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“What would you like to achieve?” Goal-Setting in Patients with Dementia in Geriatric Rehabilitation

BACKGROUND: Setting meaningful, individualized rehabilitation goals is an essential part of the rehabilitation process. Even though patients with dementia are a drastically increasing patient group in geriatric rehabilitation, empirical data about meaningful rehabilitation goals and collaborative go...

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Autores principales: Dutzi, Ilona, Schwenk, Michael, Kirchner, Marietta, Bauer, Jürgen M., Hauer, Klaus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805571/
https://www.ncbi.nlm.nih.gov/pubmed/31640595
http://dx.doi.org/10.1186/s12877-019-1296-7
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author Dutzi, Ilona
Schwenk, Michael
Kirchner, Marietta
Bauer, Jürgen M.
Hauer, Klaus
author_facet Dutzi, Ilona
Schwenk, Michael
Kirchner, Marietta
Bauer, Jürgen M.
Hauer, Klaus
author_sort Dutzi, Ilona
collection PubMed
description BACKGROUND: Setting meaningful, individualized rehabilitation goals is an essential part of the rehabilitation process. Even though patients with dementia are a drastically increasing patient group in geriatric rehabilitation, empirical data about meaningful rehabilitation goals and collaborative goal-setting in this target group is missing. Cognitive impairment and lack of insight in current deficits have been discussed as barriers for participation in goal-setting, but require empirical examination. This study investigated the feasibility of a semi-structured versus a structured goal-setting approach and the types of goals, rehabilitation patients with mild to moderate dementia perceive as personally relevant. Insights in acute functional and motor deficits, differentiated by cognitive status were explored. METHODS: Cohort study in a geriatric rehabilitation center. Semi-structured and ICF-based, structured interviews were applied to explore patients` rehabilitation goals. Patients` insight in deficits was operationalized as the relationship of self-ratings and objective measures of linked clinical assessments for the same functional construct. RESULTS: Patients (n = 101, MMSE 22 ± 2.6, age 83.9 ± 5.9 years) stated the improvement of mobility-related functions and self-care activities (> 70%) but also psychological well-being such as handling stress or mood (> 38%) as most important rehabilitation goals. The structured interview facilitated goal-setting and provided a broader view of rehabilitation needs. Correlations between self-ratings and clinical assessments were medium to high (rho = 0.29 to 0.83) with highest associations for key motor features. Trend tests identified a significant trend between values of the clinical assessment and categories of self-ratings (p ≤ 0.01) with lower cognitive status derogating this relationship. CONCLUSIONS: Collaborative goal-setting was feasible, especially when supported by a structured approach and yielded a large spectrum of functional but also psychological rehabilitation needs from the patients` perspective. Patients showed sustained insight in their actual functional impairments, limited in a subgroup of patients with more advanced cognitive impairment.
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spelling pubmed-68055712019-10-24 “What would you like to achieve?” Goal-Setting in Patients with Dementia in Geriatric Rehabilitation Dutzi, Ilona Schwenk, Michael Kirchner, Marietta Bauer, Jürgen M. Hauer, Klaus BMC Geriatr Research Article BACKGROUND: Setting meaningful, individualized rehabilitation goals is an essential part of the rehabilitation process. Even though patients with dementia are a drastically increasing patient group in geriatric rehabilitation, empirical data about meaningful rehabilitation goals and collaborative goal-setting in this target group is missing. Cognitive impairment and lack of insight in current deficits have been discussed as barriers for participation in goal-setting, but require empirical examination. This study investigated the feasibility of a semi-structured versus a structured goal-setting approach and the types of goals, rehabilitation patients with mild to moderate dementia perceive as personally relevant. Insights in acute functional and motor deficits, differentiated by cognitive status were explored. METHODS: Cohort study in a geriatric rehabilitation center. Semi-structured and ICF-based, structured interviews were applied to explore patients` rehabilitation goals. Patients` insight in deficits was operationalized as the relationship of self-ratings and objective measures of linked clinical assessments for the same functional construct. RESULTS: Patients (n = 101, MMSE 22 ± 2.6, age 83.9 ± 5.9 years) stated the improvement of mobility-related functions and self-care activities (> 70%) but also psychological well-being such as handling stress or mood (> 38%) as most important rehabilitation goals. The structured interview facilitated goal-setting and provided a broader view of rehabilitation needs. Correlations between self-ratings and clinical assessments were medium to high (rho = 0.29 to 0.83) with highest associations for key motor features. Trend tests identified a significant trend between values of the clinical assessment and categories of self-ratings (p ≤ 0.01) with lower cognitive status derogating this relationship. CONCLUSIONS: Collaborative goal-setting was feasible, especially when supported by a structured approach and yielded a large spectrum of functional but also psychological rehabilitation needs from the patients` perspective. Patients showed sustained insight in their actual functional impairments, limited in a subgroup of patients with more advanced cognitive impairment. BioMed Central 2019-10-22 /pmc/articles/PMC6805571/ /pubmed/31640595 http://dx.doi.org/10.1186/s12877-019-1296-7 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Dutzi, Ilona
Schwenk, Michael
Kirchner, Marietta
Bauer, Jürgen M.
Hauer, Klaus
“What would you like to achieve?” Goal-Setting in Patients with Dementia in Geriatric Rehabilitation
title “What would you like to achieve?” Goal-Setting in Patients with Dementia in Geriatric Rehabilitation
title_full “What would you like to achieve?” Goal-Setting in Patients with Dementia in Geriatric Rehabilitation
title_fullStr “What would you like to achieve?” Goal-Setting in Patients with Dementia in Geriatric Rehabilitation
title_full_unstemmed “What would you like to achieve?” Goal-Setting in Patients with Dementia in Geriatric Rehabilitation
title_short “What would you like to achieve?” Goal-Setting in Patients with Dementia in Geriatric Rehabilitation
title_sort “what would you like to achieve?” goal-setting in patients with dementia in geriatric rehabilitation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805571/
https://www.ncbi.nlm.nih.gov/pubmed/31640595
http://dx.doi.org/10.1186/s12877-019-1296-7
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