'Finding a balance' in involving patients in goal setting early after stroke: a physiotherapy perspective

2.50
Hdl Handle:
http://hdl.handle.net/11287/593780
Title:
'Finding a balance' in involving patients in goal setting early after stroke: a physiotherapy perspective
Authors:
Lloyd, A.; Roberts, A. R.; Freeman, J. A.
Abstract:
BACKGROUND AND PURPOSE: Collaborative goal setting (between patient and professional) confers benefits within stroke and neurological rehabilitation, and is recommended in clinical guidelines. However, evidence suggests that patient participation in rehabilitation goal setting is not maximized, particularly within the hospital setting. The purpose of this study was to investigate physiotherapists' perceptions about their experiences of collaborative goal setting with patients in the sub-acute stages after stroke, in the hospital setting. METHODS: This qualitative study employed constructivist grounded theory methodology. Nine physiotherapists, of varying experience, were selected using purposive then theoretical sampling from three National Health Service hospital stroke units in England. Semi-structured interviews were conducted, audio-recorded and transcribed. Transcripts were coded and analysed using the constant comparative method of grounded theory to find common themes. RESULTS: Three themes emerged from the data: 1) 'coming to terms with stroke' - the individual patient journey; 2) the evolution of goal setting skill - the individual physiotherapist journey; and 3) 'finding a balance' - managing expectations and negotiating interactions. A provisional grounded theory was constructed, which highlighted that, from the physiotherapists' perspective, collaboration with patients within goal setting early after stroke involved finding a balance between numerous different drivers, which have the potential to compete. Patient-directed and therapist-directed goal setting approaches could be viewed as opposite ends of a continuum, along which patient-centred goal setting is possible. DISCUSSION: Physiotherapists perceived that collaborating with patients in goal setting was important but challenging. Goal setting interactions with other professionals, patients and families were perceived as complex, difficult and requiring significant effort. The importance of individuality and temporality were recognized suggesting that the goal setting approach needs to be adapted to the context and the individuals involved.
Citation:
Physiother Res Int. 2014 Sep;19(3):147-57.
Publisher:
Wiley
Journal:
Physiotherapy research international : the journal for researchers and clinicians in physical therapy
Issue Date:
1-Sep-2014
URI:
http://hdl.handle.net/11287/593780
DOI:
10.1002/pri.1575
PubMed ID:
24302610
Additional Links:
http://dx.doi.org/10.1002/pri.1575
Type:
Comparative Study; Historical Article; Multicenter Study
Language:
eng
ISSN:
1471-2865
Appears in Collections:
2014 RD&E publications; Physiotherapy

Full metadata record

DC FieldValue Language
dc.contributor.authorLloyd, A.en
dc.contributor.authorRoberts, A. R.en
dc.contributor.authorFreeman, J. A.en
dc.date.accessioned2016-01-19T12:34:50Zen
dc.date.available2016-01-19T12:34:50Zen
dc.date.issued2014-09-01en
dc.identifier.citationPhysiother Res Int. 2014 Sep;19(3):147-57.en
dc.identifier.issn1471-2865en
dc.identifier.pmid24302610en
dc.identifier.doi10.1002/pri.1575en
dc.identifier.urihttp://hdl.handle.net/11287/593780en
dc.description.abstractBACKGROUND AND PURPOSE: Collaborative goal setting (between patient and professional) confers benefits within stroke and neurological rehabilitation, and is recommended in clinical guidelines. However, evidence suggests that patient participation in rehabilitation goal setting is not maximized, particularly within the hospital setting. The purpose of this study was to investigate physiotherapists' perceptions about their experiences of collaborative goal setting with patients in the sub-acute stages after stroke, in the hospital setting. METHODS: This qualitative study employed constructivist grounded theory methodology. Nine physiotherapists, of varying experience, were selected using purposive then theoretical sampling from three National Health Service hospital stroke units in England. Semi-structured interviews were conducted, audio-recorded and transcribed. Transcripts were coded and analysed using the constant comparative method of grounded theory to find common themes. RESULTS: Three themes emerged from the data: 1) 'coming to terms with stroke' - the individual patient journey; 2) the evolution of goal setting skill - the individual physiotherapist journey; and 3) 'finding a balance' - managing expectations and negotiating interactions. A provisional grounded theory was constructed, which highlighted that, from the physiotherapists' perspective, collaboration with patients within goal setting early after stroke involved finding a balance between numerous different drivers, which have the potential to compete. Patient-directed and therapist-directed goal setting approaches could be viewed as opposite ends of a continuum, along which patient-centred goal setting is possible. DISCUSSION: Physiotherapists perceived that collaborating with patients in goal setting was important but challenging. Goal setting interactions with other professionals, patients and families were perceived as complex, difficult and requiring significant effort. The importance of individuality and temporality were recognized suggesting that the goal setting approach needs to be adapted to the context and the individuals involved.en
dc.language.isoengen
dc.publisherWileyen
dc.relation.urlhttp://dx.doi.org/10.1002/pri.1575en
dc.title'Finding a balance' in involving patients in goal setting early after stroke: a physiotherapy perspectiveen
dc.typeComparative Studyen
dc.typeHistorical Articleen
dc.typeMulticenter Studyen
dc.identifier.journalPhysiotherapy research international : the journal for researchers and clinicians in physical therapyen
All Items in RD&E Research Repository are protected by copyright, with all rights reserved, unless otherwise indicated.