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Goal setting in rehabilitation

The present study will focus on the goal setting processes across users with various painful musculoskeletal conditions at different levels and types of services, and in different life areas.

Objectives

To explore mechanisms through which the gap between health care and social services can be bridged, and to study goal setting process across various rehabilitation and social service providers.

Background

Musculoskeletal- and rheumatic diseases cover more than 200 different conditions and affect over 100 million people of all ages across Europe. These diseases have a significant impact on function, quality of life and participation in everyday and working life. Approximately 40 percent of individuals who are on sick leave or disability pension have musculoskeletal diseases and disorders. Considering function, the goal of rehabilitation is mainly directed at improving activity level and participation in society, which may be related to self care, family life, leisure activities or work situation. In particular, work-ability has received increased focus, not only in political strategies, but also from patient organisations and other important stakeholders.

Goal planning or goal setting is considered to be an essential part of rehabilitation practice. In the context of rehabilitation, goal planning has been defined as “the process of agreeing on goals”, and the agreement in this definition usually refers to the consensus between the patient and health care providers. The process might include setting goals at various levels and in various time frames. However, little is known about the process of goal setting in Norway, and to which degree the process of goal setting influences the provision and content of services and the outcome of rehabilitation.

Rehabilitation involves a wide range of professionals and specialist health services, across different levels of health care and in collaboration with other sectors such as education and employment insitutions. The present organization of rehabilitation services is often fragmented, which is a major challenge to the quality of services. Increasing emphasis has been placed on bridging the gaps in rehabilitation services across health care levels, and pinpointed in the national health care reform termed  “The Coordination reform” (Samhandlingsreformen). However, research is needed to explore how the gap in services between health-care providers and social organizations can be bridged. It is also of interest to look into the goal setting process across rehabilitation-service providing systems - for example, in occupational rehabilitation, the interaction between different health care levels and the social security system, as well as the the increasingly important role of workplace-related actors in the rehabilitation process of the sick-listed. Reviews have shown clearly that knowledge exchange between the healthcare sector and the workplace actors has an impact on how fast the sick-listed with MSD return to work after long-term sick leave. We still know very little about if there is a clear divergence in goal-setting between major actors in rehabilitation – that the the goals of the health-care systems are most often set towards symptom reduction, whereas those of the social security and the workplace actors are mainly geared towards work and participation. If so, the consequences of such discrepancies might be consequential if reducing symptoms are not strongly correlated with increasing participation, as two new Cochrane systematic reviews do indicate.

One postdoctoral research fellow, Truls I. Juritzen, is employed to work on this project

Financing

  • Research Council of Norway through CHARM (Research Centre for Habilitation and Rehabilitation Models and Services)

Cooperation

  • Oslo University Hospitals (OUS)
  • University of Oslo, Institute of Health and Society (Helsam), Faculty of Medicine
  • Oslo and Akershus College (HIOA)
  • Norwegian Rheumatism Association (NRRK)
  • International Research Institute of Stavanger (IRIS)

Start - End

Fall 2013 - Fall 2016

Results:

Tags: Muscolo-Skeletal system, Habilitation, Rehabilitation
Published Jan. 25, 2012 2:22 PM - Last modified Aug. 25, 2017 10:26 AM