Article

OBJECTIVE: To describe goal-setting during inpatient stroke rehabilitation.
DESIGN: There were two stages: an electronic questionnaire for multidisciplinary
teams and an analysis of goal-setting documentation for rehabilitation patients.
SETTING: Five inpatient stroke units.
PARTICIPANTS: Staff involved in
goal-setting and patients undergoing stroke rehabilitation. RESULTS: A total of
13 therapists and 49 patients were recruited, and 351 documented goals were
examined. All units used therapist-led goal-setting (60% of goals were set by
therapists). In total, 72% of goals were patient-focused but patients and
families were rarely directly involved. Goals focussed on basic mobility and
activities of daily living (~50% and ~25% of goals, respectively). Only 41% of
documented goals met the SMART criteria. Review of progress was limited: 48% of
goals were never reviewed and 24% of the remainder were merely marked as
'ongoing' without a date or plan for completion. New goals and actions were often
documented without any connection to previous goals. Integration between goals
and treatment/action plans was mixed. In two units, goals were unconnected to a
treatment or action plan, but for the remainder it was 90%-100%. However, that
connection was generally vague and amounted to suggestions of the type of
treatment modality that staff might employ. CONCLUSION: Goal-setting during
inpatient stroke rehabilitation is therapist-led but discussed with the
multidisciplinary team. Therapists mainly identified patient-focussed mobility
and activities of daily living goals. Monitoring progress and revising goals were
often uncompleted. Links between goals and treatment, action plans and progress
were patchy.

Langue : ANGLAIS