Goal setting practices of occupational therapists in spinal cord injury rehabilitation in Gauteng, South Africa

Abstract

INTRODUCTION : Client-centered goal setting has multiple benefits in spinal rehabilitation. However, research has shown that many occupational therapists struggle to facilitate client-centered goal setting. South Africa presents unique challenges to client-centered goal setting, but no data is available on how it is applied. STUDY DESIGN : A qualitative research design following an appreciative inquiry stance was used. OBJECTIVE : To explore how occupational therapists implement and envision the goal setting practices in spinal rehabilitation. SETTING : Rehabilitation facilities in Gauteng, South Africa. METHODS : A focus group consisting of five occupational therapists working within spinal rehabilitation was held. An appreciative inquiry stance was used to determine current successes and future ideas on how to implement goal setting in a spinal rehabilitation setting. RESULTS : Data was analysed thematically using Braun and Clark. Themes were developed under each phase of appreciative inquiry. Discovery phase: Participants felt that current effective goal setting is therapist-directed and that client insight facilitates effective goal setting. Dream phase: Participants agreed that client-centered goal setting is the ideal. In addition, effective collaboration within the team and adequate resources were identified during the dream phase as ideals to effective goal setting practices. Design and Destination phase: Participants generated ideas on how to improve on team collaboration during goal setting and how to ensure goal setting is client-centered for effective goal setting in spinal rehabilitation to take place. CONCLUSIONS : The study emphasizes that for effective goal setting to occur, the process must remain client-centered. Essential to this process is collaboration between both the team and family members. Adequate resources and a low therapist-patient ratio supports effective goal setting.