To address the most important issues confronting Monica, the rehabilitation team defined ‘health maintenance’ and ‘prevention of pressure ulcers (PUs)’ as her global goals. Since the surgical incision was healing well and the standardized treatment scheme allowed Monica more activity, the rehabilitation team established a new service-program goal for this Rehab-Cycle® – independence in daily living.
To help achieve ‘independence in daily living’, three cycle goals were defined. Although Monica's skin was healing well, the rehabilitation team decided that cycle goal 1 should be to continue focusing on improving the structure of the skin and in skin healing. Cycle goal 2 focused on ‘mobility’ i.e. reduction of Monica’s physical limitations. Without any support, Monica remained bedridden at the start of this Rehab-Cycle®. Lastly, cycle goal 3 was defined as ‘looking after one’s health’; this included the prevention of future PUs and other secondary complications of spinal cord injury.((Please anchor “PUs” in this sentence with box 2))
"...the surgical incision was healing well..."
Intervention targets were established by the rehabilitation team for each of the three cycle goals. Intervention targets are ICF categories that correspond to specific goals outlined in the ICF Categorical Profile and that are to be addressed with interventions in a rehabilitation program. In Monica's case, the intervention targets related to the healing of the skin involved the ‘repair functions of the skin’ and the ‘structure of areas of the skin’. The intervention targets identified to help improve mobility were ‘supportive functions of the arms’, ‘transferring oneself’ and ‘changing basic body positions’ – all of which needed to be addressed in consideration of Monica's heightened risk of developing PUs.
Addressing cycle goal 3 ‘looking after one’s health’ was more complex. The intervention targets that were identified for addressing cycle goal 3 were behavioural in nature. This included improvement of the body function ‘body image’ and some of the personal factors identified during the assessment phase i.e. emotional instability, low acceptance of disease, limited self-responsibility and low levels of health behaviour. The extent to which Monica was able to look after her health naturally had consequences on reaching and maintaining success in the other two cycle goals.