The ICF forms a useful framework for classifying individual patient goals in post-acute rehabilitation

Abstract

Objective: Timely goal setting in close collaboration with the patient is essential to successful rehabilitation. We therefore sought to identify goals of patients in early post-acute rehabilitation as predictors of improved functioning.

Design: We conducted a prospective multi-centre cohort study in 5 early post-acute rehabilitation facilities.

Patients: Patients with musculoskeletal, cardiopulmonary and neurological conditions were recruited between May 2005 and August 2008.

Methods: A semi-structured questionnaire was used to identify patient goals and to assess improvement in overall functioning. Patients' goals were coded according to the International Classification of Functioning, Disability and Health (ICF). By means of a mixed effects model we examined the association between goal attainment and improved functioning.

Results: A total of 116 patients gave 546 statements, of which 426 were linked to 74 ICF categories, which were assigned to the existing comprehensive post-acute ICF Core Sets. Improvements in walking, recreation and leisure, pain, and transfer were the most frequently reported goals. In multivariable analysis patients' goal attainment was not a predictor for improved overall functioning.

Conclusion: The ICF can be used to identify and structure patients' goals. Patients' perspective should be considered in the rehabilitation process.