1. Goal setting and the use of patient-specific instruments Correspondence to: anita.stevens@zuyd.nl Research Centre: Autonomy and Participation Zuyd University p.o. Box 550, 6400 AN Heerlen The Netherlands www.aenp.zuyd.nl T +3145 4006364 F +3145 4006369 Objective Improve the use of patient-specific measures in the goal setting process, in community practices for OT, PT and ST. Research questions: 1. What patient-specific measures can be used in goal-setting and what is known about their feasibility? 2. How do professionals use patient-specific measures in the goal setting process in daily practice and what are the barriers? Introduction Setting of shared treatment goals is an important issue in client centred care. It stimulates patients’ responsibility in therapy and improves treatment outcome. Goal setting continues throughout the whole therapy process. The ‘goal-setting and action- planning practice framework’ (Scobbie et al, 2011) (fig.1) offers a systematic approach for goal setting in daily practice. Patient and therapist work together in each phase, and the cyclic process makes it to be tailored to individual patients. Patient-specific measures can objectify and support this goal setting process and reflect the patients' perspective. I think we achieved the goals Pfff, eventuall y… In cooperation with: Anita Stevens AB, Sandra Beurskens AB, Albère Köke ACD, Trudy van der Weijden B A Zuyd University of applied science: Research Centre: Autonomy and Participation, Heerlen B Maastricht University: Caphri Research group. Department of General Practice C Adelante Centre of Expertise in Rehabilitation, Hoensbroek D Maastricht University: Department of Rehabilitation Medicine Figure 1: Goal setting and the use of patient-specific instruments Method 1.Systematic review to reveal patient-specific measures used in goal-setting and to evaluate the feasibility of measures. 2. Semi-structured interviews of OT’s about their experience and use of the COPM in practice. Results 1. Eleven patient-specific measures were revealed and situated in the goal setting process (fig.1). Canadian Occupational Performance Measure, COPM Goal Attainment Scaling, GAS MACTAR, MAC Patient Goal Priority Questionnaire, PGPQ Patient Goal Priority List, PGPL Patient Specific Complaints, PSC Patient Specific Functioning Scale, PSFS Patient Specific Index, PSI Problem Elicitation Technique, PET Self Identified Goals Assessment, SIGA Talking Mats, TM The use of most instruments seemed to be feasible, but their role in goal-setting is not well described. 2. Eleven OT’s in community practices were interviewed. They used the COPM (complete or partial) in the goal negotiation phase and sometimes for evaluation purposes. Benefits: fostered client centred working and structured the elicitation of the patients’ problems. Disadvantages: time consuming and difficult scoring method for cognitive impaired patients. Conclusion Eleven measurements are used in goal setting. Nine use more or less the same method: patients score their activities on difficulty, severity and/or satisfaction and evaluate them over time. All can be used in the goal negotiation and evaluation phase. The GAS seems to be the most suitable instrument for goal setting. In OT practice, the COPM is appreciated but not used as recommended, because of time investment and difficulties in scoring system. Future research plan Qualitative studies to reveal the process of goal setting in daily practice in other professions. Improvement and adaption of goal setting measures and procedures. Development of implementation strategies. Testing and evaluation of the implementation plan. A research plan and first results ‘Goal setting and action planning framework’ Possible use of patient- specific instruments