Implementation of goal setting in rehabilitation in people with stroke

Abstract

Introduction: In clinical practice there is an evidence-to-practice gap in post-stroke care where patient-centered goal setting is underutilized. A program theory is crucial to guide goal-setting processes and overcome implementation barriers. Objectives: to investigate experiences of different stakeholders in the context of implementing goal-setting post-stroke. Methods: Qualitative study in which healthcare professionals and stroke patients/family members participated in semi-structured focus groups and interviews. Results: Communication with patients and family members is critical. Challenges include varying family involvement, difficulties in organizing family-patient discussions and differing perceptions of predictive screenings. Issues in transmural care persist, emphasizing the need for standardized transfer documents and procedures. Action plan development faces obstacles related to patient comprehension, timing and time investment, and healthcare professionals' involvement. Patient experiences reveal high trust in the team, limited goal awareness, varying desires for an active role, and insufficient explanations for prescribed exercises. Conclusion: This study reveals persistent challenges in communication, transmural care and interdisciplinary collaboration to implement goal-setting in post-stroke care.