An organizational perspective on goal setting in community-based brain injury rehabilitation.
OBJECTIVE
To use a taxonomy of goal content, developed in community-based brain injury rehabilitation to examine and compare the content of goals set within two different service settings; and to further examine the potential of the taxonomy to be a reliable and comprehensive framework for classifying goals.


METHODS
Qualitative analysis and categorization of 1492 goal statements extracted from a community-based brain injury rehabilitation service over two time periods (1996--97, 1998--99), and cross-organizational comparison of ratings of goal classifications using a random sample of 100 goal statements drawn from this data set and the original 1765 goal statements used in developing the taxonomy.


RESULTS
Application of the taxonomy beyond the original service setting in which it was developed indicated a strong inter-rater reliability, with a high test-retest agreement reported over time. For both services, a small number of categories accounted for a substantial proportion of goals set within the two time periods, while considerable change was evident in goals between the two periods for one service. Further, both placed emphasis on individually focused goals rather than relationship or family-related goals.


CONCLUSIONS
The taxonomy provides a reliable means for classifying goals and is a useful tool for exploration of the multiple influences on goal setting. Further application of the taxonomy to examine the relative influence on goal setting of client factors versus a range of organizational factors would be beneficial.
Simpson
Grahame
G
Brain Injury Rehabilitation Unit, Liverpool Health Service, Sydney, Australia. grahame.simpson@swsahs.nsw.gov.au
Foster
Michele
M
Kuipers
Pim
P
Kendall
Melissa
M
Hanna
Joe
J
D000203:Activities of Daily Living; D001315:Australia; D001930:Brain Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D003153:Community Health Services / Q000379:methods / Q000458:organization & administration*; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010347:Patient Care Planning / Q000458:organization & administration*; D012047:Rehabilitation Centers / Q000458:organization & administration; D015203:Reproducibility of Results; D012189:Retrospective Studies