ABSTRACT

This paper explored clinicians’ experiences of the goal setting process with children and adolescents with acquired brain injuries (ABI) and their families in paediatric neurorehabilitation. Semi-structured interviews were conducted with 13 clinicians, all members of an interdisciplinary paediatric rehabilitation service, who work with children and adolescents with ABI and their families. Interview transcripts and additional data were analysed using constructivist grounded theory methods. Three main themes and sub-themes were developed: (1) Seeing the bigger picture: Goals change over time; Families set bigger picture goals; Need-to-dos: Goals that the child/adolescent needs to achieve; and Want-to-dos: Goals that the child/adolescent wants to achieve; (2) Collaborating as a team: Everyone needs to be on the same page; Hearing the child's/adolescent's voice; and Parents as advocates; and (3) Recognizing and navigating challenges: Child-/adolescent- and family-related challenges and Time as a service-related challenge. Participants perceived the clinician's role during goal setting as that of an active collaborator, enabling children and adolescents with ABI and their families to generate meaningful goals. These findings demonstrate insights into goal setting in paediatric ABI neurorehabilitation from clinicians’ perspectives, and highlight the importance of collaboration, flexibility and anticipation of challenges in facilitating children's, adolescents’ and families’ involvement in this process.

摘要

本文探讨了临床医生在获得性脑损伤 (ABI) 儿童和青少年及其家庭儿童神经康复治疗目标设定过程中的经验。对 13 名临床医生进行了半结构化访谈，他们都是跨学科儿科康复服务的成员，他们与患有 ABI 的儿童和青少年及其家人一起工作。使用建构主义扎根理论方法分析了访谈记录和其他数据。制定了三个主要主题和子主题： (1) 放眼大局：目标随时间变化；家庭设定更大的目标；Need-to-dos：儿童/青少年需要实现的目标；和Want-to-dos：儿童/青少年想要实现的目标；(2) 团队协作：每个人都需要在同一页面上；听到孩子/青少年的声音；和家长作为倡导者；(3) 识别和应对挑战：与儿童/青少年和家庭相关的挑战以及与时间作为服务相关的挑战. 参与者将临床医生在目标设定过程中的角色视为积极的合作者，使患有 ABI 的儿童和青少年及其家人能够制定有意义的目标。这些发现证明了从临床医生的角度对儿科 ABI 神经康复目标设定的见解，并强调了协作、灵活性和对挑战的预测在促进儿童、青少年和家庭参与这一过程中的重要性。