Objectives To identify and synthesise existing literature on goal setting in palliative care, with a view to identifying a conceptual framework to underpin the process.
Methods Searches were conducted using MEDLINE, PSYCHINFO, EMBASE, CINAHL, ASSIA and Google Scholar data bases between November 2010 and January 2011. Additional articles were located by screening the reference lists of those which were included. Papers were included if they focused on patient centred goal setting for patients with palliative care needs. Included papers were categorised according to type (quantitative, qualitative, mixed methods, literature review, conceptual, opinion or practice based). Research papers were quality appraised. Critical interpretive synthesis was used to analyse and synthesise data.
Results 16 papers about goal setting in palliative care were included (four quantitative, one mixed methods, three qualitative, one literature review, three conceptual, one opinion based and three practice based). Research papers varied in quality and primary focus. There was no clear definition of goal setting. Three themes emerged: what goal setting is; challenges and factors that affect goal setting and emerging theory/conceptual underpinning of goal setting.
Conclusions Patient centred goal setting is recognised as an important component of palliative care and is described as beneficial for patients, families and professionals. It is proposed as a method of ensuring that care is patient led, giving patients a sense of control and bringing meaning. Goal setting appears to be slightly different in palliative care as compared to general rehabilitation settings, primarily because palliative care patients are dealing with deteriorating conditions, often at unpredictable rates. Hope theory and adaptation to life threatening illness provide useful adjuncts to already established theoretical goal setting literature.
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