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Elucidating a Goal-Setting Continuum in Brain Injury Rehabilitation

机译：阐明脑损伤康复的目标设定连续体

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For individuals with brain injury, active participation in goal setting is associated with better rehabilitation outcomes. However, clinicians report difficulty engaging these clients in goal setting due to perceived or real deficits (e.g., lack of awareness). We conducted a study using grounded theory methods to understand how clinicians from occupational therapy facilitate client engagement and manage challenges inherent in goal setting with this population. Through constant comparative analysis, a goal-setting continuum emerged. At one end of the continuum, therapists embrace client-determined goals and enable clients to decide their own goals. At the other, therapists accept preset organization-determined goals (e.g., the goal is discharge) and pay little attention to client input. Although all participants aspired to embrace client-determined goal setting, most felt powerless to do so within perceived organizational constraints. Views of advocacy and empowerment help to explain our findings and inform more inclusive practice.
机译：对于脑损伤患者，积极参与目标设定与更好的康复效果相关。但是，临床医生报告说，由于察觉或实际的缺陷（例如缺乏意识），难以使这些客户参与目标设定。我们使用扎实的理论方法进行了一项研究，以了解来自职业治疗的临床医生如何促进服务对象的参与并应对目标人群固有的挑战。通过不断的比较分析，出现了设定目标的连续体。在这一过程的最后，治疗师会接受客户确定的目标，并使客户能够决定自己的目标。另一方面，治疗师接受组织确定的预设目标（例如，目标是出院），并且很少关注客户的输入。尽管所有参与者都渴望接受客户确定的目标设定，但是大多数参与者却感到无能为力。倡导和授权的观点有助于解释我们的发现并为更具包容性的实践提供信息。

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