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Stevens A.1, Köke A.1, van der Weijden T.2, Beurskens A.1
1Zuyd University of Applied Sciences, Faculty of Health, Heerlen, Netherlands, 2Maastricht University, Family Medicine, Maastricht, Netherlands
Background: To deliver client-centered care, physical therapists need to identify the patient's individual treatment goals. This goal-setting process can be supported by patient-specific instruments. In the Netherlands, the Patient-Specific Complaint instrument (PSC), similar to the Patient Specific Functional Scale (PSFS), is a frequently used and recommended instrument to identify and score the main activity problems a patient wants to work on in therapy. However, its potential for personalized goal setting and patient involvement is hardly utilized.
Purpose: To describe the development,content and evaluation of a new PSC in order to improve physical therapy goal setting.
Methods: A user-centred development process was carried out in four phases, wherein physical therapists and patients participated. The final product was implemented, tested and evaluated in community-based physical therapy practices.
Results: The PSC instrument resulted into a PSC 2.0 method that was based on a theory-based model of goal-setting, and shared decision making. Two extra steps setting goals and planning treatment were added to the original PSC, and it has to be fully integrated in the diagnostic and therapeutic process.
The PSC 2.0 was implemented in community-based practices by means of a training course, and used and evaluated by 52 physical therapists. Patients and physical therapists were positive about the PSC 2.0. It was found feasible to enhance patient participation and to structure the goal-setting process. However, the actual setting of goals remained difficult, and the lack of integration in the electronic patient system as well as the external audit obligations, were major barriers for using it in routine practice.
Conclusion(s): The PSC 2.0 gives the physical therapist a tool to increase patients awareness and involvement in goal setting and might lead to more client-centred physical therapy.
Implications: Physical therapists can already integrate the ideas underlying PSC 2.0 in the current use of patient-specific instruments like the PSC or PSFS. For example, they can inform their patients about the reason for using the instruments, and discuss the results with their patients, in view of treatment goals and treatment plan. This would imply that instruments are not utilized as a standalone instrument, but should be integrated in the diagnostic and therapeutic process.
Funding acknowledgements: Stichting Innovatieve Alliantie, RAAK, the Netherlands. Number: PRO-1-007
Topic: Outcome measurement
Ethics approval: METC Atrium-Orbis-Zuyd, Heerlen, the Netherlands
All authors, affiliations and abstracts have been published as submitted.
