Patient and family engagement in goal setting in brain injury

Ms Jacinta Sadler1

1Caulfield Abi Unit, Alfred Health, Caulfield, Australia

Authors: J.Sadler, E.O’Shannessy, L.Jolliffe, K.Roberts, J.Morarty & N.A.Lannin

Aim:

Patient and family directed goal setting is an important component of rehabilitation models of care. This study aimed to understand strategies that health professionals use to facilitate patient and family engagement in goal setting.

Method:

A qualitative phenomenological study was conducted using a convenience sample in a metropolitan brain injury rehabilitation inpatient unit. Goal setting interviews were recorded and transcribed verbatim then analysed thematically. Interviews included a cross section of patients’, family members’ and health professionals and were conducted at various time-points in the patient journey between April and June 2015.

Results:

Inpatients (n=21) and family members (n=13) participated in the study, the majority of inpatients had sustained a traumatic brain injury (81%) and were male (62%). Consenting health professionals were from a range of disciplines (SW, OT, SP, PT, medicine).  Themes explored during interviewing highlighted key strategies and skills that facilitated successful engagement in goal setting, including investing time in developing the therapeutic relationship, breaking down goals, guiding rather than leading, displaying empathy and explaining the goal setting process in simple terms.  Therapists’ confidence, experience and skill levels were identified as key factors that impacted on goal setting success.

Significance of the findings to allied health:

While often considered an innate skill, results suggest that allied health clinicians need additional skill development to engage inpatients and their families in rehabilitation goal setting. Identifying health professionals’ within your organisation who have expert skills and involving them as key goal-setters is expected to improve the experience of patients’ and families.