Identification and comparison of rehabilitation goals after multiple injuries: an ICF analysis of the patients', physiotherapists' and other allied professionals' reported goals.

Abstract

OBJECTIVE: To explore and compare severely injured patients' rehabilitation goals with respect to their functioning and the reported goals of rehabilitation professionals. DESIGN: A prospective cohort study, including longitudinal data on patients' functioning and cross-sectional data from the patients' and professionals' goal descriptions. SUBJECTS: Sixty-six patients (53 men, 13 women, mean age 35 (standard deviation 13.8) years) with multiple injuries with a New Injury Severity Score >15 and 76 physiotherapists and other municipal rehabilitation professionals/services. METHODS: Patient questionnaire and interview were applied after return home and a further questionnaire one year post-injury. Short-Form Health Survey was used for self-assessed health. A questionnaire was applied to the professionals. Rehabilitation goals were reported by patients and professionals. International Classification of Functioning, Disability and Health coding of the goals was performed. RESULTS: Short-Form Health Survey scores were below those of the general population. The patients' goals concerned body functions/structures (8.6%), activities (16.2%) and participation (31.7%). The professionals, mainly physiotherapists, reported few participation goals (10.7%). Agreement between the patients' and professionals' goals were poor, with kappa scores < or =0.20 for musculoskeletal functions/structures, self-care, mobility, interpersonal interactions/relationships, work and recreation/leisure. A statisticaly significant difference between patients' and professionals' goals was demonstrated for musculoskeletal functions/structures (p<0.001), interpersonal interactions/relationships (p=0.002), work (p=0.001) and recreation/leisure (p=0.002). CONCLUSION: The patients mainly reported activity and participation goals. There was poor agreement between patients and professionals for body functions and participation goals.