Article

OBJECTIVE: To investigate the effects of patient participation in
multidisciplinary goal setting during early inpatient rehabilitation after
acquired brain injury. DESIGN: Case controlled retrospective study. Setting:
Regional neurological rehabilitation unit. Subjects: One hundred and five
patients with acquired brain injury. MAIN MEASURES: Numbers of goals set and
achieved per patient before and after intervention; Barthel Index and Functional
Independence Measure. RESULTS: The intervention resulted in a significant
increase in the number of goals set per patient (340 versus 411 total goals, mean
per patient 6.3 pre versus 8.05 post, P = 0.008). More patients had multiple
goals set within each domain (P = 0.023). There was an increase in the number of
patients with sleeping (0 pre, 9 post), continence (3 pre, 17 post) and leisure
(15 pre, 35 post) goals set, and leisure goals achieved (60% pre and 68% post, P
< 0.001). Correlations between goal achievement and change in activity-related
outcome measures (Barthel Index and Functional Independence Measure) also
improved with the new goal setting process. The proportion of goals achieved
remained similar (60% pre and 63% post intervention), suggesting there was no
evidence of inappropriate or unachievable goals set when the patient and family
were included. CONCLUSIONS: Real-time engagement of brain-injured patients in the
goal setting process during early inpatient rehabilitation is achievable, but
requires a structured multidisciplinary assessment of need. We found it increases
the number of domains in which goals are set and includes functional areas not
rated by commonly used global measures of outcome during inpatient rehabilitation.

Langue : ANGLAIS