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The patient’s perspective of the feasibility of a patient-specific instrument in physiotherapy goal setting: a qualitative study

Authors Stevens A, Moser A, Köke A, van der Weijden T, Beurskens A

Received 19 October 2015

Accepted for publication 5 February 2016

Published 31 March 2016 Volume 2016:10 Pages 425—434

DOI https://doi.org/10.2147/PPA.S97912

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Doris Leung

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Anita Stevens,1,2 Albine Moser,1,2 Albère Köke,1,3,4 Trudy van der Weijden,2 Anna Beurskens1,2

1Faculty of Health, Zuyd University of Applied Sciences, Heerlen, 2Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, 3Adelante Centre of Research in Rehabilitation, Hoensbroek, 4Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands

Background: Patient participation in goal setting is important to deliver client-centered care. In daily practice, however, patient involvement in goal setting is not optimal. Patient-specific instruments, such as the Patient Specific Complaints (PSC) instrument, can support the goal-setting process because patients can identify and rate their own problems. The aim of this study is to explore patients’ experiences with the feasibility of the PSC, in the physiotherapy goal setting.
Method: We performed a qualitative study. Data were collected by observations of physiotherapy sessions (n=23) and through interviews with patients (n=23) with chronic conditions in physiotherapy practices. Data were analyzed using directed content analysis.
Results: The PSC was used at different moments and in different ways. Two feasibility themes were analyzed. First was the perceived ambiguity with the process of administration: patients perceived a broad range of experiences, such as emotional and supportive, as well as feeling a type of uncomfortableness. The second was the perceived usefulness: patients found the PSC useful for themselves – to increase awareness and motivation and to inform the physiotherapist – as well as being useful for the physiotherapist – to determine appropriate treatment for their personal needs. Some patients did not perceive any usefulness and were not aware of any relation with their treatment. Patients with a more positive attitude toward questionnaires, patients with an active role, and health-literate patients appreciated the PSC and felt facilitated by it. Patients who lacked these attributes did not fully understand the PSC’s process or purpose and let the physiotherapist take the lead.
Conclusion: The PSC is a feasible tool to support patient participation in the physiotherapy goal setting. However, in the daily use of the PSC, patients are not always fully involved and informed. Patients reported varied experiences related to their personal attributes and modes of administration. This means that the PSC cannot be used in the same way in every patient. It is perfectly suited to use in a dialogue manner, which makes it very suitable to improve goal setting within client-centered care.

Keywords: goal setting, patient-specific instruments, client-centered care, patient participation

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