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Introduction/Background Person-centered goal setting is considered a core part of the rehabilitation process. However, barriers to patient involvement in goal selection exist, including: cognitive and communicative impairments; tendencies for rehabilitation professional to control and direct the goal selection process; and difficulties some patients have with identifying meaningful goals that are relevant to rehabilitation. The aim of this study was to develop an English-language version of a Japanese iPad application designed to facilitate share-decision making around goal setting in rehabilitation: Aid of Decision-making in Occupational Choice–English (ADOC-E). ADOC-E makes use of images and a structure process to facilitate goal setting discussions. Material and method Phase 1: Delphi methods to reach consensus, with a group of 12 expert occupational therapists from four countries (UK, USA, Australia, and New Zealand) on the text and images in ADOC-E. Phase 2: Testing correct recognition (unprompted and prompted) of images in ADOC-E by health service users (n = 25; age 20–95 years; Mini-Mental State Exam 13–30) in inpatient rehabilitation and residential care. Results Four Delphi rounds were required to reach consensus with the expert occupational therapists on the content of ADOC-E, ending with 100 items covering daily activities that people do and social roles they participate in. Ninety-five percent (95/100) of ADOC-E items could each be correctly identified by over 80% of participants with either unprompted or prompted recognition. Images were less like to be correctly identified (and were more challenging to represent in a single image) if they focused on goals at the level of social participation. Conclusion While a few of the more abstract concepts in ADOC-E (related to complex social roles) were less likely to be correctly recognized by all participants, the text and images ADOC-E were deemed to be fit for purpose overall, and ready for future clinical testing. |
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