Remember Me
Or use your Academic/Social account:


Or use your Academic/Social account:


You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.


Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message


Verify Password:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Scobbie, L.; Duncan, E.A.; Brady, M.C.; Wyke, S. (2014)
Publisher: Informa Healthcare
Languages: English
Types: Article
Purpose: We investigated the nature of services providing community-based stroke rehabilitation across the UK, and goal setting practice used within them, to inform evaluation of a goal setting and action planning (G-AP) framework. Methods: We designed, piloted and electronically distributed a survey to health professionals working in community-based stroke rehabilitation settings across the UK. We optimised recruitment using a multi-faceted strategy. Results: Responses were analysed from 437 services. Services size, composition and input was highly variable; however, most were multi-disciplinary (82%; n = 335/407) and provided input to a mixed diagnostic group of patients (71%; n = 312/437). Ninety one percent of services (n = 358/395) reported setting goals with “all” or “most” stroke survivors. Seventeen percent (n = 65/380) reported that no methods were used to guide goal setting practice; 47% (n = 148/315) reported use of informal methods only. Goal setting practice varied, e.g. 98% of services (n = 362/369) reported routinely asking patients about goal priorities; 39% (n = 141/360) reported routinely providing patients with a copy of their goals. Conclusions: Goal setting is embedded within community-based stroke rehabilitation; however, practice varies and is potentially sub-optimal. Further evaluation of the G-AP framework is warranted to inform optimal practice. Evaluation design will take account of the diverse service models that exist.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Scottish Intercollegiate Guidelines Network (SIGN). Management of patients with stroke or TIA: assessment, investigation, immediate management and secondary prevention. A national clinical guideline. Edinburgh: SIGN; 2008.
    • 2. Intercollegiate Stroke Working Party. National clinical guidelines for stroke - 4th edition. London: Royal College of Physicians; 2012.
    • 3. Scottish Intercollegiate Guidelines Network (SIGN). Management of patients with stroke: rehabilitation, prevention and management of complications, and discharge planning. A national clinical guideline. Edinburgh: SIGN; 2010.
    • 4. Sugavanam T, Mead G, Donaghy M, van Wijke F. The effects and experiences of goal setting - a systematic review. Disabil Rehabil 2013;35:177-90.
    • 5. Levack WM, Taylor K, Siegert RJ, et al. Is goal planning in rehabilitation effective? A systematic review. Clin Rehabil 2006;20: 739-55.
    • 6. Rosewilliam S, Roskell C, Pandyan A. A systematic review and synthesis of the quantitative and qualitative evidence behind patientcentred goal setting in stroke rehabilitation. Clin Rehabil 2011;25: 501-14.
    • 7. Wells M, Williams B, Treweek S, et al. Intervention description is not enough: evidence from an in-depth multiple case study on the untold role and impact of context in randomised controlled trials of seven complex interventions. Trials 2012;13:95.
    • 8. Tomoaia-Cotisel A, Scammon DL, Waitzman NJ, et al. Context matters: The experience of 14 research teams in systematically reporting contextual factors important for practice change. Ann Family Med 2013;11:S115-23.
    • 9. Taylor WJ, Brown M, William L, et al. A pilot cluster randomized controlled trial of structured goal-setting following stroke. Clin Rehabil 2012;26:327-38.
    • 10. Scobbie L, Dixon D, Wyke S. Identifying and applying psychological theory to setting and achieving rehabilitation goals. Clin Rehabil 2009;23:321-33.
    • 11. Scobbie L, Dixon D, Wyke S. Goal-setting and action planning in the rehabilitation setting: development of theoretically informed practice framework. Clin Rehabil 2011;25:468-82.
    • 12. Scobbie L, McLean D, Dixon D, et al. Implementing a framework for goal setting in community based stroke rehabilitation: a process evaluation. BMC Health Services Res 2013;13:190.
    • 13. Craig P, Dieppe P, MacIntyre S, et al. Medical Research Council. Developing and evaluating complex interventions: new guidance. Available from: http://www.mrc.ac.uk/documents/pdf/complexinterventions-guidance/ [last accessed 8 Aug 2014].
    • 14. Hoddinott P, Britten J, Pill R. Why do interventions work in some places and not others: a breastfeeding support group trial. Soc Sci Med 2010;70:769-78.
    • 15. Talbot A, Brady M, Furlanetto DL, et al. Oral care and stroke units. Gerodontology 2005;22:77-83.
    • 16. Brady MC, Stott DJ, Norrie J, et al. Developing and evaluating the implementation of a complex intervention: using mixed methods to inform the design of a randomised controlled trial of an oral healthcare intervention after stroke. Trials 2011;12:168.
    • 17. Enderby P, Wade DT. Community rehabilitation in the United Kingdom. Clin Rehabil 2001;15:577-81.
    • 18. Holliday RC, Antoun M, Playford ED. A survey of goal-setting methods used in rehabilitation. Neurorehabil Neural Repair 2005;19: 227-31.
    • 19. Playford ED, Siegert R, Levack W, Freeman J. Areas of consensus and controversy about goal setting in rehabilitation: a conference report. Clin Rehabil 2009;23:334-44.
    • 20. McMillan TM, Ledder H. A survey of services provided by community neurorehabilitation teams in south east England. Clin Rehabil 2001;15:582-8.
    • 21. Geddes J, Chamberlain MA. Stroke community rehabilitation: a classification of four different types of service. Int J Ther Rehabil 2003;10:299-304.
    • 22. Stroke Unit Trialists' Collaboration. Organised inpatient (stroke unit) care for stroke. Cochrane Database of Systematic Reviews 2007. Available from: http://onlinelibrary.wiley.com/doi/10.1002/ 14651858.CD000197.pub2/pdf [last accessed 8 Aug 2014].
    • 23. Fearon P, Langhorne P, Early Supported discharge trialists. Services for reducing duration of hospital care for acute stroke patients. Cochrane Database of Systematic Reviews 2012, Issue 9. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858. CD000443.pub3/pdf [last accessed 8 Aug 2014].
    • 24. Francis J, Fisher M, Rutter D. Reablement: a cost effective route to better outcomes. London: Social Care Institute for Excellence; 2011. Available from: http://www.scie.org.uk/publications/briefings/ briefing36/index.asp [last accessed 8 Aug 2014].
    • 25. Maximising Recovery, Promoting Independence: the Intermediate Care Framework for Scotland. The Scottish Government. Edinburgh; 2012. Available from: http://www.scotland.gov.uk/Resource/0038/ 00386925.pdf [last accessed 29 April 2014].
    • 26. Integration of Health and Social Care. The Scottish Government, Edinburgh. Available from: http://www.scotland.gov.uk/Topics/ Health/Policy/Adult-Health-SocialCare-Integration [last accessed 29 April 2014].
    • 27. Integrated Care: Our Shared Commitment. Department of Health; 2013. Available from: https://www.gov.uk/government/publications/ integrated-care [last accessed 23 May 2014].
    • 28. National Institute for Health and Care Excellence (NICE). Stroke rehabilitation: long term rehabilitation after stroke. National Institute for Health and Care Excellence; 2013. Available from: http://www.nice.org.uk/Guidance/CG162 [last accessed 29 April 2014].
    • 29. Turner-Stokes L. Goal attainment scaling (GAS) in rehabilitation: a practical guide. Clin Rehabil 2009;23:362-70 [published erratum appears in Clin Rehabil 2010;24:191].
    • 30. Carswell A, McColl MA, Baptiste S, et al. The Canadian occupational performance measure: a research and clinical literature review. Can J Occup Ther 2004;71:210-22.
    • 31. Stevens A, Beurskens A, Ko¨ke A, van der Weijden T. The use of patient-specific measurement instruments in the process of goalsetting: a systematic review of available instruments and their feasibility. Clin Rehabil 2013;27:1005-19.
    • 32. Dunne E, Wrosch C, Miller GE. Goal disengagement, functional disability, and depressive symptoms in old age. Health Psychol 2011;30:763-70.
    • 33. Coffey L, Gallagher P, Desmond D, Ryall N. Goal pursuit, goal adjustment, and affective well-being following lower limb amputation. Brit J Health Psychol 2014;19:409-24.
    • 34. Sanson-Fisher RW, Bonevski B, Green LW, D'Este C. Limitations of the randomized controlled trial in evaluating population-based health interventions. Am J Prev Med 2007;33:155-61.
    • 35. Brown CA, Lilford RJ. The stepped wedge design - a systematic review. BMC Med Res Methodol 2006;6:54.
    • 36. Kjeken I, Berdal G, Bo I, et al. Evaluation of a structured goal planning and tailored follow-up programme in rehabilitation for patients with rheumatic diseases: protocol for a pragmatic, stepped-wedge cluster randomized trial. BMC Musculoskel Disorders 2014;15:153.
    • 37. Pawson R, Tilly N. Realist evaluation. London: Sage Publications Ltd; 1997.
    • 38. Middleton S. Keeping it simple: the power of three clinical protocols. J Clin Nurs 2012;21:3195-7.
    • 39. Reablement: the added value of Occupational Therapists. London: College of Occupational Therapists; 2010. Available from: www.cot. co.uk/sites/default/files/position_statements/public/positionstatement-reablement.pdf [last accessed 13 Aug 2014].
    • 40. National Service Framework for older people. London: Department of Health; 2001. Available from: https://www.gov.uk/government/ uploads/system/uploads/attachment_data/file/198033/National_ Service_Framework_for_Older_People.pdf [last accessed 13 Aug 2014].
  • No related research data.
  • No similar publications.

Share - Bookmark

Cite this article