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Theresa Marie Smith; Goal Setting in Low Vision Rehabilitation. Invest. Ophthalmol. Vis. Sci. 2020;61(7):1560.
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Goals are to be set in collaboration with patients who are motivated to work on goals they want to achieve. Goal setting by occupational therapists (OTs) involves more factors than patient aspirations. In addition to patient rehab potential, safety issues, cognitive abilities and insurance coverage, OTs must consider their practice domain, skill level, ethical standards and licensure laws. Goals must also be feasible, achievable and a priority. Determinates of goal setting are important with greater accountability for rehab expenditures. A study is needed on reasons OTs choose not to include a patient identified (PID) goal in patient plan of care (POC).
A survey research design was used. A survey was developed with 15 most likely reasons affecting OTs’ decision not to include a PID goal in POC. PID goals were determined using the Activity Inventory (AI). If a patient rated an activity as important and moderately difficulty to complete, it was considered a PID goal. AI items were divided into 4 categories of self-care (BADLs), instrumental activities of daily living (IADLs), social participation and leisure activities. Using AI results, treating OT decided whether to include a goal in patient POC. OTs were sent an individualized survey to choose reasons that led them to not include PID goals in POC. The surveys included only PID goals on the AI for which the individual OT did not include in POC.
Five OTs practicing in low vision rehabilitation completed the survey on 91 patients. The activity category most often not to have PID goals set was IADLs followed by leisure, BADLs and social participation. The most common reasons given to not include PID in POC are as follows: IADL goal wasn’t set because goals are not attainable or are unrealistic; leisure goals due to many other goals the patient wanted to work on; BADLs had 3 reasons tied of many other goals that the patient wanted to work on; goal judged not to be a priority; and patient has caregiver to perform task and patient choose not to address; and social participation was many other goals that the patient wanted to work on. The most common reason to not include a PID goal in patient POC was many other goals that the patient wanted to work on.
The level of value a patient puts on a singular goal may not be known from intake data. Goal setting and prioritizing requires OTs to limit number of goals in POC.
This is a 2020 ARVO Annual Meeting abstract.
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