The use and perceived usefulness of a patient-specific measurement instrument in physiotherapy goal setting. A qualitative study

Abstract

Objectives: Physiotherapists are encouraged to set goals together with their patients to deliver client-centred care. In practice however, this goal-setting process is poorly specified, with limited patient involvement. The Patient-Specific Complaints instrument (PSC) can support the goal-setting process. Despite its being frequently used by Dutch physiotherapists, its actual role in goal setting is unknown. The objective was to examine physiotherapy goal-setting and the use of the PSC within this process, as well as the physiotherapists' perception of the usefulness of the PSC.

Methods: Consultations between physiotherapists and patients were observed and physiotherapists were interviewed. Data were analysed by directed content analysis, using a goal-setting framework as the coding scheme whose phases include: goal negotiation, goal setting, planning, and appraisal and feedback.

Results: The patients' problems were comprehensively explored, with the PSC focussing on activity problems. Goal-setting and planning phases were poorly specified and mainly physiotherapist-led. The physiotherapists appreciated the PSC for patient involvement during goal negotiation and evaluation. Its perceived usefulness for goal setting and planning ranged from useful for tailoring goals to the patient's needs to not useful at all. One major reason to use it was meeting external audit obligations.

Conclusions: There are some discrepancies between how physiotherapists use the PSC and how they perceived its usefulness. Physiotherapists did use the PSC in a goal-setting process, though often as a standalone tool without integration in the whole physiotherapy process, and with limited patient involvement. In this way, its full potential for goal setting is not utilized.

Keywords: Client-centred care; Goal setting; Patient-specific measurement instruments; Physiotherapy.