Shared Decision Aids for Rehabilitation Goal Setting

Zsofia Torok

Shared Decision Aids for Rehabilitation Goal Setting

Author(s)	Dr. Zsofia Torok
Country	United States
Abstract	Goal setting is a central component of rehabilitation because it translates broad aspirations for recovery into priorities that can organize assessment, therapy, interdisciplinary coordination, and evaluation of progress. Yet a rehabilitation goal is not genuinely patient-centered merely because it is written in measurable language. Meaningful goal setting also requires patients and rehabilitation professionals to exchange information, clarify expectations, consider feasible alternatives, and determine which outcomes matter most to the individual. A systematic review by Rose, Rosewilliam, and Soundy found substantial variation in patient involvement within rehabilitation goal setting and relatively few examples of fully patient-centered shared decision-making. The present study develops a simulation-based framework for evaluating shared decision aids for rehabilitation goal setting. The proposed decision aid is not designed to generate goals automatically. Instead, it prepares patients and clinicians for collaborative discussion by presenting possible rehabilitation domains, eliciting patient priorities, clarifying trade-offs, identifying expected functional outcomes, and documenting areas in which patient and professional priorities converge or differ. Because no original rehabilitation dataset was provided, 600 synthetic patient profiles were modeled across three conditions: usual rehabilitation goal setting, a structured goal-setting conversation, and a shared decision aid combined with clinician facilitation. The simulated mean patient–clinician goal-concordance score increased from 56.5 under usual goal setting to 69.0 following a structured goal-setting conversation and 82.0 when the shared decision aid was combined with clinician facilitation. The proportion of simulated cases achieving goal-concordance scores of at least 75 increased from 12.0% to 31.5% and 77.5%, respectively. Modeled decisional conflict decreased while perceived involvement, goal clarity, and rehabilitation engagement increased. These values are synthetic and should not be interpreted as measured intervention effects.The conceptual interpretation is supported by established shared-decision-making evidence. Patient decision aids generally improve knowledge, clarify values, and encourage more active participation in health decisions, while rehabilitation-specific research suggests that shared decision-making has considerable potential but remains inconsistently embedded in goal-setting practice. Community rehabilitation research also indicates that patients and providers can perceive goal-setting participation differently, emphasizing the importance of measuring the patient's experience rather than assuming that professional intention proves collaboration.
Keywords	shared decision making; rehabilitation goal setting; patient decision aids; patient-centered rehabilitation; goal concordance; rehabilitation engagement; collaborative care; functional recovery
Field	Engineering
Published In	Volume 4, Issue 5, September-October 2023
Published On	2023-09-04

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American Journal of Advanced Multidisciplinary Innovation and Research

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Shared Decision Aids for Rehabilitation Goal Setting

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