[Rehabilitation goals in discharge reports and in patient questionnaires--on the example of endometriosis patients]
1Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung Medizinische Hochschule Hannover.
Background:
[corrected] The goal orientation of rehabilitation has increasingly found its way in research and practice. Though, shortcomings were ascertained for the implementation into the clinical routine furthermore. An empirical analysis of goal setting in clinical practice should complement the available evidence.
Methods:
The study is based on a cross-sectional survey of all endometriosis patients, who had been treated at a rehabilitation center in 2008 or 2009. Data stemmed from the uniform medical rehabilitation discharge reports, and a patient questionnaire, which was sent to the registered women by the clinic routinely before the beginning of the rehabilitation. Data about rehabilitation goals were available as free text information for both the discharge reports as well as the patient questionnaires. A category system oriented at the ICF system (International Classification of Functioning, Disability and Health), was developed to structure the goals.
Results:
293 patients had provided information concerning their rehabilitation goals, while 69 patients didn’t reply to the question of their rehabilitation goals. The latter were excluded to the analysis. In the discharge reports, altogether, more goals were documented than in the patient questionnaires (5.98 compared to 4.97 goals per patient). In 35% of the numbers of rehabilitation goals clear congruence was found between the data in the discharge reports and the patient questionnaires.
Conclusion:
The results support the assumption that the included patients had difficulties in goal-setting. In addition it is obvious that the goals in the discharge reports had little relation to the goals framed by the patients, in language and content. A goal-setting process less oriented towards the medical and clinical needs but more towards the patients needs and expectation would be desirable particularly with regard to a more intensive patient orientation. The implementation of a prepared list of possible rehabilitation goals could serve for the shared goal-setting process in the context of anamnesis.
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