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. 2022 Feb 4;17(2):e0262843.
doi: 10.1371/journal.pone.0262843. eCollection 2022.

Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis

Dagje Boeykens  1   2 , Pauline Boeckxstaens  2 , An De Sutter  2 , Lies Lahousse  3 , Peter Pype  2   4 , Patricia De Vriendt  1   5   6 , Dominique Van de Velde  1   5 ; Primary Care Academy
Affiliations

Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis

Dagje Boeykens et al. PLoS One. .

Abstract

Background: The healthcare system is faced by an ageing population, increase in chronic conditions and multimorbidity. Multimorbid patients are faced with multiple parallel care processes leading to a risk of fragmented care. These problems relate to the disease-oriented paradigm. In this paradigm the treatment goals can be in contrast with what patients value. The concept of goal-oriented care is proposed as an alternative way of providing care as meeting patients' goals could have potential benefits. Though, there is a need to translate this concept into tangible knowledge so providers can better understand and use the concept in clinical practice. The aim of this study is to address this need by means of a concept analysis.

Method: This concept analysis using the method of Walker and Avant is based on a literature search in PubMed, Embase, Cochrane Library, PsychInfo, CINAHL, OTSeeker and Web of Science. The method provides eight iterative steps: select a concept, determine purpose, determine defining attributes, identify model case, identify additional case, identify antecedents and consequences and define empirical referents.

Results: The analysis of 37 articles revealed that goal-oriented care is a dynamic and iterative process of three stages: goal-elicitation, goal-setting, and goal-evaluation. The process is underpinned by the patient's context and values. Provider and patient preparedness are required to provide goal-oriented care. Goal-oriented care has the potential to improve patients' experiences and providers' well-being, to reduce costs, and improve the overall population health. The challenge is to identify empirical referents to evaluate the process of goal-oriented care.

Conclusion: A common understanding of goal-oriented care is presented. Further research should focus on how and what goals are set by the patient, how this knowledge could be translated into a tangible workflow and should support the development of a strategy to evaluate the goal-oriented process of care.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart demonstrating the search string.
Fig 2
Fig 2. Schematic representation of the antecedents, attributes and consequences.
See this image and copyright information in PMC

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