PARTICIPATION OF REHABILITEES WITH ACUTE DISEASE IN THE GOAL SETTING PROCESS

¹Jyväskylä University, Health Sciences, Jyväskylä, Finland

Background: Goal setting is an essential phase of the physiotherapy and multidisciplinary rehabilitation process in hospital after acute illness. Identifying, prioritizing and setting the appropriate goals for patients with acute diseases forms the basis for their successful physiotherapy and rehabilitation process.

Purpose: The aim of this study was to evaluate the rehabilitees' meanings of participation in goal setting discussions.

Methods: In this phenomenological study 20 acute stroke and low back pain rehabilitees from Central Hospital of Central Finland, Department of the Demanding Rehabilitation participated in goal setting for multidisciplinary rehabilitation using goal attainment scaling (GAS). A three phase data collection started with the observation of the goal setting discussions. Then the rehabilitees and relatives were interviewed about their experiences in goal setting discussion individually and the professionals in focus groups. Data of 805 transcription pages was analysed by Spiegelberg`s 7 phase meaninganalysis.

Results: The rehabilitees’ meanings in the goal setting discussion varied from limited participation to shared power and responsibility in decision making. The rehabilitees trusted in professionals and their self-efficacy and respectful attendance played a significant role in goal setting discussions. Professionals’ commitment to work with a client-centered manner was also essential. Moreover, relatives were important in the discussion.

Conclusion(s): An acute disease per se is not a barrier to active participation in the goal setting process if professionals use adequate, person-centered methods to support the decision making. Disturbing pain and unpredictable fear can disturb rehabilitees’ participation in goal setting process. When a rehabilitee did not realise his/her situation, he/she did not fully participated in goal setting without help of professionals. This study increases our understanding of the meanings of rehabilitees` participation in goal setting process after acute illness and helps to identify person-centered methods which support rehabilitees` engagement in physiotherapy process.

Implications: Professionals who work with patients with acute disease should utilize person-centered methods such as dignified and respectful interaction with rehabilitees, i.e. to see rehabilitees as individuals and experts of their own life, and to put rehabilitees and their families at the center of decision-making, and to support them during the goal setting process and encourage them to take power and responsibility in decision making.

Funding acknowledgements: No funding

Topic: Disability & rehabilitation

Ethics approval: The design of the study were approved by the Ethical Committee of Central Hospital of Central Finland (3E/2014.24.6.2014 and 3.10.2014).

All authors, affiliations and abstracts have been published as submitted.