Patient-centered goal-setting in stroke rehabilitationreview: a scoping review

Background: Patient-centered goal-setting is an important part of the
rehabilitation process. The guidelines for stroke rehabilitation in adults
recommend setting goals that are meaningful and relevant for the patient,
focusing on activity and participation, and involving the patient. Patient-centered goal-setting is to improve rehabilitation outcomes. However, patient-centered goal-setting occurs partly or not at all. There is also a lack of continuity in goalsetting across sectors.
Objective: This study aimed to identify existing research-based knowledge on
procedures used in patient-centered goal-setting processes in stroke rehabilitation.
Methods: A scoping review was conducted by searching PubMed, CINAHL
Complete, EMBASE, APA PsycINFO, Scopus, and Cochrane databases for studies
involving adults receiving or clinicians delivering stroke rehabilitation and focusing on patient-centered goal-setting processes. The included studies were analyzed using inductive content analyses and linked to five domains in goal-setting processes: person-centeredness, collaboration with healthcare professionals and patients, coordination across sectors, monitoring, and evaluation.
Results: Eighteen studies were included. Inductive content analysis identified
elements related to goal-setting processes, mainly occurring at the beginning
of the rehabilitation. Linking the studies to five domains revealed gaps in
cross-sectoral coordination, monitoring, and evaluation.
Conclusion: Patient-centered goal-setting in stroke rehabilitation is practiced
variably, and there is no overall agreement about the procedures to ensure
that goal-setting is patient-centered. Therapist- and team-led goal-setting
processes are used. Evaluation procedures and cross-sectoral coordination are
rarely described.