Patient-Specific Goal-Setting Method

Abstract

The Patiënt Specifieke Goal-setting methode (PSG), or Patient-Specific Goal-setting method, is an interactive clinical approach designed to support the cyclical process of goal-setting in healthcare, particularly within the field of physiotherapy. This method emphasizes the active involvement of the patient throughout the entire cycle, which includes problem clarification, goal definition, treatment planning, and systematic evaluation. The PSG is a significant revision and expansion of its predecessor, the Patiënt Specifieke Klachten (PSK) scale. Key enhancements include the full integration of the method into standard professional practice, standardized instructions for administration, and a shift in scoring methodology from assessing ‘difficulty of execution’ to evaluating the ‘possibility of execution,’ leading to a more positive, functional assessment framework where a higher score signifies better functioning.

Keywords

Goal-setting, Patient-Specific Goal-setting method, PSG, PSK, Physiotherapy, Musculoskeletal disorders, Rehabilitation, Patient-centered care, Functional assessment, Psychological testing, Clinical assessment.

Authors

Stevens A (2017)

Purpose

The primary purpose of the PSG is to systemically structure and enhance the collaborative goal-setting process between the clinician and the patient. It serves as a framework to ensure that treatment objectives are relevant, specific, and directly related to the patient’s self-identified functional challenges and desired outcomes. By shifting the focus from limitations to the patient’s capabilities, the PSG aims to promote patient autonomy and engagement in the rehabilitation process.

Unlike previous methods, the PSG is intended to be fully integrated into the standard methodology of the treating professional, ensuring that goal definition and evaluation are seamless components of the overall care plan rather than isolated measurement events. This integration is supported by detailed instructions aimed at standardizing the application of the method across different clinical settings.

Construct

The PSG measures the patient’s self-reported functional status and capability relative to specific, personally relevant goals. The underlying construct assessed is the degree of successful **functional performance** and **goal attainment**. It operates on a **patient-specific** and **contextual** framework, recognizing that relevant outcomes vary significantly between individuals.

Crucially, the PSG measures the perceived **possibility of execution** of specific activities, which reflects a positive psychological and functional approach to rehabilitation. This construct emphasizes the patient’s perspective on their potential for recovery and functional improvement, moving away from a purely deficit-based model. This shift aligns the scoring logic with patient expectations, where a higher score logically represents a better functional result.

Validity

While specific psychometric validation studies (such as criterion or discriminant validity coefficients) are often detailed in accompanying literature, the methodological revisions of the PSG relative to the PSK implicitly enhance its face and content validity. The integration of goal-setting and treatment planning steps ensures that the instrument’s content aligns strongly with the clinical practice it is intended to support (content validity).

The change in scoring anchors—from scoring difficulty to scoring capability—is designed to improve construct validity by aligning the measurement more closely with modern, positive models of health (e.g., the International Classification of Functioning, Disability and Health or ICF). Further research would typically be required to fully establish predictive and concurrent validity across diverse populations, especially those with varying degrees of **musculoskeletal system** impairment.

Reliability

Specific data on inter-rater reliability, test-retest reliability, or internal consistency (where applicable) are usually found in the scale’s manual or peer-reviewed publications. However, the methodological requirement for mandatory **training** for practitioners and the provision of **uniform instructions** for every step are structural elements intended to significantly increase the reliability of the PSG administration process. These measures minimize variance introduced by assessor interpretation, thereby supporting higher levels of consistency in the application of the scale.

Factor Analysis

The PSG is fundamentally a patient-specific, ipsative measure, meaning it measures change within the individual based on unique goals rather than comparing individuals across a fixed set of items. Therefore, traditional factor analysis, which seeks to identify underlying latent factors common across a population, is generally not applicable or meaningful for instruments of this design. The PSG does not yield a single, global score based on a fixed factor structure; rather, it provides individualized change scores specific to the patient’s chosen functional goals.

Instrument

Test Type: Questionnaire (Patient-Reported Outcome Measure / Goal-Setting Framework)

Format: Interactive, structured method integrated into clinical practice. It involves detailed instructions for problem clarification, goal setting, treatment planning, and evaluation.

Language Available: Dutch (Original language of publication and primary use).

Population Group: Clinical populations presenting with functional limitations related to movement.

Age Group: Adults, Elderly (Ouderen, Volwassenen)

Population Details: Individuals with conditions affecting the **musculoskeletal system** (Bewegingsapparaat) requiring physiotherapeutic intervention focused on functional **Activities**.

Test Methodology: Cyclic, interactive goal-setting process. Scoring utilizes anchors related to the ‘possibility of execution’ of patient-defined goals, with a higher score indicating better functional status.

Keywords

Patient-centered, Goal attainment, Functional improvement, Rehabilitation outcomes, Clinical measurement, Stevens A, PSK revision, Physiotherapy assessment, **Goal-setting** framework.

Authors

Author ORCID Identifier: Information not provided in the source content.

Affiliation Email addresses: Information not provided in the source content.

Correspondence Address: Information not provided in the source content.

Permissions & Fee and Test Year

The scale was published and revised by Stevens A in **2017**. The source material references the scale on a university website, suggesting it is intended for clinical and research use. The official website for further documentation is: https://www.zuyd.nl/onderzoek/lectoraten/projecten-autonomie-en-participatie/producten-en-diensten/psg. Specific information regarding licensing fees or formal permissions for clinical use should be sought directly from the author or the affiliated institution (Zuyd University of Applied Sciences).

Reference’s

Stevens A (2017). Patiënt Specifieke Goal-setting methode (PSG). Zuyd University of Applied Sciences.

The original Toelichtingsformulier (Explanation Form) can be downloaded here: https://scales.arabpsychology.com/wp-content/uploads/instrumenten/PSG-form.pdf

The official Meetinstrument (Measurement Instrument) can be downloaded here: https://scales.arabpsychology.com/wp-content/uploads/instrumenten/PSG-meetinstr.pdf

The Handleiding (Manual) can be downloaded here: https://scales.arabpsychology.com/wp-content/uploads/instrumenten/PSG-handl.pdf

Items of the Patiënt Specifieke Goal-setting methode

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The source content provides a description of the methodology and the changes relative to the PSK, rather than a list of the specific items or goals used in the PSG. The method itself is defined by the cyclical process and the scoring changes:

• De PSG is stapsgewijs geïntegreerd in het fysiotherapeutisch methodisch handelen, en niet als een ‘los’ meetinstrument wordt zoals bij de originele PSK het geval was.
• Alle stappen zijn voorzien van een instructie zodat de afname uniform gebeurt.
• Elke stap wordt aan de patiënt geïntroduceerd en de reden ervan uitgelegd, waardoor patiënt actiever betrokken wordt bij het hele proces.
• Er zijn twee extra stappen: ‘doelen stellen’ en ‘behandelplan maken’, toegevoegd.
• De ankers van het van scoren zijn veranderd, dat wil zeggen dat de patiënt nu de ‘mogelijkheid tot uitvoeren’ scoort in plaats van de ‘moeite met uitvoering’.
• De wijze van score is daardoor ook veranderd. Een hogere score betekent nu dus beter functioneren.