Goal attainment scaling with older people in general practice: A feasibility study.

Abstract

The impact of health problems on daily life and consequent treatment goals differ from person to person, particularly for older people with multiple health problems. Personalized care in general practice can help address these health problems, but evaluation of its effects remains difficult. In rehabilitation, a common approach to the evaluation of personalized care is Goal Attainment Scaling. This feasibility study assesses whether goal attainment scaling can also be applied to the evaluation of personal care for community-dwelling older people in general practice. General practices were invited to participate in this longitudinal, observational feasibility study. Practice nurses and general practitioners received training in care plans and goal attainment scaling. They were each asked to create care plans and goal attainment scales for patients (aged ≥75 years) and to carry out evaluations at three and six months. Professionals and patients both completed a short questionnaire to evaluate their experiences regarding the (dis)advantages of goal attainment scaling. Professionals (n=10) and patients (n=23) were able to set goals and scales (n=57) for problems across five health domains (somatic, functional, social, psychological and communicative), but experienced difficulties formulating goals and corresponding goal attainment scaling levels. Reported benefits of goal attainment scaling were 1) important problems were addressed, 2) patients were involved and motivated to attain goals, and 3) evaluation was straightforward once a scale was created. Disadvantages were 1) difficult for older people, 2) time-consuming and complex for clinical practice. Goal attainment scaling shows potential benefit for clinical practice and general practice research in terms of the setting and evaluation of goals for community-dwelling older persons. Further research is needed to develop more standardized and less time-consuming goal attainment scaling methods.