Identification and comparison of rehabilitation goals after multiple injuries: An ICF analysis of the patients’, physiotherapists’ and other allied professionals’ reported goals
To explore and compare severely injured patients' rehabilitation goals with respect to their functioning and the reported goals of rehabilitation professionals. A prospective cohort study, including longitudinal data on patients' functioning and cross-sectional data from the patients' and professionals' goal descriptions. 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. 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. 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). The patients mainly reported activity and participation goals. There was poor agreement between patients and professionals for body functions and participation goals.