***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives : The recent National Service Framework for Long Term Conditions recommends that patients participate more in decision making about their care . However , few protocol s exist to support this . One potentially useful method is goal setting , but little has been done to evaluate the added value of increasing patient participation in this way . Therefore , this study examined the impact of an increased participation goal setting protocol in a neurorehabilitation setting . Design : The study was an AB optimised balance block design with each block lasting 3 months , over an 18 month period . Setting and participants : Patients ( n = 201 ) were recruited from an inpatient neurological rehabilitation unit . Interventions : Patients ( n = 100 ) recruited in phase A were involved in “ usual practice ” goal setting .  Patients ( n = 101 ) recruited in phase B were involved in “ increased participation ” goal setting , which included a protocol to help them define and prioritise their own goals . Main outcome measures : Patients ’ perceptions of the relevance of goal setting and their autonomy within the process ; the number , type and outcome of goals ; and level of functional ability . Results : Phase B patients ( “ increased participation ” ) set fewer goals , of which significantly more were participation related . These patients perceived the goals to be more relevant , and expressed greater autonomy and satisfaction with goal setting . There were no differences in functional outcomes between the groups . Conclusion : This study has shown that patients prefer increased participation in the goal setting process over st and ard procedures , perceiving their goals as more relevant and rehabilitation more patient centred despite the absence of functional gains . Effective patient centred care can be realised by using structures that help support patients to identify and communicate their priorities . As such , our findings suggest patients would benefit from greater participation in this aspect of clinical decision making Objective : To examine the feasibility of and clinical experiences with goal attainment scaling when used for the evaluation of cognitive rehabilitation in people with acquired brain injury . Design : A prospect i ve observational longitudinal study . Setting : A 21-week cognitive rehabilitation programme and a cognitive programme with varying length in two different Dutch rehabilitation centres . Subjects : Forty-eight consecutive patients with acquired brain injury enrolled during a 15-month period . Interventions : Cognitive rehabilitation programme . Main measure : Goal attainment scaling ; the number of goals was counted ; time to set goals was recorded ; the number of different domains in which goals were set was counted ; goal attainment scaling score was calculated at baseline , one week after the end of the cognitive rehabilitation programme and at six months follow-up ; clinical experiences that could be useful for both clinical and research practice were recorded . Results : The mean ( SD ) age of the patients was 46.1 ( 10.7 ) years ; 29 ( 60 % ) were male ; 186 goals were set with a mean ( SD ) number of 4 ( 1 ) goals per patient . It was possible to set at least three realistic goals per patient within 30 minutes . Most goals were set in the cognitive domain ( i.e. memory and attention ) , followed by the behavioural domain ( i.e. fatigue and aggression ) . Conclusion : It proved possible to set three goals within an acceptable time-frame , to involve patients in the goal - setting procedure , to set realistic goals , and to set goals within relevant domains . Based on clinical experiences , goal attainment scaling is less feasible for research when patients lack insight , or suffer from comorbidity or mood problems Objective : To determine the acceptability and clinical application of two recently developed goal - setting interventions ( Goal Management Training and Identity Oriented Goal Training ) in people with traumatic brain injury . Design : A three parallel group , r and omized controlled pilot study . Setting : Inpatient and community rehabilitation facilities . Subjects : Thirty-four people with moderate to severe traumatic brain injury ( Goal Management Training , n = 12 ; Identity Oriented Goal Training , n = 10 ; usual care , n = 12 ) and their rehabilitation clinicians . Interventions : For both Goal Management Training and Identity Oriented Goal Training participants met face to face with their key worker weekly over a period of 6—8 weeks , during which time the key worker worked to engage them in goal setting and goal performance using the strategy prescribed by their group allocation . Usual care was provided to the other participants . Main measures : Largely qualitative using observation , individual interviews and focus groups . Participants also completed a Goal Attainment Scale at baseline , post intervention and at three months follow-up . Results : Both approaches were acceptable to the majority of participants with many reporting improved mood and goal attainment . Clinicians found working in a different way with patients both challenging and rewarding , with both experimental approaches enhancing a focus on the person 's own goals . Identity Oriented Goal Training seemed particularly helpful in engaging people in the goal - setting process while Goal Management Training appeared particularly helpful in providing a structured framework for error prevention in attempting goal performance . Conclusion : These theoretically informed approaches to goal setting showed promise but were time intensive and at times difficult for practitioners to utilize 
    Output:
    
Conclusion : The main barriers and facilitators to goal - setting during stroke rehabilitation have been identified .
They suggest that current methods of goal - setting during inpatient/early stage stroke or neurological rehabilitation are not fit for purpose