Goal setting in rehabilitation for people with COPD: Respiratory physiotherapists' perspectives

Abstract

Background: Goal-setting is an integral part of physiotherapy practice and in rehabilitation has been described as a 9cornerstone9. However, there is currently a paucity of research into goal-setting in respiratory rehabilitation . Aim: To explore respiratory physiotherapists9 views on goal setting in rehabilitation for people with COPD. Methods: 17 UK respiratory physiotherapists were recruited. They were purposively sampled to reflect diversity in age (25-49 years), gender (13 F), experience (AfC bands 6-8) and geographic location. Data were collected using audio-recorded semi-structured interviews and subjected to thematic analysis. Results: Two competing discourses were identified: 9Patient-focused goal setting9 (enablement, making therapy meaningful, individualising treatment); 9Profession-focused goal setting9 (professional expectations, historic imperative, means of evaluating performance). The former was viewed more positively than the latter. Barriers / facilitators to goal setting arose from environment and person specific factors. Therapeutic environment, physiotherapist experience of goal-setting, the patient9s understanding of their condition and physiotherapy and the degree to which physiotherapists and patients are goal-orientated were all identified as influential. Conclusion: If respiratory physiotherapists are to embrace goal setting, we need wider debate to achieve consensus about the purpose and use of goal setting in respiratory rehabilitation. To cultivate an environment conducive to collaborative goal-setting, provision of adequate time and team support are significant facilitators.