Aiming for a healthier life: a qualitative content analysis of rehabilitation goals in patients with rheumatic diseases

Abstract

Purpose: To explore and describe rehabilitation goals of patients with rheumatic diseases during rehabilitation stays, and examine whether goal content changed from admission to discharge.

Method: Fifty-two participants were recruited from six rehabilitation centers in Norway. Goals were formulated by the participants during semi-structured goal-setting conversations with health professionals trained in motivational interviewing. An inductive qualitative content analysis was conducted to classify and quantify the expressed goals. Changes in goal content from admission to discharge were calculated as percentage differences. Goal content was explored across demographic and contextual characteristics.

Results: A total of 779 rehabilitation goals were classified into 35 categories, within nine overarching dimensions. These goals varied and covered a wide range of topics. Most common at admission were goals concerning healthy lifestyle, followed by goals concerning symptoms, managing everyday life, adaptation, disease management, social life, and knowledge. At discharge, goals about knowledge and symptoms decreased considerably, and goals about healthy lifestyle and adaptation increased. The health profession involved and patient gender influenced goal content.

Conclusions: The rehabilitation goals of the patients with rheumatic diseases were found to be wide-ranging, with healthy lifestyle as the most prominent focus. Goal content changed between admission to, and discharge from, rehabilitation stays.

Implications for rehabilitation

• Rehabilitation goals set by patients with rheumatic diseases most frequently concern healthy lifestyle changes, yet span a wide range of topics.

• Patient goals vary by gender and are influenced by the profession of the health care worker involved in the goal-setting process.

• To meet the diversity of patient needs, health professionals need to be aware of their potential influence on the actual goal-setting task, which may limit the range of topics patients present when they are asked to set rehabilitation goals.

• The proposed framework for classifying goal content has the capacity to detect changes in goals occurring during the rehabilitation process, and may be used as a clinical tool during goal-setting conversations for this patient group.

Keywords:

• Goals
• patient-centered
• rehabilitation
• rheumatic diseases
• qualitative content analysis

Acknowledgements

The authors would like to thank all the patients and health professionals at the six participating rehabilitation centers for their contribution to the original data. We also thank biostatistician Petter Mowinckel for drawing the sample, NVivo consultant Elizabeth Wiredu, researcher Heidi A. Zangi for assistance with data analysis and patient research partner Ellen Sann for reviewing the coding framework.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

The study was funded by the South-Eastern Norway Regional Health Authority (2012096).