title: Patient inclusion in goal setting during early inpatient rehabilitation after acquired brain injury.
abstract: OBJECTIVE
  To investigate the effects of patient participation in multidisciplinary goal setting during early inpatient rehabilitation after acquired brain injury.
  
  
  METHODS
  Case controlled retrospective study.
  
  
  METHODS
  Regional neurological rehabilitation unit.
  
  
  METHODS
  One hundred and five patients with acquired brain injury.
  
  
  METHODS
  Numbers of goals set and achieved per patient before and after intervention; Barthel Index and Functional Independence Measure.
  
  
  RESULTS
  The intervention resulted in a significant increase in the number of goals set per patient (340 versus 411 total goals, mean per patient 6.3 pre versus 8.05 post, P = 0.008). More patients had multiple goals set within each domain (P = 0.023). There was an increase in the number of patients with sleeping (0 pre, 9 post), continence (3 pre, 17 post) and leisure (15 pre, 35 post) goals set, and leisure goals achieved (60% pre and 68% post, P < 0.001). Correlations between goal achievement and change in activity-related outcome measures (Barthel Index and Functional Independence Measure) also improved with the new goal setting process. The proportion of goals achieved remained similar (60% pre and 63% post intervention), suggesting there was no evidence of inappropriate or unachievable goals set when the patient and family were included.
  
  
  CONCLUSIONS
  Real-time engagement of brain-injured patients in the goal setting process during early inpatient rehabilitation is achievable, but requires a structured multidisciplinary assessment of need. We found it increases the number of domains in which goals are set and includes functional areas not rated by commonly used global measures of outcome during inpatient rehabilitation.
authors.affiliation: Regional Neurological Rehabilitation Unit, Homerton University Hospital, London, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Dalton
authors.forename: Rachel
authors.initials: R
authors.lastname: Farrell
authors.forename: Annette
authors.initials: A
authors.lastname: De Souza
authors.forename: Evelyn
authors.initials: E
authors.lastname: Wujanto
authors.forename: Ann
authors.initials: A
authors.lastname: McKenna-Slade
authors.forename: Sharmen
authors.initials: S
authors.lastname: Thompson
authors.forename: Clarence
authors.initials: C
authors.lastname: Liu
authors.forename: Richard
authors.initials: R
authors.lastname: Greenwood
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D016022:Case-Control Studies; D003299:Cooperative Behavior; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D006801:Humans; D015601:Injury Severity Score; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D010358:Patient Participation / Q000706:statistics & numerical data*; D026741:Physical Therapy Modalities; D011369:Professional-Patient Relations; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom