Determining whether occupational therapy goals match between pairs of occupational therapists and their clients: a cross-sectional study

Abstract

Purpose

This study examined the degree to which goals perceived by occupational therapists (OTs) matched those perceived by their clients.

Methods

A total of 100 clients and 79 OTs were recruited from seven subacute rehabilitation wards in Japan. Matched pairs of OTs and their clients were independently asked for their perception about the clients' occupational therapy goals through semi-structured interviews.

Results

Collectively, the OTs reported 239 goals, while the clients reported 161 goals. While both the OTs and the clients reported a high level of client engagement in the goal setting process, 79% of the goal statements were mismatched between pairs of OTs and their clients. Goal matching was slightly better for goals about activities of daily living or participation than for goals about body structure or body function.

Conclusions

Although most OTs and their clients perceived that they engaged in goal-setting together, only 21% of reported goals actually matched between OTs and clients. It would also be worth investigating whether there is any correlation between the content of goals, patient engagement in goal setting, degree of goal matching, and health outcomes achieved by clients following discharge from rehabilitation services.

Implications for rehabilitation

• Although most occupational therapists (OTs) and their clients perceived that they engaged in goal-setting together, 79% of the goals independently reported by OTs and their clients did not match in seven post-acute rehabilitation wards across Japan.

• Goals were slightly more likely to match if the topic of the goals related to instrumental activities of daily living or participation (30.3%) or basic activities of daily living (24.7%) than if the topic of the goals were about body structure or body function (11.2%); however, the overall rate of goal matching was low.

• Japanese OTs need to develop more effective methods for recording or communicating goals in ways that clients can understand; this may be the same for other countries.

Keywords:

• Occupational therapy
• goal setting
• goal matching
• person-centeredness
• decision making

Acknowledgements

The authors thank all the occupational therapists and clients that participated in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research in Japan is supported by Error! Hyperlink reference not valid. from the Japanese Society for the Promotion of Science (grant number: 15K01425).