Abstract
Takarada H, Honke T. Short-term effects of goal setting by
rehabilitation professionals on aspects of psychology: a non-randomized
controlled trial involving recovering stroke survivors. Jpn J Compr
Rehabil Sci 2025; 16: 1-8.
Objective
In rehabilitation, goals expected to have an effect on aspects of
psychology, such as promoting participation in the program and reducing
anxiety, are set between the patient and the therapist. This study aimed
to compare and test the short-term effects of goal setting on such
psychological aspects in an experimental group, in which the therapist
selected the highest priority goals proposed by the patient, and a
control group, in which the goals were proposed by the therapist.
Methods
Between October 2023 and March 2024, 88 stroke survivors were
admitted to the Kaifukuki Rehabilitation Ward, of whom 32 met the
inclusion criteria. The patients were divided into two groups: a
goal-setting group in which the patient chose the highest priority goal
(experimental group: n = 17) and a goal-setting group in which the patient agreed with the goal proposed by the therapist (control group: n
= 15). The primary outcome was treatment engagement in rehabilitation,
and the secondary outcomes were anxiety/depression and mental health
scores.
Results
Outcomes improved in both groups after goal setting. Between-group
comparisons showed a significant improvement in treatment engagement in
the experimental group (p < 0.001). The sample size required for the randomized controlled trial was 46 participants in each group.
Conclusion
In the short term, treatment engagement was influenced by the patient's consideration and choice of priority goals.
Keywords: goal setting, physical therapist, occupational therapist, speech and language therapists, psychological effects
Introduction
To set goals and explain strategies for stroke survivors in Japan,
rehabilitation is accompanied by comprehensive plan evaluation and
goal-setting support and management fees. Here, goal setting is defined
as the process of informed discussion between the patient and
health-care provider to determine when and how rehabilitation should
take place [1].
It has been reported that when goal setting is implemented in
rehabilitation, both the patient's satisfaction and motivation improve [2, 3].
In addition, focusing on goals that are a high priority for the patient
has been shown to be effective in improving motivation and reducing
anxiety, which can have a positive psychological impact [4].
In a non-randomized controlled trial of goal setting in convalescent
patients in Japan, goal setting using the life goal concept was shown to
improve treatment engagement [5].
However, only physical therapists (PTs) and patients with
cerebrovascular or orthopedic conditions were included in that study.
Similarly, there have been few reports on goal setting conducted outside
Japan, with studies of goal setting conducted only for PTs or
occupational therapists (OTs) [6, 7].
Therefore, the effects of priority goals on aspects of psychology
among stroke survivors undergoing rehabilitation in the recovery phase
remain unclear. In the present study, we hypothesized that sharing
priority goals with patients might have more beneficial effects on
aspects of psychology compared with PTs, OTs, and speech and language
therapists (STs) sharing their own goals with patients.
In addition, reports examining the effects of goal setting on aspects
of psychology have been conducted over study periods ranging from 3
weeks to several months; to our knowledge, no studies examining
short-term effects (e.g., about 1 week) have been reported [8].
If short-term effects can be demonstrated through goal setting for
stroke survivors, this could facilitate improvements in outcomes related
to psychological aspects such as anxiety and increased motivation to
participate from the start of rehabilitation. Given this background, the
present study aimed to compare and verify the short-term effects of
goal setting on aspects of psychology in an experimental group, in which
the PT, ST, and OT selected the highest priority goals proposed by the
patient, and in a control group, in which the goals were proposed by the
PT, ST, and OT.
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