Facilitators and Barriers for Physiotherapists to Engage in Goal-Setting With Patients During Their Hospital Stay-An Explanatory Sequential Mixed-Methods Study.

Abstract

Background and purpose: Goal setting is a key aspect of patient-centered physiotherapy, helping to motivate patients, align healthcare efforts, prevent oversight, and stop ineffective interventions. This study aims to identify facilitators and barriers for physiotherapists in hospitals to set and document patient treatment goals.

Methods: An explanatory sequential mixed-methods approach was used. The survey, informed by systematic reviews of factors influencing shared decision-making and the theoretical domains framework (TDF), included 25 statements to be rated. Two focus groups (n = 8) discussed (1) factors from the survey, (2) the goal-setting processes, and (3) brainstormed facilitators and barriers for documenting physiotherapy goals.

Results: Survey findings showed mixed opinions but agreement on two factors, which indicate that the goal influences the therapeutic interventions and motivates the therapists. The focus group identified four themes: "Goal," "Physiotherapeutic Self-Conception," "Interprofessionality", and "Hospital Setting." Issues included limited space and poor placement in documentation systems, mental rather than written goal conceptualization, and a perceived lack of interest from interprofessional team members, leading to deprioritization by physiotherapists. Finally, joint goal setting was deemed impractical for certain patients.

Discussion: Hospital physiotherapists set treatment goals with their patients. The process is influenced by various factors, including interprofessional dynamics and the hospital setting. The identified themes align with existing literature. Effective documentation of patient-centered physiotherapy goals in hospitals requires well-designed tools and interprofessional collaboration. Further, it is crucial to understand professional self-conception and acknowledge situations where physiotherapists need to set goals independently.