Goal setting: Engaging patients with an acquired brain injury and their families

Background: Patient-centred goal setting is an essential part of care planning for persons with a severe brain injury however, there is limited research exploring how healthcare workers facilitate patient and family engagement... [ view full abstract ]

Background:
Patient-centred goal setting is an essential part of care planning for persons with a severe brain injury however, there is limited research exploring how healthcare workers facilitate patient and family engagement in goal setting. This study sought to examine patients’, families’ and healthcare workers’ perceptions of patient engagement in goal setting.

Method:
A mixed methods exploratory study of a novel approach to using the Goal Engagement Scale (GES) was conducted in both inpatient trauma and rehabilitation units at a healthcare service. Participants were twenty-two triads (patients with moderate-severe traumatic brain injury or stroke, their family member/s and a treating healthcare worker) participating in routine goal setting interviews. Goal setting interviews were recorded, transcribed and thematically analysed whilst the GES scores were analysed descriptively.

Results:
Perception of patient’s level of engagement in goal setting differed between healthcare workers, patients and families, whilst healthcare worker views dominated the goal setting process. Goal setting interview data revealed four main themes: i) The experience of injury and hospitalisation: supporting people through the unknown; ii) Building a trusting relationship; iii) Being responsive to the needs of patient and family and iv) Eliciting goals: a collaborative process.

Conclusion:
Drawing upon the findings of this study, 18 strategies for enhancing patient and family engagement in goal setting were identified.

Application to Practice:
Healthcare workers are encouraged to use reflective listening skills and build trusting relationships with patients and families to support their engagement in meaningful, collaborative goal setting.