Goal attainment scaling as a measure of clinically important change in nursing-home patients.

Abstract

To assess the feasibility, validity and responsiveness of an individualized measure--goal attainment scaling-in long-term care. Prospective descriptive study. One academic and three community-based long-term care facilities. 53 nursing-home patients seen in consultation between July 1996 and June 1997. Specialized geriatric medicine consultation. 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. 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). 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.