Goal attainment scaling outcomes in general inpatient rehabilitation: association with functional independence and perceived goal importance and difficulty
Irina Churilov, Kim Brock, James M. Churilov, Emma Sutton, David Murphy, Richard J. MacIsaac , Elif I. Ekinci
Department of Rehabilitation, St Vincent’s Hospital Melbourne, Fitzroy, Australia. E-mail: Irina.Churilov@gmail.com
Objective: To investigate the association of goal attainment scaling outcomes with change in the Func-tional Independence Measure, and the association between the perceived importance, difficulty and degree of achievement of individual goals in general inpatient rehabilitation.
Design: Prospective cohort study.
Participants: A total of 208 participants admitted to inpatient rehabilitation in a metropolitan tertiary referral hospital in Melbourne, Australia.
Methods: Participants determined the nature of the goals and their importance, and therapists determined the difficulty of the goals. The associations were investigated using median regression and random effect ordinal regression.
Results: An increase of each point in the goal attainment scaling score was associated with an adjusted median increase of 0.34 points (95% confidence interval (CI): 0.18–0.5, p < 0.001) in Functional Independence Measure change. More important goals of similar difficulty (very important vs a little important: adjusted common odds ratio (cOR) = 1.97, 95% CI: 1.01–3.83, p = 0.045) and less difficult goals of similar importance (moderately difficult vs a little difficult cOR = 0.59, 95% CI: 0.04–0.87, p = 0.007; very difficult vs a little difficult cOR = 0.59, 95% CI 0.37–0.94, p = 0.027) were better achieved.
Conclusion: Rehabilitation progress measured using the goal attainment scaling method is associated with changes in functional outcomes. For goals with similar difficulty, those with higher importance were better achieved, while for goals with similar importance, less difficult goals were better achieved.
In inpatient rehabilitation the progress made by patients can be measured by setting them individual goals, then measuring how well they achieve the goals using a me-thod called “goal attainment scaling”. An important part of this method is articulating the importance of the set goals by the patient. This study investigates how well the set goals are achieved and whether this can help with understanding patient’s progress in rehabilitation. The results show that the goal attainment scaling me-thod accurately describes patients’ progress in rehabilitation. Goals of similar difficulty that patients considered more important were better achieved. Further research is needed to find out whether routine discussion with the patient of the importance of setting goals is associated with better patient progress in rehabilitation.
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