Study designs of evaluations included in the review
Randomised controlled trials (RCTs) were eligible for inclusion.
Specific interventions included in the review
Studies that allowed an independent assessment of some aspect of goal planning or an approach to goal planning were eligible for inclusion. Aspects of goal planning could include: identification and/or documentation of goals for treatment or rehabilitation; stakeholder involvement in goal selection (including but not limited to patient involvement); feedback on patient performance towards specific goals and encouragement to attain goals (generic encouragement must be controlled for); and the development of a plan or the provision of information on how to attain goals (generic education and/or levels of health professional contact must be adequately controlled for). Studies of goal-directed decision-making by medical staff in emergency or intensive care settings were excluded from the review.
All of the included studies used standardised forms and/or procedures. Approaches included collaborative goals that involved negotiation between the health professional and patient, and goals prescribed by health professionals; one study combined collaborative and prescribed goals and another varied the level of patient involvement. Six studies involved regular, often weekly, meetings to discuss feedback on progress and three used formal processes that allowed patients to monitor their own progress.
Participants included in the review
Studies of adults suffering from postacute or chronic disabling conditions, defined according to the World Health Organization’s International Statistical Classification of Diseases and Health Related Problems (ICD-10), were eligible. Such conditions included burns, injuries or diseases (congenital or developmental conditions were excluded) of the musculoskeletal system or connective tissue, skin or subcutaneous tissue, or the respiratory, circulatory, nervous, endocrine, nutritional or metabolic systems, or any mental or behavioural disorders (except those due to psychoactive substance use, mental retardation, or psychological development). The included participants had musculoskeletal disorders, central nervous system disorders or injuries, mental health conditions, cardiovascular disorders, endocrine or dietary disorders, or were described as frail elderly.
Outcomes assessed in the review
Eligible studies had to assess a patient outcome using a standardised measure. A wide variety of outcome measures were assessed in the included studies. Most of the outcomes were assessed over a period of weeks or months as part of a treatment and/or rehabilitation programme; six studies assessed immediate outcome measures over a few hours or days. The effects on rehabilitation programmes, patient motivation and/or treatment adherence, and patient self-regulation were assessed.
How were decisions on the relevance of primary studies made?
Two reviewers independently assessed the eligibility of studies. Any disagreements were resolved through discussion or, if required, through arbitration with a third reviewer.