title: Training in client-centeredness enhances occupational therapist documentation on goal setting and client participation in goal setting in the medical records of people with stroke.
abstract: OBJECTIVE
  The aim of the present study was to compare client-centeredness as it was documented by the occupational therapists in the units randomized to the intervention clusters with documentation by occupational therapists in the control clusters.
  
  
  METHODS
  Comparison of medical records.
  
  
  METHODS
  The study is conducted in a context of a randomized controlled trial in Sweden, with 16 post-stroke rehabilitation units cluster randomized to intervention or control group.
  
  
  METHODS
  Occupational therapist documentation in medical records of 279 clients with stroke.
  
  
  METHODS
  The medical records were reviewed for their level of client-centeredness using a protocol developed from the Stewart et al model. The occupational therapists in the intervention groups participated in a workshop training to enhance their client-centeredness.
  
  
  RESULTS
  Occupational therapists with training in client-centeredness documented significantly more on goal setting (OR = 4.1; 95% CI, 1.87-8.81), on client participation in goal setting (OR=11.34; 95% CI, 5.97-21.57), on how the goals could be reached (OR=2.8; 95% CI, 1.7-4.62), on client participation in how goals could be reached (OR=4.56; 95% CI, 2.73-7.64), on the follow-up on goals (OR=5.77; 95% CI, 2.78-11-98) and on client participation in follow-up on goals (OR=7.44, 95% CI, 4.33-12.8). This association remained after adjustment for healthcare setting, client socio-demographic variables, and stroke severity.
  
  
  CONCLUSIONS
  Documentation of goal setting and client participation in goal setting can be influenced by training.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Social Work, Karolinska Institutet, Stockholm, Sweden maria.flink@ki.se.|Department of Social Work, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Flink
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ann-Sofie
authors.initials: AS
authors.lastname: Bertilsson
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ulla
authors.initials: U
authors.lastname: Johansson
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Guidetti
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Tham
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.|Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: von Koch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D009788:Occupational Therapy; D010347:Patient Care Planning; D010358:Patient Participation; D018802:Patient-Centered Care; D020521:Stroke / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D000071939:Stroke Rehabilitation; D055815:Young Adult
keywords: Stroke; goal setting; occupational therapy; patient-centred care; rehabilitation