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Barriers and enablers to aligning rehabilitation goals to patient life roles following acquired brain injury
Acquired Brain Injury Rehabilitation Centre, Caulfield Hospital, Melbourne, VIC, Australia.
Occupational Therapy Department, Alfred Health, Melbourne, VIC, Australia.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. School of Health, Medical and Applied Science, Central Queensland University, QLD, Australia.ORCID iD: 0000-0001-6430-2823
2018 (English)In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 65, no 6, p. 512-522Article in journal (Refereed) Published
Abstract [en]

Background/aim: Life roles are integral to occupational therapy practice. Goal setting is a method of establishing priorities to measure outcomes. While acquired brain injury can impact a person's ability to fulfil meaningful life roles, the alignment of goals set in rehabilitation to life roles, is unclear. This study aimed to (i) explore the alignment of goals with life roles for people with an acquired brain injury participating in inpatient rehabilitation; and (ii) identify barriers and enablers to life role discussions within a patient-directed goal setting framework.

Method: A mixed-methods study was conducted on an inpatient rehabilitation unit in Victoria, Australia. Quantitative data were obtained from a retrospective file audit of randomly selected medical records. Qualitative data were collected through: a) interviews with patients and their families; and b) A focus group with occupational therapists. Thematic analysis of both audit data and narrative data was undertaken.

Results: Thirty files were examined and demonstrated 33% alignment between goals and life roles. Four interviews were completed with patients, with a family member participating in two of these. Themes identified were: readiness, role concept, recovery concept and goal review. Five therapists attended the focus group. Themes identified were: Patient factors, goal review, expectations, role change and environment. Interview and focus group data identified that barriers to life role discussions included: lack of patient and family readiness, patients’ difficulty understanding role concept, focus on impairments and lack of family/ significant others support. Enablers included: having early conversations involving family, regular goal review and use of standardised tools.

Conclusion: Goal setting in alignment with life roles is important in acquired brain injury rehabilitation, but may be limited. This process can be enhanced by including patients and their significant others in early goal setting conversations, along with regular goal review across the rehabilitation process. 

Place, publisher, year, edition, pages
John Wiley & Sons, 2018. Vol. 65, no 6, p. 512-522
Keywords [en]
adult, brain injury, goals, rehabilitation, role
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:hj:diva-42332DOI: 10.1111/1440-1630.12492ISI: 000452413000005PubMedID: 29920690Scopus ID: 2-s2.0-85057748519Local ID: HHJÖvrigtISOAI: oai:DiVA.org:hj-42332DiVA, id: diva2:1271727
Available from: 2018-12-18 Created: 2018-12-18 Last updated: 2018-12-20Bibliographically approved

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Unsworth, Carolyn

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