SDM for goal setting

goals 包含內容（含標的與進步量）與時間，如於2週內手功能進步20％
【goals 以 short term 為主，因為 long term goals對個案/家屬太遙遠/不實際 】

meeting 的流程仍待內容強化

積極目標：1. 確認醫病雙方皆認為最佳之短期治療重點
2. 藉由衛教與逐次目標修訂，協助個案/家屬建立 insight，進而由治癒轉移至代償

請惠賜意見

* Why goal-setting is important but difficult for both patients and therapists?

Treatment goals should be set before the intervention of OT. The goals set are used to guide the intervention plans and would definitely affect the outcomes of OT. Thus, goal-setting is critical for both patients and therapists. 

However, the impact of stroke is multiple that makes the goal setting complex. Several physical, mental, and social domains of a patients are very likely to be simultaneously affected after stroke. Patients and their families are commonly focused on recovery of physical domains. However, the recovery of physical domains tends to reach plateau in a short period after onset. Most patients and families cannot accept the plateau and keep the recovery of  physical domains as their primary goal. Partly because of ethical considerations and limited time for communication/education, some patients may keep unrealistic goals for a while so that the outcomes are affected. Thus, how to set realistic goals, particularly for patients reached recovery plateau of physical domains (e.g., patients at subacute or chronic stage) is a critical issue for both patients and therapists.