Getting to know our patients and what matters: exploring the elicitation of patient values, preferences, and circumstances in neurological rehabilitation

Abstract

Purpose

Patient values, preferences, and circumstances are critical to decision-making in both patient-centred and evidence-based practice models of healthcare. Despite the established importance of integrating these patient attributes, the ways they are elicited in rehabilitation remain unclear. This study aimed to explore how health professionals elicit and share patients’ ‘values’, ‘preferences’, and ‘circumstances’, and what they understand by the terms.

Methods

This exploratory qualitative descriptive study used interviews with 13 clinicians from interprofessional teams in inpatient neurological rehabilitation. Data were analysed using a general inductive approach.

Results

Participants understood ‘values’ to mean what is important and meaningful; ‘preferences’ as likes/dislikes and choices; and ‘circumstances’ as the social, physical, and environmental context surrounding the person. Formal and informal strategies were used to gather information directly from patients or indirectly from other sources. The processes of eliciting and communicating this information were influenced by relationships and relied on contributions from many people. Elicitation involved a flexible approach tailored to the individual and considering each unique context.

Conclusion

The strategies used and the approach used to implement these strategies were both essential to eliciting patient values, preferences, and circumstances in neurological rehabilitation. These findings offer insights into the practices of interprofessional rehabilitation clinicians.

Implications for rehabilitation

• Eliciting patient values, preferences, and circumstances involves a combination of strategies and approaches that are applied gradually throughout the continuum of rehabilitation.

• These processes are flexible, and strategies should be tailored to individual patients/families and phases of rehabilitation.

• Clinicians should be attentive to informal opportunities to gather valuable information throughout rehabilitation.

• Establishing positive relationships and using effective communication is foundational to these processes.

Keywords:

• Elicitation
• values
• preferences
• circumstances
• interprofessional
• rehabilitation

Acknowledgements

The authors would like to thank the clinicians who participated in this study for generously giving their time and valuable insight.

Disclosure statement

The authors report no conflicts of interest.

Notes

1 Whānau is the Te Reo Māori word referring to immediate and extended family.

2 Māori are the indigenous people of Aotearoa New Zealand.

3 Te Tiriti o Waitangi (The Treaty of Waitangi) is the founding document of Aotearoa New Zealand.