Giving hope, ticking boxes or securing services? A qualitative study of respiratory physiotherapists’ views on goal-setting with people with chronic obstructive pulmonary disease

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Abstract

Objective:

To explore respiratory physiotherapists’ views and experiences of using goal-setting with people with chronic obstructive pulmonary disease in rehabilitation settings.

Participants:

A total of 17 respiratory physiotherapists with ≥12 months current or previous experience of working with patients with chronic obstructive pulmonary disease in a non-acute setting. Participants were diverse in relation to age (25–49 years), sex (13 women), experience (Agenda for Change bands 6–8) and geographic location.

Method:

Data were collected via face-to-face qualitative in-depth interviews (40–70 minutes) using a semi-structured interview guide. Interview locations were selected by participants (included participants’ homes, public places and University). Interviews followed an interview guide, were audio-recorded and transcribed verbatim.

Data Analysis:

Data were analysed using thematic analysis; constant comparison was made within and between accounts, and negative case analysis was used.

Results:

Three themes emerged through the process of analysis: (1) ‘Explaining goal-setting’; (2) ‘Working with goals’; and (3) ‘Influences on collaborative goal-setting’. Goal-setting practices among respiratory physiotherapists varied considerably. Collaborative goal-setting was described as challenging and was sometimes driven by service need rather than patient values. Lack of training in collaborative goal-setting at both undergraduate and postgraduate level was also seen as an issue.

Conclusion:

Respiratory physiotherapists reflected uncertainties around the use of goal-setting in their practice, and conflict between patients’ goals and organisational demands. This work highlights a need for wider discussion to clarify the purpose and implementation of goal-setting in respiratory rehabilitation.

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