Should rehabilitation goals reflect all aspects of functioning in relation to a biopsychosocial ICF perspective?

To classify short-term and long-term rehabilitation goals and analyse how they capture functioning in a biopsychosocial International Classification of Functioning, Disability and Health (ICF) perspective.

A retrospective study was conducted at two specialised outpatient multidisciplinary rehabilitation centres for polio survivors and accident victims. Rehabilitation goals extracted from patient journals were linked to the ICF according to linking rules.

One hundred patients were included. Four hundred and eighty-seven short-term and long-term rehabilitation goals were linked to the ICF. Fifty-seven per cent were linked to Activity and Participation, 22% to Body Functions, 1% to Body Structure, 4% to Environmental Factors, 4% to Personal Factors, whereas 11% were not defined and 1% was not covered. The identified categories covered all ICF domains. The most frequent categories for short-term goals were d450 "Walking" and d570 "Looking after one's health." For long-term goals, d850 "Remunerative Employment" and d920 "Recreation and Leisure" were the most frequent.

The study showed challenges in capturing all aspects of biopsychosocial functioning in rehabilitation goals, particularly Contextual Factors. This study indicates that rehabilitation goals capture capacity rather than performance. Further research could highlight if functioning is captured in the rehabilitation plan, and in this way include both capacity and performance.Implications for rehabilitationHealth professionals in a post-acute or long-term rehabilitation setting should pay attention to capacity and performance when rehabilitation goals are set.The rehabilitation plan should contain goals and a description of patient's contextual factors and both should be equally valued and combined in a description of functioning.In a post-acute or long-term rehabilitation setting short-term and long-term goals are affected by the context. A longer rehabilitation intervention lead to goals linked to activity and participation.