Age and Ageing, Vol 28, 275-281, Copyright © 1999 by British Geriatrics Society
JE Gordon, C Powell and K Rockwood
OBJECTIVES:To assess the feasibility, validity and responsiveness of an
individualized measure--goal attainment scaling-in long-term care. DESIGN:
Prospective descriptive study. SETTING: One academic and three
community-based long-term care facilities. SUBJECTS: 53 nursing-home
patients seen in consultation between July 1996 and June 1997.
INTERVENTION: Specialized geriatric medicine consultation. MAIN OUTCOME
MEASURES: 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). CONCLUSION: 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.
ARTICLES
Goal attainment scaling as a measure of clinically important change in nursing-home patients
Centre for Health Care of the Elderly, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
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