Patient centred goal setting in a hospice setting: A comparative case study of how healthcare practitioners understand and use goal setting in practice

Abstract

Aim: To investigate healthcare practitioners' understanding and practice of patient centred goal setting in a hospice. Methods: A comparative case study of 10 healthcare practitioners in one hospice. Nonparticipant observations (n=28), semi-structured interviews (n=10) and case-note analysis (n=67) were undertaken. Data were analysed using framework analysis. Results: Participants viewed goal setting as part of routine practice. However, goal setting focused around what was seen as important from the health practitioner's perspective rather than being person centred. Participants' goal setting practice was implicit and opportunities to support patients to pursue goals were missed. Participants emphasised problem solving and alleviating symptoms rather than focusing on patient priorities and establishing patient centred goals. Conclusion: While goal setting is valued, it is practiced in an implicit, practitioner centred and inconsistent manner. An explicit person centred goal setting process may support practitioners consistently help patients to identify their priorities and enhance their quality of life.