Article

OBJECTIVE: To map out from the literature the nature, extent and effects of
application of patient-centred goal setting in stroke rehabilitation practice.
Systematic review. DATA SOURCES: A search was conducted in the Cochrane
(Wiley), AMED, Medline (EBSCO), Embase, Sports discuss, Medline (Ovid) and CINAHL
databases. Secondary search based on references from the preliminary search was
undertaken. REVIEW METHODS: Quantitative and qualitative studies that included
aspects of patient-centredness and goal setting in stroke patients from 1980 to
June 2010 were collected. Studies were scrutinized for relevance and quality
based on published methodology. The findings were synthesized by aggregating the
themes from the qualitative studies and relating them to relevant findings from
the quantitative studies. RESULTS: Eighteen qualitative and eight quantitative
and one mixed method study conducted in stroke rehabilitation services ranging
from acute to community rehabilitation were included. Themes that emerged were
related to perceptions of patients and professionals regarding
patient-centredness, nominal adoption of this concept, consequences of
discrepancies in the perceptions and practice, related ethical conflicts,
challenges to application and strategies to improve its application. The effects
of following patient-centred goal-setting practice have been studied mostly with
weak methodologies and studies show some benefit with psychological outcomes.
CONCLUSION: Patient-centred goal setting is minimally adopted in goal-setting
practice due to various barriers. Since the effects of incorporating this concept
have not been evaluated rigorously it is suggested that further research is
essential to investigate its effect on patient outcomes.

Langue : ANGLAIS