title: A systematic review and synthesis of the quantitative and qualitative evidence behind patient-centred goal setting in stroke rehabilitation.
abstract: OBJECTIVE
  To map out from the literature the nature, extent and effects of application of patient-centred goal setting in stroke rehabilitation practice.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors: School of Health and Population Sciences-Nursing and Physiotherapy, University of Birmingham, UK. s.b.rosewilliam@bham.ac.uk
authors: Sheeba
authors: S
authors: Rosewilliam
authors: Carolyn Anne
authors: CA
authors: Roskell
authors: A D
authors: AD
authors: Pandyan
mesh_terms: D001291:Attitude of Health Personnel; D016206:Databases, Bibliographic; D005069:Evaluation Studies as Topic; D006040:Goals; D006801:Humans; D010358:Patient Participation / Q000523:psychology*; D057240:Patient Preference; D018802:Patient-Centered Care; D010465:Perception; D011369:Professional-Patient Relations; D036301:Qualitative Research; D000071939:Stroke Rehabilitation