title: Giving hope, ticking boxes or securing services? A qualitative study of respiratory physiotherapists' views on goal-setting with people with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  To explore respiratory physiotherapists' views and experiences of using goal-setting with people with chronic obstructive pulmonary disease in rehabilitation settings.
  
  
  METHODS
  A total of 17 respiratory physiotherapists with ⩾12 months current or previous experience of working with patients with chronic obstructive pulmonary disease in a non-acute setting. Participants were diverse in relation to age (25-49 years), sex (13 women), experience (Agenda for Change bands 6-8) and geographic location.
  
  
  METHODS
  Data were collected via face-to-face qualitative in-depth interviews (40-70 minutes) using a semi-structured interview guide. Interview locations were selected by participants (included participants' homes, public places and University). Interviews followed an interview guide, were audio-recorded and transcribed verbatim.
  
  
  METHODS
  Data were analysed using thematic analysis; constant comparison was made within and between accounts, and negative case analysis was used.
  
  
  RESULTS
  Three themes emerged through the process of analysis: (1) 'Explaining goal-setting'; (2) 'Working with goals'; and (3) 'Influences on collaborative goal-setting'. Goal-setting practices among respiratory physiotherapists varied considerably. Collaborative goal-setting was described as challenging and was sometimes driven by service need rather than patient values. Lack of training in collaborative goal-setting at both undergraduate and postgraduate level was also seen as an issue.
  
  
  CONCLUSIONS
  Respiratory physiotherapists reflected uncertainties around the use of goal-setting in their practice, and conflict between patients' goals and organisational demands. This work highlights a need for wider discussion to clarify the purpose and implementation of goal-setting in respiratory rehabilitation.
authors.affiliation: 1 Faculty of Health Sciences, University of Southampton, Southampton, UK.
authors.forename: Rachael H
authors.initials: RH
authors.lastname: Summers
authors.affiliation: 2 NIHR CLAHRC Wessex, University of Southampton, Southampton, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Ballinger
authors.affiliation: 3 St George's School of Rehabilitation Sciences, St George's University of London/Kingston University, London King, UK.|4 Institute of Infection and Immunity, St George's University of London, London, UK.
authors.forename: Dimitra
authors.initials: D
authors.lastname: Nikoletou
authors.affiliation: 5 King's College Hospital NHS Foundation Trust, Physiotherapy London, London, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Garrod
authors.affiliation: 1 Faculty of Health Sciences, University of Southampton, Southampton, UK.|2 NIHR CLAHRC Wessex, University of Southampton, Southampton, UK.|6 Southampton NIHR Respiratory Biomedical Research Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Bruton
authors.affiliation: 7 Arbeitsbereich Interdisziplinäre Alternswissensschaft, Goethe-Universitat Frankfurt am Main, Main, Germany.
authors.forename: Miranda
authors.initials: M
authors.lastname: Leontowitsch
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D059825:Physical Therapists / Q000592:standards* / Q000639:trends; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000534:rehabilitation*; D036301:Qualitative Research; D012138:Respiratory Therapy / Q000592:standards* / Q000639:trends; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Chronic obstructive pulmonary disease (COPD); goal -setting; pulmonary rehabilitation; qualitative study