ArticleHealth expectations : an international journal of public participation in health care and health policy2018
A three-goal model for patients with multimorbidity: A qualitative approach.
Article in Health expectations : an international journal of public participation in health care and health policy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Understanding GPs' clinical reasoning processes involved in managing patients suffering from multimorbidity: A systematic review of qualitative and quantitative research.International journal of clinical practice · 2021Pooled it
- Barriers and facilitators for shared decision making in older patients with multiple chronic conditions: a systematic review.BMC geriatrics · 2021Pooled it
- General practitioner strategies for managing patients with multimorbidity: a systematic review and thematic synthesis of qualitative research.BMC family practice · 2020Pooled it
- Clinical decision-making and care pathways for people with multiple long-term conditions admitted to hospital: a scoping review.BMJ open · 2025Article
- Goals should be defined as CLEVER before specifying them into SMART goals: A phenomenological hermeneutical study to facilitate the implementation of goal-oriented care in primary care.The British journal of occupational therapy · 2025Article
- A thematic analysis of shared decision-making in consultations with patients with a presumed brain tumor and neurosurgeons.Neuro-oncology practice · 2025Article
- Ensuring Goal-Aligned Care in a Busy Surgical Practice.Seminars in colon & rectal surgery · 2024Article
- Characteristics of goal-setting tools in adult rehabilitation: A scoping review.Clinical rehabilitation · 2024Article
- Satisfaction of chronic patients with community-based health insurance schemes and related factors: Explanatory sequential mixed methods study.PLOS global public health · 2024Article
- The effect of a goal-setting strategy with integrated feedback on goal attainment in inflammatory arthritis patients: a mixed method study.Rheumatology international · 2023Article
- Experience of living with multimorbidity and health workers perspectives on the organization of health services for people living with multiple chronic conditions in Bahir Dar, northwest Ethiopia: a qualitative study.BMC health services research · 2023Article
- Effects of a shared decision making intervention for older adults with multiple chronic conditions: the DICO study.BMC medical informatics and decision making · 2023Article
- Person-centered goal setting is feasible in people with Parkinson's disease who have subjective cognitive decline: a mixed methods study.Disability and rehabilitation · 2023Article
- Eliciting patients' healthcare goals and concerns: Do questions influence responses?Chronic illness · 2022Article
- Patient values in healthcare decision making among diverse older adults.Patient education and counseling · 2022Article
- Goal-oriented care for patients with chronic conditions or multimorbidity in primary care: A scoping review and concept analysis.PloS one · 2022Article
- Review
- Patients' decision to contribute to a biobank in the light of the patient-recruiter relationship-a qualitative study of broad consent in a hospital setting.Journal of community genetics · 2021Article
- Article
- Goal-Based Shared Decision-Making: Developing an Integrated Model.Journal of patient experience · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo meet the challenge of multimorbidity in decision making, a switch from a disease-oriented to a goal-oriented approach could be beneficial for patients and clinicians. More insight about the concept and the implementation of this approach in clinical practice is needed.
objectiveThis study aimed to develop conceptual descriptions of goal-oriented care by examining the perspectives of general practitioners (GPs) and clinical geriatricians (CGs), and how the concept relates to collaborative communication and shared decision making with elderly patients with multimorbidity.
methodQualitative interviews with GPs and CGs were conducted and analyzed using thematic analysis.
resultsClinicians distinguished disease- or symptom-specific goals, functional goals and a new type of goals, which we labelled as fundamental goals. "Fundamental goals" are goals specifying patient's priorities in life, related to their values and core relationships. These fundamental goals can be considered implicitly or explicitly in decision making or can be ignored. Reasons to explicate goals are the potential mismatch between medical standards and patient preferences and the need to know individual patient values in case of multimorbidity, including the management in acute situations.
conclusionBased on the perspectives of clinicians, we expanded the concept of goal-oriented care by identifying a three-level goal hierarchy. This model could facilitate collaborative goal-setting for patients with multiple long-term conditions in clinical practice. Future research is needed to refine and validate this model and to provide specific guidance for medical training and practice.
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