Siddique, F;
(2016)
Unpacking the 'Black Box' of Patient-Centred Care in Neurological Rehabilitation: Exploring the Process of Setting Goals.
Doctoral thesis , UCL (University College London).
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Abstract
Aims: The aim of the study was to explore and examine the processes and experiences of goal setting at an inpatient rehabilitation unit by video recording and rating goal setting sessions. Another aim of the study was to explore staff, patient and carer perspectives in encouraging patient centred goal setting behaviour by using a newly introduced tool for the purpose of facilitating these behaviours. Methods: Data was collected using three different methods. Goal setting sessions were video recorded and the interactions were coded using a checklist of behaviours. The checklist was compiled from structured observation tools in patient centred care. Simple rating scales were used to record the experience of the sessions. Results from the rating scales were reported using simple descriptive statistics. Focus groups were used to explore staff, patient and carer perspectives in use of a tool that enabled patient centred behaviour. Data from the focus groups was analysed using thematic analysis. Results: The behaviour checklist coded four categories of behaviour – goal setting, goal setting related patient-centredness, generic patient centred behaviours and documentation. A fifth category of behaviours observed from the recorded sessions were also noted. Patients, carers and staff also reported experiencing the sessions as satisfactory with sufficient support and involvement in treatment planning. Focus group results identified three main themes of benefits, barriers and suggestions for using the tool. Conclusions: Exploratory research into the processes involved in setting collaborative goals is crucial in identifying factors that contribute to successful outcomes. The checklist of behaviours could be further developed and used to train and monitor staff. The goal setting tool may be useful as a teaching aid to develop and encourage these behaviours.
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