title: What are the barriers and facilitators to goal-setting during rehabilitation for stroke and other acquired brain injuries? A systematic review and meta-synthesis.
abstract: OBJECTIVE
  To identify the barriers and facilitators to goal-setting during rehabilitation for stroke and other acquired brain injuries.
  
  
  METHODS
  AMED, Proquest, CINAHL and MEDLINE.
  
  
  METHODS
  Two reviewers independently screened, extracted data and assessed study quality using the Mixed Methods Appraisal Tool and undertook thematic content analysis for papers examining the barriers and facilitators to goal-setting during stroke/neurological rehabilitation (any design). Last searches were completed in May 2016.
  
  
  RESULTS
  Nine qualitative papers were selected, involving 202 participants in total: 88 patients, 89 health care professionals and 25 relatives of participating patients. Main barriers were: Differences in staff and patients perspectives of goal-setting; patient-related barriers; staff-related barriers, and organisational level barriers. Main facilitators were: individually tailored goal-setting processes, strategies to promote communication and understanding, and strategies to avoid disappointment and unrealistic goals. In addition, patients' and staff's knowledge, experience, skill, and engagement with goal-setting could be either a barrier (if these aspects were absent) or a facilitator (if they were present).
  
  
  CONCLUSIONS
  The main barriers and facilitators to goal-setting during stroke rehabilitation have been identified. They suggest that current methods of goal-setting during inpatient/early stage stroke or neurological rehabilitation are not fit for purpose.
authors: University of Manchester, UK.
authors: Sarah E
authors: SE
authors: Plant
authors: University of Manchester, UK sarah.tyson@manchester.ac.uk.
authors: Sarah F
authors: SF
authors: Tyson
authors: University of Manchester, UK.
authors: Susan
authors: S
authors: Kirk
authors: University of Auckland, New Zealand.
authors: John
authors: J
authors: Parsons
mesh_terms: D001930:Brain Injuries / Q000209:etiology / Q000534:rehabilitation*; D006040:Goals; D006297:Health Services Accessibility; D006801:Humans; D010347:Patient Care Planning; D000071939:Stroke Rehabilitation
keywords: Stroke; barriers; facilitators; goal setting; rehabilitation