Samenvatting

Background: Patient participation and goal setting appear to be difficult in daily physiotherapy practice, and
practical methods are lacking. An existing patient-specific instrument, Patient-Specific Complaints (PSC), was
therefore optimized into a new Patient Specific Goal-setting method (PSG). The aims of this study were to examine
the feasibility of the PSG in daily physiotherapy practice, and to explore the potential impact of the new method.
Methods: We conducted a process evaluation within a non-controlled intervention study. Community-based
physiotherapists were instructed on how to work with the PSG in three group training sessions. The PSG is a
six-step method embedded across the physiotherapy process, in which patients are stimulated to participate in the
goal-setting process by: identifying problematic activities, prioritizing them, scoring their abilities, setting goals,
planning and evaluating. Quantitative and qualitative data were collected among patients and physiotherapists by
recording consultations and assessing patient files, questionnaires and written reflection reports.
Results: Data were collected from 51 physiotherapists and 218 patients, and 38 recordings and 219 patient files
were analysed. The PSG steps were performed as intended, but the ‘setting goals’ and ‘planning treatment’ steps
were not performed in detail. The patients and physiotherapists were positive about the method, and the
physiotherapists perceived increased patient participation. They became aware of the importance of engaging
patients in a dialogue, instead of focusing on gathering information. The lack of integration in the electronic
patient system was a major barrier for optimal use in practice. Although the self-reported actual use of the PSG, i.e.
informing and involving patients, and client-centred competences had improved, this was not completely
confirmed by the objectively observed behaviour.
Conclusion: The PSG is a feasible method and tends to have impact on increasing patient participation in the
goal-setting process. However, its full potential for shared goal setting has not been utilized yet. More
implementation effort is needed to achieve the required behaviour change and a truly client-centred attitude, to
make physiotherapists totally ready for shared goal setting.