. The use of a patient-specific instrument in physiotherapy goal setting Anita Stevens AB, Albine Moser ABE,, Albère Köke CD, Trudy van der Weijden BE,

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. The use of a patient-specific instrument in physiotherapy goal setting Anita Stevens AB, Albine Moser ABE,, Albère Köke CD, Trudy van der Weijden BE, Anna Beurskens ABE A Zuyd University of applied science: Faculty of Health, Heerlen. B Maastricht University: Caphri Research group. C Adelante Centre of Expertise in Rehabilitation, Hoensbroek. D Maastricht University: Department of Rehabilitation Medicine. E Maastricht University: Department of Family Practice Figure 1: The stepwise process of the PSC Introduction Physiotherapists need to identify the treatment goals that the patient wants to achieve. In daily practice this is difficult and not as client-centred as it should be. The Patient Specific Complaints instrument (PSC) 1 (fig 1) can support this process 2 because patients identify and rate their own activity problems. The PSC is similar to the PSFS and recommended in nearly all Dutch guidelines. Despite its extensive dissemination, its actual use in the process of goal setting is not well known. Purpose To explore the actual use of the PSC and investigate the physiotherapists’ perspective on the feasibility of the PSC in physiotherapy daily practice. Method A descriptive qualitative study design. Physiotherapy consultations were observed and semi-structured interviews were conducted with physiotherapists. Data were analysed with directed content analysis. Results 23 consultations were observed and 10 physiotherapists were interviewed: Contact details Research Centre for Autonomy and Participation of Persons with a Chronic Illness. Zuyd University p.o. Box 550, 6400 AN Heerlen. The Netherlands. Observation The use of the PSC varied in time and method Patients were not informed about the purpose of the PSC Identified problems were not linked to treatment goals Treatment goals were hardly discussed Results Contextual factors Physiotherapists’ competences and attitude towards using measurement instruments in practice Physiotherapists’ opinion about the patients’ ability to understand and appreciate measurement instruments Feasibility of the PSC Easy and quick to apply Useful to: - objectify patients’ problems - evaluate treatment - increase patients’ awareness - deliver client-centred care - meet audit obligations Not useful for treatment Conclusion Physiotherapists appreciated the PSC as a brief and simple instrument. The observed variety in administration methods emphasizes the tailored manner in which the PSC can be used. However, therapists rarely involve patients in the actual goal setting. The PSC is mainly used for external accountability. Its potential of the PSC to support the goal setting process is therefore not fully used. Implication Targeted use of the PSC within the process of goal setting can help to improve client centred care References 1. Beurskens A, de Vet H, Koke A, Lindeman E, van der Heijden G, Regtop W & Knipschild P. (1999). A patient-specific approach for measuring functional status in low back pain. J Manipulative Physiol Ther, 22(3), Stevens A, Beurskens A, Koke A, van der Weijden T. (2013). The use of patient- specific measurement instruments in the process of goal setting: a systematic review of available instruments and their feasibility. Clin.Rehabil., 27(11). “You can confront patients with their improved scores on the PSC” “It helps me to identify what the patient really wants” “To me, it [using the PSC] is just the obligation to the insurance company”