of team meetings related to participating patients.

Data analysis

Interview transcripts and field notes were coded, clustered under categories and descriptively summarised. Additionally, data from patients' documents were summarised. These summaries were then mapped on to an a-priori frame work of patient-centredness from which further interpretative themes were derived.

Results

Seven patients and seven health-care professionals participated. Goal-setting was not consistently patient-centred as evidenced by a) incongruities between patients and professionals in setting, communicating and prioritising of goals and b) dysfunctional therapeutic relationships. The factors that influenced patient-centred goal-setting were both professional and patient beliefs and attributes, work-culture, practice model, limitations in knowledge and systems that disempowered both professionals and patients.

Conclusion

It may be possible to infer that current local practice of goal-setting was inadequately patient-centred. Further research is required to identify strategies to overcome these challenges and to develop patient-centred goal-setting methods.

Source: Europe PubMed Central