Goal planning for adults with acquired brain injury: How clinicians talk about involving family

Abstract

Primary objective: Although family involvement is frequently identified as a key element of successful rehabilitation, questions remain about 'how' clinicians can best involve them. This study explored how clinicians talk about the involvement of families in goal-planning during rehabilitation of adults with acquired brain injury. Research design: Qualitative study drawing on grounded theory to elicit practitioner perspectives. Methods and procedures: Nine clinicians froma range of professional backgrounds were interviewed. Interview data were transcribed and analysed using the constant comparative method of grounded theory. NVivo software was used to assist with data management. Main outcomes and results: While family were often considered valuable contributors to the goal-planning process, they were also seen as potential barriers to the negotiation of goals between clinicians and patients and to patient-clinician relationships. Clinicians described restricting involvement of family members in situations where such involvement was thought not to be in the best interests of the patient. Conclusions: Goal-planning appeared patient-centred rather than family-centred. Further, clinicians identified concerns about extending family involvement in goal-planning. If clinicians intend to address the needs of family members as well as patients, current approaches to goal-planning (and rehabilitation funding) may need to be reconsidered.