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Survival, momentum, and things that make me “me”: patients’ perceptions of goal setting after stroke

2013; Informa; Volume: 36; Issue: 12 Linguagem: Inglês

10.3109/09638288.2013.825653

1464-5165

Melanie Brown, William Levack, Kathryn McPherson, Sarah Dean, Kirk Reed, Mark Weatherall, William J. Taylor,

Musculoskeletal pain and rehabilitation

Purpose: Goal setting and patient-centredness are considered fundamental concepts in rehabilitation. However, the best way to involve patients in setting goals remains unclear. The purpose of this study was to explore patient experiences of goal setting in post-acute stroke rehabilitation to further understanding of its application to practice. Method: Thematic analysis was used to analyse interview transcripts from 10 stroke survivors, recruited from 4 rehabilitation units as part of a pilot study investigating the effects of a structured means of eliciting patient-centred goals in post-acute stroke rehabilitation. Results: Three key themes emerged: (1) “A Day by Day Momentum”, comprising subordinate themes of “Unpredictability” and “Natural Progression” in which daily progress forwards was seen as an integral part of rehabilitation; (2) “Battle versus Alliance” in which issues of struggle versus support influenced participants’ advancement; and (3) “The Special Things”, consisting of subordinate themes of “What Makes Me ‘Me’” and “Symbolic Achievements” concerning issues defining individuals and their rehabilitation experiences. Conclusions: Patients’ discourse around goal setting can differ from the discourse conventionally used by clinicians when describing “best practice” in rehabilitation goal setting. Understanding patients’ non-conventional views of goals may assist in supporting and motivating them, thus providing drive for their rehabilitation.