Client-centred assessment and the identification of meaningful treatment goals for individuals with a spinal cord injury

Spinal Cord, 2004 · DOI: 10.1038/sj.sc.3101589 · Published: May 1, 2004

Simple Explanation

This study explores how people with spinal cord injuries (SCI) identify their problems and goals during rehabilitation, focusing on self-care, productivity, and leisure. The Canadian Occupational Performance Measure (COPM) was used to understand the individual's perspective, and its relationship with the Functional Independence Measure (FIM) was examined. The study highlights the importance of client-centered approaches in SCI rehabilitation, where individuals actively participate in identifying their needs and setting goals.

Study Duration

2 Years

Participants

41 individuals with a SCI

Evidence Level

Level 3, Retrospective analysis

Key Findings

1
Self-care goals were identified most frequently (79%) followed by productivity (12%) and leisure (9%) goals by individuals with SCI during rehabilitation.
2
The most common problems reported were functional mobility (including transfers and wheelchair use), dressing, and grooming.
3
A fair relationship was found between the COPM and the FIM, indicating that they measure different aspects of function.

Research Summary

This retrospective study examined the self-care, productivity, and leisure problems identified by individuals with SCI during rehabilitation, their satisfaction and performance levels, and the relationship between the COPM and FIM. The results indicated that self-care goals were the most frequently identified, with functional mobility, dressing, and grooming being the top problems. The study concludes that including client-centered outcome measures like the COPM is important in assessing individuals with SCI and provides initial support for its use in this population.

Practical Implications

Client-Centered Care

Emphasizes the importance of incorporating client-centered assessments like the COPM in SCI rehabilitation to actively involve individuals in their care.

Goal Setting

Highlights the need to prioritize self-care goals, particularly functional mobility, dressing, and grooming, in the early stages of SCI rehabilitation.

Comprehensive Assessment

Suggests using both client-centered (COPM) and functional (FIM) measures to gain a more comprehensive understanding of an individual's needs and progress.

Study Limitations

1
Participants from only one rehabilitation program, which may limit the generalizability.
2
Small sample size, limiting the ability to examine occupational performance problems by subcategories.
3
The study only reassessed initially identified problems at discharge, not capturing evolving issues during rehabilitation.

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