Goal setting in Dutch paediatric rehabilitation. Are the needs and principal problems of children with cerebral palsy integrated into their rehabilitation goals?
OBJECTIVE
To evaluate whether the needs and principal problems of children with cerebral palsy (CP) as formulated in their interdisciplinary rehabilitation reports are integrated into the goal descriptions and whether this depends on the nature of the needs and problems.


METHODS
Descriptive multiple-case study.


METHODS
Five Dutch paediatric rehabilitation facilities.


METHODS
The rehabilitation profiles of 41 children with cerebral palsy aged between 4 and 8 years.


METHODS
The raw text data were extracted and organized, after which two raters independently linked the extracted content to the categories of the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). Matches between needs, problems and goals were identified by ICF-CY code comparisons.


RESULTS
The Cohen's kappas for ICF-CY encoding were all in the range of "fair to good" (0.52-0.78). For five children (12%) no needs had been formulated and the reports of 10 (24%) were excluded from further analyses as they lacked a principal goal. In the 31 reports analysed, 29 (23%) need constructs and 46 (46%) problem constructs were incorporated into the goals. Of the total of 95 goal constructs 49 (52%) were not related to either a need or a problem construct. No clear relationship could be established between the type of needs and problems and their inclusion or exclusion in the principal goals.


CONCLUSIONS
Overall, the integration of the needs and principal problems of children with their rehabilitation goals was not optimal. However, integration was difficult to objectify because needs, problems and goals were poorly documented.
Nijhuis
Bianca J G
BJ
Center for Rehabilitation and Graduate School for Health Research SHARE, University Medical Center Groningen, University of Groningen, The Netherlands. B.Nijhuis@uu.nl
Reinders-Messelink
Heleen A
HA
de Blécourt
Alida C E
AC
Boonstra
Anne M
AM
Calamé
Esther H M
EH
Groothoff
Johan W
JW
Nakken
Han
H
Postema
Klaas
K
D000328:Adult; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002662:Child Health Services / Q000458:organization & administration* / Q000592:standards; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D019982:Organizational Case Studies; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards; D011368:Professional-Family Relations; D012047:Rehabilitation Centers / Q000458:organization & administration* / Q000592:standards