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Goal setting in Dutch paediatric rehabilitation. Are the needs and principal problems of children with cerebral palsy integrated into their rehabilitation goals?

Center for Rehabilitation and Graduate School for Health Research SHARE, University Medical Center Groningen, University of Groningen, B.Nijhuis{at}uu.nl

Heleen A Reinders-Messelink

Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag

Alida CE de Blécourt

Center for Rehabilitation, University Medical Center Groningen, University of Groningen

Anne M Boonstra

Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag

Esther HM Calamé

Sophia Revalidatie, The Hague

Johan W Groothoff

Graduate School for Health Care Research SHARE and Department of Social Medicine, University Medical Center Groningen, University of Groningen

Han Nakken

Department of Special Education, University of Groningen

Klaas Postema

Center for Rehabilitation and Graduate School for Health Research SHARE, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

Objective: To evaluate whether the needs and principal problems of children with cerebral palsy (CP) as formulated in their interdisciplinary rehabilitation reports are integrated into the goal descriptions and whether this depends on the nature of the needs and problems.

Design: Descriptive multiple-case study.

Setting: Five Dutch paediatric rehabilitation facilities.

Subjects: The rehabilitation profiles of 41 children with cerebral palsy aged between 4 and 8 years.

Methods: The raw text data were extracted and organized, after which two raters independently linked the extracted content to the categories of the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). Matches between needs, problems and goals were identified by ICF-CY code comparisons.

Results: The Cohen's kappas for ICF-CY encoding were all in the range of `fair to good' (0.52—0.78). For five children (12%) no needs had been formulated and the reports of 10 (24%) were excluded from further analyses as they lacked a principal goal. In the 31 reports analysed, 29 (23%) need constructs and 46 (46%) problem constructs were incorporated into the goals. Of the total of 95 goal constructs 49 (52%) were not related to either a need or a problem construct. No clear relationship could be established between the type of needs and problems and their inclusion or exclusion in the principal goals.

Conclusion: Overall, the integration of the needs and principal problems of children with their rehabilitation goals was not optimal. However, integration was difficult to objectify because needs, problems and goals were poorly documented.

Clinical Rehabilitation, Vol. 22, No. 4, 348-363 (2008)
DOI: 10.1177/0269215507083055


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