TY - JOUR
T1 - Individual Goal Attainment Scaling versus standardized measures for evaluation outcome in rehabilitation.
T2 - American Academy of Physical and Rehabilitation Medicine. 68th Annual assembly. Boston
AU - Turner-Stokes, Lynne Frances
AU - Williams, H.
AU - Johnson, Juli
PY - 2007
Y1 - 2007
N2 - Objective: To compare Goal Attainment Scaling (GAS) and standardized measures in the evaluation of outcome following rehabilitation. Design: A prospective cohort analysis. Setting: A tertiary inpatient neurorehabilitation service for younger adults with complex neurologic disability. Participants: Consecutive patients (n=77; male/female ratio, 3:2; mean age ± SD, 45.5±14y) admitted for rehabilitation between January 3, 2005, and January 8, 2006, with diagnosis of 65% strokes, 22% other brain injury (eg, trauma, anoxia inflammation), and 13% other neurologic conditions. Interventions: An individualized goal-orientated rehabilitation program. Main Outcome Measures: Functional Assessment Measure (UK FIM+FAM), FIM instrument, and Barthel Index were measured on admission and discharge. GAS-rated achievement of 1 to 6 individual priority goals selected by the patients and agreed to by the treating team. Results: Mean length of stay was 82±45 days. All measures changed significantly between admission and discharge (P<.001). The mean GAS score was 32.2±5.0 at baseline and 45.9±7.2 at discharge. Median FIM+FAM scores were 124 (IQR, 93−151) baseline, and 168 (IQR, 136−191) at discharge. There was a moderately strong correlation between change in FIM+FAM and change in GAS score (Spearman ρ=0.4, P<.001); and slightly weaker correlations with change in FIM and Barthel Index (ρ=.35, ρ=.37; P<.001), respectively. Of 317 goals set, 241 were achieved or partially achieved, of which 10% were in areas not reflected in the standard measures (eg, parenting, work-related, use of computers). Conclusions: GAS provides an alternative individualized approach to assessment of outcome following rehabilitation, which may be used to assess change in areas of critical importance to the individual. While many goals overlap with items in commonly used standardized outcome measures, the relationship is only moderate, suggesting that GAS may perhaps offer added value as an adjunct to outcome measurement in patients with complex disability.
AB - Objective: To compare Goal Attainment Scaling (GAS) and standardized measures in the evaluation of outcome following rehabilitation. Design: A prospective cohort analysis. Setting: A tertiary inpatient neurorehabilitation service for younger adults with complex neurologic disability. Participants: Consecutive patients (n=77; male/female ratio, 3:2; mean age ± SD, 45.5±14y) admitted for rehabilitation between January 3, 2005, and January 8, 2006, with diagnosis of 65% strokes, 22% other brain injury (eg, trauma, anoxia inflammation), and 13% other neurologic conditions. Interventions: An individualized goal-orientated rehabilitation program. Main Outcome Measures: Functional Assessment Measure (UK FIM+FAM), FIM instrument, and Barthel Index were measured on admission and discharge. GAS-rated achievement of 1 to 6 individual priority goals selected by the patients and agreed to by the treating team. Results: Mean length of stay was 82±45 days. All measures changed significantly between admission and discharge (P<.001). The mean GAS score was 32.2±5.0 at baseline and 45.9±7.2 at discharge. Median FIM+FAM scores were 124 (IQR, 93−151) baseline, and 168 (IQR, 136−191) at discharge. There was a moderately strong correlation between change in FIM+FAM and change in GAS score (Spearman ρ=0.4, P<.001); and slightly weaker correlations with change in FIM and Barthel Index (ρ=.35, ρ=.37; P<.001), respectively. Of 317 goals set, 241 were achieved or partially achieved, of which 10% were in areas not reflected in the standard measures (eg, parenting, work-related, use of computers). Conclusions: GAS provides an alternative individualized approach to assessment of outcome following rehabilitation, which may be used to assess change in areas of critical importance to the individual. While many goals overlap with items in commonly used standardized outcome measures, the relationship is only moderate, suggesting that GAS may perhaps offer added value as an adjunct to outcome measurement in patients with complex disability.
U2 - 10.1016/j.apmr.2007.06.553
DO - 10.1016/j.apmr.2007.06.553
M3 - Poster abstract
SN - 0003-9993
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
ER -