Participatory Action Research to Enhance Patient-Centred Goal Setting in Geriatric Rehabilitation: A Nursing Team's Quest

Abstract

Aim

The aim of this study was to provide insights into how, through exploring goal-setting interventions, a nursing team in geriatric rehabilitation might refine their patient-centred strategies.

Design

The study design was participatory action research (PAR).

Method

Team members and nursing students, under the guidance of a facilitator, performed two PAR cycles. In the first cycle, the action phase consisted of preparing a multidisciplinary team meeting (MTM) with a patient. In the second cycle, based on the evaluation of the first, the participants worked with goals on a whiteboard in the patient's room. The data were collected in The Netherlands between February 2020 and June 2022. The data collection methods included the facilitator's logbook, observations, (group) interviews, charting activities and short surveys. Data analysis was conducted in weekly team sessions. The Guidelines for Best Practices in the Reporting of Participatory Action Research were followed.

Results

In the first PAR cycle, the team learned that preparing an MTM with a patient did not enhance the patient's engagement in achieving their rehabilitation goals, but it was beneficial for the nurses' intermediate role between the patient and the multidisciplinary team. Clarity about responsibilities in the multidisciplinary team was a prerequisite for nurses to take on this role adequately. In the second PAR cycle, it became clear that working with a whiteboard in the patient's room had a positive effect on the patient's engagement in the rehabilitation process, and the nurses gained knowledge about a broader variety of professional rehabilitation domains.

Conclusion

Through PAR, the nursing team learned two lessons: cooperating with patients through MTM preparation and working with whiteboards enhanced their patient-centredness, but patients needed tangible goals to become engaged in their rehabilitation planning.

Implications for the Profession and Patient Care

• Prepare the multidisciplinary team meeting with the patient, as discussing rehabilitation goals can indirectly boost motivation by making older patients feel seen and heard, even if they seem unable to fully participate in the conversation.
• Clarify responsibilities in the multidisciplinary geriatric rehabilitation team. This is a prerequisite for nurses to take on an advocacy role for patients in multidisciplinary team meetings.
• To enhance patient-centred care, consider working with tangible goals on a whiteboard in the patient's room.

Patient and Public Contribution

No public and patient involvement.