Person-Centered Goal Setting: A Systematic Review of Intervention Components and Level of Active Engagement in Rehabilitation Goal-Setting Interventions.

Abstract

This systematic review aims to examine (1) what components are used in current person-centered goal-setting interventions for adults with health conditions in rehabilitation and (2) the extent to which the engagement of people in their rehabilitation goal setting is encouraged. PubMed/MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature, Scopus, and Web of Science from inception to November 2020. Primary inclusion criteria were peer-reviewed articles that evaluated person-centered goal-setting interventions for adults with health conditions in rehabilitation. Two independent reviewers screened 28,294 records, and 22 articles met inclusion criteria. Two reviewers independently completed data extraction and quality assessment using the Physiotherapy Evidence Database (PEDRo) scale based on the original authors' descriptions, reports, and protocol publications. Any discrepancies were resolved by consensus or in consultation with another senior reviewer. Using narrative synthesis, we found that current person-centered goal setting has variability in their inclusion of intervention components. A considerable number of components are underimplemented in current practice, with formulation of coping plan and follow-up being most commonly left out. The active engagement of people does appear to be promoted within the components that are included in the interventions. Nine studies were high-quality defined as a total PEDro scale score of 6 or above. Although current person-centered goal setting encourages the active engagement of people, many of these interventions lack components considered important for supporting goal achievement and optimal outcomes. Future practice may be improved by incorporating a comprehensive set of goal-setting components and encouraging the active engagement of people throughout the entire goal-setting process. Together, these practices may facilitate the achievement of meaningful rehabilitation goals and improve rehabilitation outcomes for adults with health conditions.