Goal attainment scaling as a measure of clinically important change in nursing-home patients.
OBJECTIVE
To assess the feasibility, validity and responsiveness of an individualized measure--goal attainment scaling-in long-term care.


METHODS
Prospective descriptive study.


METHODS
One academic and three community-based long-term care facilities.


METHODS
53 nursing-home patients seen in consultation between July 1996 and June 1997.


METHODS
Specialized geriatric medicine consultation.


METHODS
Effect size and relative efficiency of the Barthel index, hierarchical assessment of balance and mobility, global deterioration scale, axis 8 (behaviour) of the brief cognitive rating scale, cumulative illness rating scale and the goal attainment scale.


RESULTS
Mean goal attainment scale at follow-up was 46+/-7. The goal attainment scale was the most responsive measure, with an effect size of 1.29 and a relative efficiency of 53.7. The goal attainment scale did not correlate well with the other measures (-0.22 to 0.17).


CONCLUSIONS
Goal attainment scaling is a feasible and responsive measure in long-term care. Although fewer problems in nursing-home patients than elderly inpatients are susceptible to intervention, clinically important goals can be achieved in this population.
Gordon
J E
JE
Centre for Health Care of the Elderly, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
Powell
C
C
Rockwood
K
K
D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000534:rehabilitation*; D003704:Dementia / Q000534:rehabilitation; D006233:Persons with Disabilities / Q000534:rehabilitation; D006040:Goals; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D009735:Nursing Homes; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D011594:Psychometrics; D015203:Reproducibility of Results