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Table 1: Factors Influencing Goal Setting
Factor Influence Evidence
Time Facilitator or barrier [22]
Social supports Family and friends may help or [23]
hinder
Pain Barrier [23]
Health Facilitator or barrier
professionals’ expertise or [22][24]
lack of
Cognition Barrier [4]
The patient’s self Facilitator or barrier [25]
awareness
Patient involvement Facilitator or barrier [24][26][27]
Patient’s desire to pursue Facilitator
goals and modify as [28]
needed
Author Dat Populati N Intervention Outcome
Main Results
e on = Measure
Rasquin 200 Acquired 48 Cognitive Goal Attainme
It is possible to set
et al.[29] 9 brain rehabilitation nt Scaling,
three realistic goals
injury programme number of
per patient within 30
goals made,
minutes. Goals were
time to set
set in cognitive
goals, domains
and behavioural dom
in which goals
ains
were set
Rosewilli 201 Stroke N/ Systematic N/A Nominal adoption of
am et al. 1 A review of 18 goals setting,
[3]
qualitative discrepancies
studies, eight between perceptions
quantitative and practice of goal
studies and setting, related
one mixed ethical conflicts,
methods strategies to improve
study goal setting, weak
methodologies, some
improvement in
psychological
outcomes, further
research needed.
Coffey et 201 Lower 64 Not WHODAS 2.0, High levels of
al.[28] 4 limb applicable WHO-QOL- disability in this
amputatio BREF, population. QoL
n stable over first six
Tenacious Goal
months. Stronger
Pursuit Scale,
goal pursuit and goal
Flexible Goal
adjustment
Adjustment
Scale tendencies predicted
lower disability and
higher QoL six
months post
discharge
Alanko et 201 Stroke 20 Not Qualitative Five meanings:
al.[23] 8 and back applicable interviews and
1) “trust in the
pain analysis of
rehabilitation
rehabilitees
situation,
perspectives
professionals, oneself
on goal setting
and relatives”
in
rehabilitation 2) “respectful
presence”
3) “confusing awaren
ess”
4) “disturbing pain”
5) “fear of
unpredictability”
QoL – Quality of Life
SMART Goals
S Specific
M Measurable
A Attainable or Assignable
R Realistic
T Time-related
Meanind
M Meaning
E Engage
A Anchor
N Negotiate
I Intention-implementation gap
N New goals
G Goals as behaviour change
Goal Attainment Scaling (GAS) by Turner-Stokes[
Questions
What can’t you do since your injury that you want to get back
to?
What are you finding more difficult since your injury that you’d
like to be easier?
How will you know when you’re ready to stop coming to see
me?
Initial Goal More Functional & Turning The Functional Example Of Evidence-Based
Statement Meaningful Real- Goal Statement Into A Therapy Tasks Which Can Help
World Goal SMART Goal
Statement
Talk Better “I want to On 4 out of 7 nights this All Speaking tasks, for example:
participate in the week, I will use my word- Name Pictures & Name Verbs.
dinner table finding strategies at the
conversation with dinner table to share 3 things
my family.” that happened to me that
day.
Be Able to “I want to bake with On Saturday I will use Instruction Sequencing
Follow my grandkids.” strategies (e.g. note-taking,
Directions verbal mediation, planning)
to follow a 6-step brownie
recipe with 95% accuracy.
Improve “I want to On 5 out of 7 days this All Visual Memory Tasks and
Memory remember to take week, I will use my memory Auditory Memory Tasks are
my morning pills strategies to independently relevant. For example: Repeat
without a reminder take my medicine every Number Sequences and Picture N-
from my spouse.” morning at 8 a.m. Back Memory
Be Able to “I want to read to On 3 out of 7 nights this Read Active Sentences
Read my son at bedtime.” week, I will read a short AloudRead Passive Sentences
storybook to my son. AloudRead Number Sequences
Aloud
Not Get So “I want to watch my On Sunday I will use my Playing Card SlapjackSpoken
Distracted daughter’s soccer strategies to attend to my Word N-Back Memory
game without daughter’s soccer game for
getting distracted.” 20 min without getting
distracted.
Not Get Lost “I want to walk This week I will map out the Map Reading
In New around the town route to town & walk there 3
Places without getting times without getting lost.
lost.”
Be Able To “I want to write in “On 3 out of 7 nights this Picture Spelling
Write my journal again.” week, I will write 2 complete
sentences in my journal.
Get My “I want to return to When I go out to lunch with CurrencySpeak
Math Skills paying for things my family tomorrow, I CurrencyFunctional Math
Back when I go out with will use strategies (e.g. note-
my family.” taking, slowing down,
double-checking work) to
accurately calculate the tip
on the bill.
Measuring Goals
Measuring person-centred goals is a helpful way to measure
outcomes in rehabilitation, particularly patient satisfaction with their
performance of a specific goal[19]. Sometimes a person's goals may
not seem realistic to the clinician, or, the person not achieve their
goals. Instead of regarding this as failure, the unachieved goals can
be used for a discussion about what might be a realistic outcome for
the person's rehabilitation and to guide challenging discussions on
expectations versus reality. Additionally, the unachieved goal could be
broken down into smaller, more achievable parts[19]. Differentiating
between goals and hope, aspirations and dreams within the goal
setting process is also an important consideration [21][11].
As above, GAS is another way to measure goals.
Influences on Goal Setting
There are some factors which can facilitate or create barriers to
successful goal setting, see Table 1 below.
Table 1: Factors Influencing Goal Setting
Factor Influence Evidenc
e
Time Facilitator or barrier [22]
Social supports Family and friends [23]
may help or hinder
Pain Barrier [23]
Health professionals’ expertise or Facilitator or barrier [22][24]
lack of
Cognition Barrier [4]
The patient’s self awareness Facilitator or barrier [25]
Patient involvement Facilitator or barrier [24][26][27]
Patient’s desire to pursue goals Facilitator [28]
and modify as needed
