Health care professionals' experiences with goal setting during initial rehabilitation after newly acquired spinal cord injury/ disorder - a qualitative focus group study

Patricia Lampart; Livia Schäppi; Wolf Axel Langewitz; Sara Rubinelli; Diana Sigrist-Nix; Anke Scheel-Sailer

doi:10.3389/fresc.2022.982321

Health care professionals' experiences with goal setting during initial rehabilitation after newly acquired spinal cord injury/ disorder - a qualitative focus group study

Front Rehabil Sci. 2022 Aug 18:3:982321. doi: 10.3389/fresc.2022.982321. eCollection 2022.

Authors

Patricia Lampart^{1

2}, Livia Schäppi^{1

2}, Wolf Axel Langewitz³, Sara Rubinelli^{2

4}, Diana Sigrist-Nix¹, Anke Scheel-Sailer^{1

2}

Affiliations

¹ Swiss Paraplegic Center, Nottwil, Switzerland.
² Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
³ Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland.
⁴ Swiss Paraplegic Research, Nottwil, Switzerland.

Abstract

Introduction: Goal setting (GS) is an important aspect of initial spinal cord injury/ disorder (SCI/D) rehabilitation. However, because expected outcomes are individual and often difficult to determine, GS is not straightforward. The aim of this study was to explore the health care professionals' (HCP's) experiences with and perspectives on the goal-setting process (GSP) during initial SCI/D rehabilitation.

Method: Five semi-structured focus groups (FG) (22 purposively sampled HCP, mostly in leadership positions, six different professions). The FG were transcribed verbatim. We analyzed the transcripts for qualitative content analysis following Braun and Clarke (2013).

Results: HCP described GS-influencing aspects at the macro, meso and micro levels. At the macro level, participants spoke about restrictions imposed by health insurers or difficulties in planning the post-inpatient setting. Regarding the meso level, HCP spoke of institutional structures and culture that facilitated the GSP. At the micro level, knowledge of the diagnosis, expected outcomes, and individual patient characteristics were mentioned as important to the rehabilitation process. It was important for HCP to be patient and empathetic, to endure negative emotions, to accept that patients need time to adjust to their new situation, and to ensure that they do not lose hope. Open communication and interprofessional collaboration helped overcome barriers in the GSP.

Discussion: This paper shows the complex relationship between external (e.g., health insurers), emotional, and communication aspects. It calls for a comprehensive approach to optimizing the GSP, so that patients' experiences can be fully considered as a basis to identify the most appropriate care pathway.

Keywords: focus group (MeSH d017144); goal setting (GS); health care professionals (HCP); health personnel (MeSH); organizational objectives; patient care team; rehabilitation; spinal cord injuries (MeSH).