The Validity of Goal Achievement as an Outcome Measure in Physical Rehabilitation Day Hospitals for Older People

Abstract

Physical rehabilitation day hospitals are widely used community-based services designed to meet the medical and rehabilitation needs of older people. While there is evidence for the effectiveness of these services, concerns about the shortcomings of how this is measured has led to the recommendation the achievement of individually tailored goals be used to assess outcomes. This study considered whether such goal achievement demonstrated validity with respect to a standardised measure. The association between goal achievement and change in Nottingham Health Profile-Part 1 (NHP-1) scores was considered for 102 people attending four physical rehabilitation day hospitals. The predicted significant positive relationship between the percentage of goals achieved by participants and NHP-1 scores was not found.This remained evident when functional goals were considered separately to medical goals.

A multi-site study of the feasibility and clinical utility of Goal Attainment Scaling in geriatric day hospitals

“…These findings contradict results from a recent investigation of the congruence of goal achievement (not specifically GAS) with the Nottingham Health Profile (NHP-1) in a sample of older adults participating in physical rehabilitation day hospitals [66]. Kneebone et al [66] predicted a significant positive relationship between the percentage of goals achieved and NHP-1 scores, however they found that the actual relationship was highly quadratic (curvilinear) -for participants who had higher than average scores, there was a significant negative association between the goal achievement and NHP-1 scores and for those with lower than average scores, there was a significant positive association. We suspect their results relate to their choice of the NHP as their comparative measure, which we have found in earlier work to be unresponsive to change in a geriatric rehabilitation setting [33].…”

Implementierung von ICF als Sprache und Struktur in die Teambesprechung der muskulo-skelettalen Rehabilitation

“…Wesentliches Ziel der Teambesprechung ist, die rehabilitativen Inhalte orientiert an den individuellen Teilhabezielen des Patienten abzustimmen und im Verlauf im Sinne des Rehab-CYCLE ® -Modells zu justieren [14]. Der Vorteil einer Zielorientierung von rehabilitativen Maßnahmen ist gut untersucht und in der Rehabilitation fest etabliert [15][16][17]. Die praktische Umsetzung und Strukturierung der Teambesprechung im Rahmen einer rehabilitativen Maßnahme ist jedoch bisher nicht verbindlich und nur für einzelne Bereiche beispielhaft beschrieben [18][19][20].…”