Rehabilitees perspective on goal setting in rehabilitation – a phenomenological approach

Abstract

Purpose: Setting meaningful goals for the rehabilitation process after acute illness is essential for rehabilitees recovery. The aim of this study was to understand the meanings of the goal setting situation with professionals from rehabilitees point of view.

Method: We included 20 acute stroke and back pain rehabilitees (mean age 66 y) who set goals with a multidisciplinary rehabilitation team. Data was collected by interviewing the rehabilitees after the goal setting situations. A qualitative analysis from a phenomenological perspective using Spiegelberg’s seven-phase meaning analysis was performed to reveal meanings.

Results: The five meanings were identified as: (i) “trust in the rehabilitation situation, professionals, oneself, and relatives;” (ii) “respectful presence;” (iii) “confusing awareness;” (iv) “disturbing pain;” and (v) “fear of unpredictability.” When professionals committed to working in a patient-centred manner, the rehabilitees felt respected and they trusted professionals and thus their self-efficacy was empowered. Moreover, relatives were an important support in the situation. However, disturbing pain and fear of the future limited patients level of participation in the situation.

Conclusion: Rehabilitee commitment to rehabilitation can be supported with equality in communication and presence of relatives, while pain and uncertainty because of changed health limit participation in a goal setting situation.

Implications for Rehabilitation

• Multidisciplinary rehabilitation professionals should be recommended to support the active role of a patient in the goal setting situation.

• Relatives are recommended to participate in goal setting situation as they are an important support for rehabilitees.

• Professionals should be recommended to remove obstacles that restrain patient’s participation in the goal setting situation.

• Professionals should be recommended to recognize patients with changed health and offer psychosocial support for those in need to improve their participation in rehabilitation process.

Keywords:

• Goal setting
• phenomenology
• meaning analysis
• rehabilitation
• client-centred
• hospital

Acknowledgements

The authors would like to thank all the participants, without whom this study would not have been possible to accomplish. Additionally, we would like to thank the staff of Central Finland Health Care District for giving us the opportunity to carry out this study in the Department of Demanding Rehabilitation. Especially we would like to thank the following colleagues for the assistance given in recruiting participants for this study: Satu Auvinen, Senior Physician of Rehabilitation, Marja Arkela, PhD, Clinical Chief, Niina Ylönen-Käyrä, Clinical Chief of the Department of Demanding Rehabilitation, and Maarit Heinonen, Clinical Chief of Physiotherapy. We would like to thank the Social Insurance Institution of Finland for funding the project. We would also like to thank Tiina Suomela-Markkanen, MD, for her support with data collection.

Disclosure statement

The authors report no declaration of interest.

Additional information

Funding

This research project was funded by the Social Insurance Institution of Finland.