Exploring readiness to patient-centered goal-setting in stroke Rehabilitation-A qualitative study.

Abstract

This study aims to explore perspectives of stroke survivors, caregivers, and physiotherapists on goal-setting in stroke rehabilitation. A qualitative study included in-depth interviews with 15 stroke survivors and seven caregivers and four focus groups with 16 physiotherapists. Data were analyzed using reflexive thematic analysis. An overarching theme "Readiness to patient-centered goal-setting in physiotherapy" emerged, reflecting goal-setting as a clinician-led process with limited involvement of stroke survivors and caregivers. Four themes were identified: a) Attitudes and perceived roles regarding goal-setting throughout rehabilitation, (b) Uncertainty as a barrier to goal-setting, (c) Strategies and challenges in communicating goals, and (d) Health system and policies challenges to person-centered goal-setting. While physiotherapists recognized the importance of patient involvement, goal-setting was often implicit, informal, and constrained by individual, organizational, and systemic factors. The findings suggest a systemic lack of preparedness for implementing person-centered goal-setting in post-stroke physiotherapy. Addressing this gap may require structured approaches that combine training, communication strategies, and organizational support to promote collaborative goal-setting and enhance stroke survivors' and caregivers' engagement in rehabilitation planning. Further research should focus on testing and refining theory-informed behavior change and implementation strategies to support the uptake of person-centered goal-setting practices.