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Balkin, Richard S. "Validation of the Goal Attainment Scale of Stabilization." Measurement and Evaluation in Counseling and Development 46, no. 4 (October 2013): 261–69. http://dx.doi.org/10.1177/0748175613497040.
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LIN, Dong, Wanyu ZHUANG, Xiaozhen HUANG, Lili LIN, and Qiang WU. "Goal Attainment Scale and Clinical Efficacy Evaluation of Acupuncture." Rehabilitation Medicine 25, no. 3 (2015): 18. http://dx.doi.org/10.3724/sp.j.1329.2015.03018.
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Urach, S., CMW Gaasterland, M. Posch, B. Jilma, K. Roes, G. Rosenkranz, JH Van der Lee, and R. Ristl. "Statistical analysis of Goal Attainment Scaling endpoints in randomised trials." Statistical Methods in Medical Research 28, no. 6 (June 19, 2018): 1893–910. http://dx.doi.org/10.1177/0962280218777896.
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Goal Attainment Scaling is an assessment instrument to evaluate interventions on the basis of individual, patient-specific goals. The attainment of these goals is mapped in a pre-specified way to attainment levels on an ordinal scale, which is common to all goals. This approach is patient-centred and allows one to integrate the outcomes of patients with very heterogeneous symptoms. The latter is of particular importance in clinical trials in rare diseases because it enables larger sample sizes by including a broader patient population. In this paper, we focus on the statistical analysis of Goal Attainment Scaling outcomes for the comparison of two treatments in randomised clinical trials. Building on a general statistical model, we investigate the properties of different hypothesis testing approaches. Additionally, we propose a latent variable approach to generate Goal Attainment Scaling data in a simulation study, to assess the impact of model parameters such as the number of goals per patient and their correlation, the choice of discretisation thresholds and the type of design (parallel group or cross-over). Based on our findings, we give recommendations for the design of clinical trials with a Goal Attainment Scaling endpoint. Furthermore, we discuss an application of Goal Attainment Scaling in a clinical trial in mastocytosis.
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Rew, Lynn, and Heather Becker. "Use of a Goal-Attainment Scale With Homeless Young Women." Journal of Adolescent Health 58, no. 2 (February 2016): S52—S53. http://dx.doi.org/10.1016/j.jadohealth.2015.10.117.
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Boltz, Marie, Ashley Kuzmik, Barbara Resnick, Irene Best, and Jacqueline Mogle. "Engagement of Family in a Goal Setting Strategy: Impact Upon 30-Day Hospital Readmissions." Innovation in Aging 5, Supplement_1 (December 1, 2021): 373. http://dx.doi.org/10.1093/geroni/igab046.1447.
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Abstract Family-centered Function-focused Care (Fam-FFC) works with family caregivers as care partners in the assessment, function-promoting goal setting, implementation, and evaluation of goal attainment during hospitalization and immediate post-acute period. ANCOVA technique examined the preliminary impact of Fam-FFC upon 30-day hospital readmissions and logistic regression tested the association of goal attainment, measured with the Goal Attainment Scale (GAS) with 30-day hospital readmissions. The majority of the patients were Black (50%), female (62%), had a mean age of 81.6 (SD=8.4), mean Barthel Index of 60.29 (SD=27.7), and mean MoCA of 10.67 (SD=7.0). Goals represented six main categories: mobility, cognition, self-care, toileting, sleep, and pain management. Patients in the intervention group had less 30-day hospitalizations (F= 4.6, p=.033) and goal attainment was significantly associated with less recidivism (B=.179, Wald= 2.8 (1), p= .045). FamFFC shows promise in reducing 30-day hospital readmissions; results support the contribution of family engagement and use of GAS
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Georgy, Ehab. "Stroke early supported discharge: the impact of patients' characteristics and clinical profile on rehabilitation goal attainment and clinical outcomes." International Journal of Therapy and Rehabilitation 28, no. 3 (March 2, 2021): 1–11. http://dx.doi.org/10.12968/ijtr.2020.0009.
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Background/aims Stroke early supported discharge services were introduced to provide a comprehensive stroke specialist therapy input, while reducing cost of acute care. Early supported discharge services resulted in better health-related outcomes. A consensus has not yet been established regarding specific early supported discharge patient characteristics and clinical profile. The main aim of this study was to establish evidence to support the development of an early supported discharge patient profile (demographics and clinical) and eligibility criteria to enable early supported discharge services achieve their purposes of reducing post-stroke disability and institutionalisation rates. This article outlines the relationship between early supported discharge patients' clinical profiles and clinical outcomes, in terms of disability, goal attainment and institutionalisation rates. Methods A retrospective review of data was implemented to determine whether specific early supported discharge patients' clinical profiles and characteristics correlate with clinical outcomes. Data were collected for patients admitted to the Suffolk Stroke Early Supported Discharge Service between August and October 2016, comprising patients' demographics and clinical profiles, including stroke type, Barthel Index and Modified Rankin Scale. Performance data were collected at the end of the early supported discharge service including therapy frequency and intensity, as well as clinical outcomes including the Goal Attainment Scale. Results Data were collected for 53 patients. Data were analysed for all patients in three groups: goals not achieved; goals achieved; and goals achieved to a higher level), according to the Goal Attainment Scale. A Chi-square test showed no significant difference with regard to sex and stroke side (P=0.27). Analysis of variance revealed no significant difference in age. Conversely, results showed a significant association between goal attainment and the stroke subtype, severity and length of hospital stay. Conclusions Specific clinical characteristics and disease profiles correlate with functional outcomes and could influence goal attainment and functional status. A specific patient cohort seems to benefit the most from early supported discharge services in terms of optimised functional outcomes and recovery.
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Trawińska, Joanna, Joanna Skręt-Magierło, Renata Raś, Bogusław Gawlik, Andrzej Skręt, Sławomir Januszek, and Edyta Barnaś. "Nomothetic EORTC IN-PATSAT 32 and idiographic GAS questionnaires in the assessment of surgical treatment in patients with endometrial cancer." Current Gynecologic Oncology 19, no. 1 (July 30, 2021): e1-e7. http://dx.doi.org/10.15557/cgo.2021.0001.
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Introduction: Identification and attainment of the goals of cancer patients is an important aspect of personalized treatment. Aim of the study: The study aimed to assess the following aspects in patients treated surgically for endometrial cancer: 1) level of satisfaction with hospitalization using the EORTC IN-PATSAT32 nomothetic questionnaire; 2) degree of goals attainment using the Goal Attainment Scaling (GAS) idiographic questionnaire; 3) correlation between these evaluation methods. Material and method: The study included 123 patients with endometrial cancer (FIGO I–II) treated surgically at the Department of Obstetrics and Gynecology in Rzeszów in 2012–2014. EORTC IN-PATSAT32 and GAS questionnaires were used. The collected material was analyzed using the Statistica 10.0 software. Results: The overall level of satisfaction measured with the IN-PATSAT32 scale was 72.2 ± 20.5. The technical skills were rated the highest in nurses (74.5 ± 17.6) and doctors (69.3 ± 17.8), while the lowest score was awarded for hospital assess (54.7 ± 23.3). The overall satisfaction with care was 72.2 ± 20.5. In the personalized GAS scale, the patients listed individual expectations before the surgery, assigning ranks to their importance. For most of them, it was a very high (A) or high (B) rank. The patients assigned the highest ranks to quick mobilization, success of the operation, and willingness to be healthy. The average value of the level of goal attainment on the discharge date was 63.7 ± 9.4 points. Statistically significant correlations between the questionnaires were found for the level of goal attainment and the assessment of various aspects of hospital care. Conclusions: The study proved that the EORTC IN-PATSAT32 questionnaire was correlated with GAS questionnaire, and additionally provided knowledge about individual goals of care and the degree of their attainment. The use of nomothetic and idiographic tools gives wider possibilities in the planning and implementation of personalized care.
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Mowell, Barry. "NGO Goal-Setting/Attainment and Perceptions of Benefits Derived within the Framework of the UNECOSOC Consultative Status Program." Open Political Science 3, no. 1 (May 29, 2020): 97–116. http://dx.doi.org/10.1515/openps-2020-0009.
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AbstractThe main vehicle in the UN-NGO dynamic is the consultative status program within the UN Economic and Social Council (ECOSOC). Existing literature addresses UN efforts in facilitating formal collaboration with international civil society, but little research has been undertaken to examine macro-scale patterns of NGOs within such collaborations. This study sought to partly address the latter gap in the literature by examining NGO goals and goal/benefit attainment within the UN-ECOSOC consultative status program. The results of a survey sent to a random sample of 10% of all NGOs holding consultative status revealed that (1) a varied range of both extrinsic and intrinsic considerations motivated NGOs to acquire consultative status; (2) NGOs commonly were not achieving their initial goals or otherwise not deriving benefit from the collaboration; and (3) the degree/sense of goal or benefit attainment correlated strongly with the level of accreditation afforded to NGOs, with lower levels of consultative status usually corresponding to lower reported levels of goal/benefit attainment.
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Barclay, David A. "Impact of “Sick” and “Recovery” Roles on Brain Injury Rehabilitation Outcomes." Rehabilitation Research and Practice 2012 (2012): 1–10. http://dx.doi.org/10.1155/2012/725078.
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This study utilizes a multivariate, correlational, expost facto research design to examine Parsons’ “sick role” as a dynamic, time-sensitive process of “sick role” and “recovery role” and the impact of this process on goal attainment (H1) and psychosocial distress (H2) of adult survivors of acquired brain injury. Measures used include the Brief Symptom Inventory-18, a Goal Attainment Scale, and an original instrument to measure sick role process. 60 survivors of ABI enrolled in community reentry rehabilitation participated. Stepwise regression analyses did not fully support the multivariate hypotheses. Two models emerged from the stepwise analyses. Goal attainment, gender, and postrehab responsibilities accounted for 40% of the shared variance of psychosocial distress. Anxiety and depression accounted for 22% of the shared variance of goal attainment with anxiety contributing to the majority of the explained variance. Bivariate analysis found sick role variables, anxiety, somatization, depression, gender, and goal attainment as significant. The study has implications for ABI rehabilitation in placing greater emphasis on sick role processes, anxiety, gender, and goal attainment in guiding program planning and future research with survivors of ABI.
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Cairns, Alice, David Kavanagh, Frances Dark, and Steven M. McPhail. "Setting measurable goals with young people: Qualitative feedback from the Goal Attainment Scale in youth mental health." British Journal of Occupational Therapy 78, no. 4 (April 2015): 253–59. http://dx.doi.org/10.1177/0308022614562584.
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Lee, R., D. Lam, W. Mansell, and A. Farmer. "Sense of hyper-positive self, goal-attainment beliefs and coping strategies in bipolar I disorder." Psychological Medicine 40, no. 6 (September 15, 2009): 967–75. http://dx.doi.org/10.1017/s0033291709991206.
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BackgroundThere is some evidence that cognitive therapy (CT) is beneficial in reducing relapses in bipolar disorder. However, not all bipolar patients benefit from it. A previous study found that a group of non-responders to CT shared common characteristics: they value some of the high goal-attainment beliefs and characteristics associated with being in a state of mild hypomania – a high ‘sense of hyper-positive self’ (SHPS). To promote of our understanding of this group of patients, the present study investigated the relationship between SHPS, preferred internal state, dysfunctional attitudes and coping with hypothetical manic prodromal scenarios.MethodFifty-four bipolar I patients filled in self-report questionnaires that assess preferred mood state, coping with scenarios, dysfunctional attitudes and SHPS.ResultsThe Sense of Hyper-positive Self Scale Ideal score (SHPSS-Ideal) predicted patients' preferred internal state of mania. Coping with hypothetical scenarios was predicted by Dysfunctional Attitude Scale (DAS) goal-attainment scores: the higher the goal-attainment score, the higher the participant's tendency to identify with self-descriptors linked to hypomania and to engage in stimulating behaviours that may escalate the prodromal stage to mania.ConclusionsClinicians should check and modify goal-attainment beliefs, particularly of those who exhibit features of SHPS. These patients' tendency to identify with hypomanic traits as self-descriptors should be dealt with by psychological techniques such as cognitive restructuring.
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Shi, Zhaofeng, Chen Zhao, Manke Guan, Xuxu Wei, Jiayuan Hu, Xiaoyu Zhang, Min Li, and Hongcai Shang. "Individualized Efficiency of Traditional Chinese Medicine for Non-ST Segment Elevation Acute Coronary Syndrome: Study Protocol for Observational Research by the Evidence-Based Goal Attainment Scale." Evidence-Based Complementary and Alternative Medicine 2020 (September 14, 2020): 1–9. http://dx.doi.org/10.1155/2020/7653040.
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Background. Non-ST segment elevation acute coronary syndrome has been one of the most serious diseases threatening human health. Long-term cardiac rehabilitation and secondary prevention is the essential method to control the recurrence and mortality of the disease. Traditional Chinese medicine has proved the efficiency on the treatment of non-ST segment elevation acute coronary syndrome, but there is a lack of appropriate methodological design to reflect the characteristics of individualized diagnosis and treatment of it. Therefore, this study used the evidenced-based Goal Attainment Scale to evaluate the clinical effectiveness of traditional Chinese medicine on the treatment of non-ST segment elevation acute coronary syndrome. Method. This is observational research with the prospective feature. A total of 200 patients will be recruited and observed in the three months by telephone or door visit, collecting the individualized intervention of traditional Chinese medicine and evaluating through the method of evidence-based Goal Attainment Scale. Participants will be included according to the inclusion and exclusion criteria. Any reasons for loss to follow-up and adverse events will be recorded strictly. Discussion. The evidence-based Goal Attainment Scale provides a personalized method of evaluation based on the Goal Attainment Scale and combined with evidence-based medicine, which can better reflect the characteristics and superiority of individualized and dynamic intervention for traditional Chinese medicine on the long-term prevention and treatment of non-ST segment elevation acute coronary syndrome than other methods of design. It is of great significance to explore and promote this method of design in the future.
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Newton, Margaret. "Evaluating the outcome of counselling in primary care using a goal attainment scale." Counselling Psychology Quarterly 15, no. 1 (March 2002): 85–89. http://dx.doi.org/10.1080/09515070110104033.
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Gordon, Andi B., Mark L. McMulkin, and Glen O. Baird. "Modified Goal Attainment Scale outcomes for ambulatory children: With and without orthopedic surgery." Gait & Posture 33, no. 1 (January 2011): 77–82. http://dx.doi.org/10.1016/j.gaitpost.2010.09.028.
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Debreceni-Nagy, Adél, Judit Horváth, Szabina Nagy, Ágnes Bajusz-Leny, and Zoltán Jenei. "Feasibility of six-point Goal Attainment Scale among subacute and chronic stroke patients." International Journal of Rehabilitation Research 42, no. 4 (December 2019): 365–70. http://dx.doi.org/10.1097/mrr.0000000000000372.
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Hanlan, A., P. Mills, R. Lipson, and H. Finlayson. "Interdisciplinary spasticity management clinic outcomes using the Goal Attainment Scale: A retrospective chart review." Journal of Rehabilitation Medicine 49, no. 5 (2017): 423–30. http://dx.doi.org/10.2340/16501977-2228.
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Peters, Jaclyn, Kevin Choi, Elizabeth Chapman, Andrew Tri, Sarah Lim, Farooq Ismail, Chris Boulias, Shannon Gallagher, and Chetan P. Phadke. "Spasticity and Goal Attainment Scale Characteristics in Individuals Receiving Botulinum Toxin Type-A Injections." Archives of Physical Medicine and Rehabilitation 95, no. 10 (October 2014): e86. http://dx.doi.org/10.1016/j.apmr.2014.07.284.
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Zhang, Cheng, Chee Wei Phang, Qingsheng Wu, and Xueming Luo. "Nonlinear Effects of Social Connections and Interactions on Individual Goal Attainment and Spending: Evidences from Online Gaming Markets." Journal of Marketing 81, no. 6 (November 2017): 132–55. http://dx.doi.org/10.1509/jm.16.0038.
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Although it seems intuitive for firms to leverage social connections and interactions to influence consumers’ goal attainment and spending, the authors present a caveat of such strategies. Using two large-scale data sets with more than 5 million people-day observations from online gaming markets, Studies 1 and 2 show consistently nonlinear effects. Although some social connections and interactions boost goal attainment and spending (positive linear term), after a certain point too many of them have a diminished marginal effect (negative squared term). The results are robust to a wide array of modeling techniques addressing self-selection, unobserved individual heterogeneity, and endogeneity. In addition, novices can benefit more from greater social connections and interactions, yet also suffer more from the diminishing effects. Regarding the underlying mechanism, the follow-up experiment Study 3 shows that consistent with the information processing theory, some social connections and interactions can provide information support for goal attainment, but too many of them can introduce an information overload problem and, thus, hamper goal attainment intention. Together, these findings refute a simple, linear view of the effects of social connections and interactions and provide pivotal theoretical and practical implications.
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López de Munain, Lourdes, Josep Valls-Solé, Irene Garcia Pascual, and Pascal Maisonobe. "Botulinum Toxin Type A Improves Function According to Goal Attainment in Adults with Poststroke Lower Limb Spasticity in Real Life Practice." European Neurology 82, no. 1-3 (2019): 1–8. http://dx.doi.org/10.1159/000503172.
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Introduction: Botulinum toxin type A (BoNT-A) is an effective and well-tolerated treatment for adult lower limb spasticity. However, data are inadequate to determine BoNT-A efficacy for active function. This study evaluated functional goal achievement (measured by goal attainment scaling [GAS]) following lower limb BoNT-A injection in clinical practice. Methods: Phase 4, postmarketing, multicenter, prospective, observational study (NCT01444794) in adults with poststroke lower limb spasticity receiving one BoNT-A injection cycle. Assessments were at baseline (pretreatment), 1 month ±7 days (visit 1), and 3–5 months posttreatment (visit 2). Primary outcome measure was GAS; additional assessments included Modified Ashworth Scale, Demeurisse Motricity Index, 10-meter walk test, and Disability Assessment Scale. Results: Of 100 enrolled patients, 94 completed the study. Most common primary treatment goals at baseline were improving mobility (57.5%) and positioning (18.1%). At visit 2, 88.3% achieved their primary goal; 87.0% (n = 47/54) for mobility, and 100.0% (n = 17/17) for positioning. In total, 79.1% of patients achieved their secondary goals. Two factors were predictive of primary goal achievement: time since stroke onset (OR 0.907; 95% CI 0.827–0.995; p = 0.038); and absence of stiff knee spasticity pattern (OR 0.228; 95% CI 0.057–0.911; p = 0.036). All functional scales showed improvements; walking speed (mean [SD]) improved by 0.06 (0.13) and 0.05 (0.20) m/s at visits 1 and 2, respectively. Conclusions: BoNT-A injection for lower limb spasticity led to high goal achievement rates in patient-centered GAS evaluation and functional and symptomatic improvements. BoNT-A may therefore deliver clinically meaningful functional improvements in real-life practice.
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Baggio, Louis, and David J. Buckley. "Detecting change in patient outcomes in a rural ambulatory rehabilitation service: the responsiveness of Goal Attainment Scaling and the Lawton Scale." Australian Health Review 40, no. 1 (2016): 63. http://dx.doi.org/10.1071/ah14218.
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Objective The Wagga Wagga Ambulatory Rehabilitation Service (WWARS) clinicians felt the Australian Modified Lawton’s Instrumental Activities of Daily Living Scale (Lawton Scale) was unresponsive to changes detected in many patients following their individualised programs. This study examined the performance of the Goal Attainment Scaling (GAS) concomitantly with the Lawton Scale in ambulatory rehabilitation patients. Methods Consecutive patients (n = 83) of WWARS were evaluated pre and post treatment with the Lawton Scale and GAS. The statistical properties, particularly responsiveness, of the scales were compared. Results Statistically significant change (P < 0.001) was observed following treatment on both the Lawton Scale and GAS. Mean GAS scores changed by 38.7% compared with 8.3% for the Lawton Scale. GAS demonstrated a greater effect size (Cliff’s δ) of 1.67 (95% confidence interval 1.51–1.91) than the Lawton Scale 0.83 (95% confidence interval 0.57–0.94). In 33.7% of patients, the Lawton Scale was invariant but improved with GAS. Conclusions GAS was a more responsive measure than the Lawton Scale in rural ambulatory rehabilitation patients. Consequently, GAS is recommended as a performance outcome measure in the evaluation of ambulatory rehabilitation services to supplement standardised outcome measures such as the Lawton Scale. What is known about the topic? GAS has been shown to be more responsive in detecting changes in patient outcomes than the original Lawton’s Instrumental Activities of Daily Living Scale when assessing the requirements of the elderly for geriatric services and for people with acquired brain injury undergoing cognitive rehabilitation. Its responsiveness in patients with greater casemix diversity, such as those found in rural ambulatory rehabilitation services, remains uncertain. What does this paper add? This study demonstrates GAS is more responsive than the Lawton Scale for detecting clinically meaningful change in a rural Australian ambulatory rehabilitation service delivering programs to people with heterogeneous goals. What are the implications for practitioners? GAS facilitates the delivery of patient-centred care, accommodates the heterogeneity of patient-centred goals for evaluation, and better measures goal-achievement. Global standardised measures such as the Lawton Scale may be useful for the comparison of differing patient populations, but a weakness is they may not capture the individualised goals valued by each patient seen in rehabilitation. Consequently, GAS should be considered as an additional outcome measure in the evaluation of ambulatory rehabilitation services in assessing program effectiveness and possibly for service comparison. Furthermore, ongoing training and support in GAS application should be provided to ensure the maintenance of accurate goal setting and scaling.
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Guyot, Patricia, Chrysostomos Kalyvas, Carole Mamane, and Natalya Danchenko. "Botulinum Toxins Type A (Bont-A) in the Management of Lower Limb Spasticity in Children: A Systematic Literature Review and Bayesian Network Meta-analysis." Journal of Child Neurology 34, no. 7 (February 25, 2019): 371–81. http://dx.doi.org/10.1177/0883073819830579.
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Background: Botulinum neurotoxins type A (BoNT-As) are used in pediatric lower limb spasticity, which affects more than 2.5 million children worldwide. Botulinum neurotoxins type-A improve active function and delay musculoskeletal complications. The objective of this analysis was to evaluate the efficacy and safety of abobotulinumtoxinA versus other botulinum neurotoxins type A in pediatric spasticity, in the absence of head-to-head evidence. Methods: A systematic literature review was conducted to identify relevant randomized controlled trials. The evidence base was synthesized with Bayesian network meta-analyses. Outcomes analyzed included Modified Ashworth Scale, Tardieu Scale (TS) spasticity grade, and Goal Attainment Scale (standard mean difference only) at 12 weeks postinjection, and adverse events occurring during study periods. Results: Thirty-eight studies were identified, 10 of which met inclusion criteria for quantitative synthesis. On Modified Ashworth Scale, abobotulinumtoxinA 15 U/kg/leg was significantly more efficacious than onabotulinumtoxinA 4 U/kg/leg (–0.99 [–1.34, –0.64]) and onabotulinumtoxinA 4 U/kg/leg+casting (–0.81 [–1.16, –0.46]) and numerically better than onabotulinumtoxinA 8 U/kg (–0.40 [–0.67, –0.14]). AbobotulinumtoxinA 10 U/kg/leg was significantly more efficacious than onabotulinumtoxinA 4 U/kg/leg (±casting). On Goal Attainment Scale, abobotulinumtoxinA 15 U/kg/leg and 10 U/kg/leg were significantly more efficacious than onabotulinumtoxinA 12 U/kg/leg. On Tardieu Scale spasticity grade, abobotulinumtoxinA was comparable to other treatments. AbobotulinumtoxinA demonstrated adverse event rates comparable to all doses of onabotulinumtoxinA. Conclusions: In pediatric lower limb spasticity, abobotulinumtoxinA offered significant or numerical efficacy advantages on tone (Modified Ashworth Scale) and functional outcomes (Goal Attainment Scale), and comparable efficacy on Tardieu Scale spasticity grade. AbobotulinumtoxinA was comparable to onabotulinumtoxinA on tolerability. Results should be interpreted in the context of heterogeneity and sparsity of the evidence base.
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Delgado, Mauricio R., Marcin Bonikowski, Jorge Carranza, Edward Dabrowski, Dennis Matthews, Barry Russman, Ann Tilton, Juan Carlos Velez, Anne-Sophie Grandoulier, and Philippe Picaut. "Safety and Efficacy of Repeat Open-Label AbobotulinumtoxinA Treatment in Pediatric Cerebral Palsy." Journal of Child Neurology 32, no. 13 (September 15, 2017): 1058–64. http://dx.doi.org/10.1177/0883073817729918.
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This was a prospective, repeat-treatment, open-label study (NCT01251380) of abobotulinumtoxinA for the management of lower limb spasticity in children who had completed a double-blind study. Children (2-17 years) received injections into the gastrocnemius-soleus complex, and other distal and proximal muscles as required (maximum total dose per injection cycle: 30 U/kg or 1000U). A total of 216 of the 241 double-blind patients entered the extension study and 207 received ≥1 open label injection into the gastrocnemius-soleus; 17-24% of patients also had injections into the hamstrings. The most frequent adverse events were related to common childhood infections and the most frequent treatment-related adverse event was injection site pain (n = 10). There was no evidence of a cumulative effect on adverse events. Sustained significant clinical improvements in muscle tone (Modified Ashworth Scale), spasticity (Tardieu Scale), overall clinical benefit (Physicians Global Assessment), and goal attainment (Goal Attainment Scale) were also observed across treatment cycles.
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Jung, Youngsu, Jaehoon Sim, Joonhyun Park, Jongmoon Kim, and MinYoung Kim. "Usefulness of Goal Attainment Scaling in Intensive Stroke Rehabilitation During the Subacute Stage." Annals of Rehabilitation Medicine 44, no. 3 (June 30, 2020): 181–94. http://dx.doi.org/10.5535/arm.19087.
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Objective To investigate the usefulness of goal attainment scaling (GAS) in intensive stroke rehabilitation during the subacute stage.Methods Medical records of subacute post-stroke patients who had undergone intensive rehabilitation under hospitalization, before and after the application of GAS, were collected. GAS was conducted at the initial evaluation of each patient. Specific goals were suggested by physical and occupational therapists and were determined by the responsible physiatrist. A 5-point scale was used for the GAS score after 4 weeks of rehabilitation according to the preset criteria of each goal. To evaluate the influence of GAS in rehabilitation practice, functional improvements were compared between two patient groups before (n=121) and after (n=141) GAS. To assess progress in GAS practice, the standard GAS score was calculated, and the changes were observed over a 3-year period. The standard GAS score converged to 50 points when the goal was achieved. The therapists who used GAS also completed a survey regarding its usefulness.Results There were no statistical differences in the motor and cognitive outcomes of the patient groups before and after applying GAS scoring. Successive yearly changes in the standard GAS scores showed progressive convergence to 50 points, signaling that the patient’s goal-setting abilities improved. According to the survey, most therapists felt that GAS enhanced the quality of therapies (84.6%).Conclusion GAS improved goal-setting for the rehabilitation of subacute post-stroke patients and might have a positive effect on rehabilitation.
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Joireman, Jeffrey A. "Additional Evidence for Validity of the Consideration of Future Consequences Scale in an Academic Setting." Psychological Reports 84, no. 3_suppl (June 1999): 1171–72. http://dx.doi.org/10.2466/pr0.1999.84.3c.1171.
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The present study examined the relationship between scores on the Consideration of Future Consequences scale and academic achievement within two samples of undergraduates ( ns = 36 and 24) enrolled in separate statistics courses. Scale scores were positively correlated with grade point average in both samples and predicted success and goal attainment within the second sample.
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Paul, Friedemann, and Carlos Vila Silván. "Effect of nabiximols on Goal Attainment Scale scores in patients with treatment-resistant multiple sclerosis spasticity." Neurodegenerative Disease Management 11, no. 2 (April 2021): 143–53. http://dx.doi.org/10.2217/nmt-2020-0060.
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Background: Nabiximols oromucosal spray (Sativex®) is an approved add-on treatment option for moderate-to-severe treatment-resistant multiple sclerosis (MS) spasticity. Materials & methods: This prospective, observational, noninterventional, 3-month follow-up pilot study assessed the evolution of patient-selected goal attainment scale (GAS) item scores and of MS spasticity and associated symptoms during nabiximols treatment. Results: In the full analysis set (n = 21), the mean (SD) overall unweighted GAS score increased from 32.1 (3.4) at baseline to 43.6 (14.6) at month 3 (p = 0.0060), constituting a clinically meaningful change. Slight improvements were observed in MS spasticity and most associated symptoms. Nabiximols improved walking ability and was well tolerated. Conclusion: The study provides proof-of-concept that GAS methodology can be applied to MS management in daily practice.
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McMorran, D., L. W. Robinson, G. Henderson, J. Herman, J. E. Robb, and M. S. Gaston. "Using a goal attainment scale in the evaluation of outcomes in patients with diplegic cerebral palsy." Gait & Posture 44 (February 2016): 168–71. http://dx.doi.org/10.1016/j.gaitpost.2015.12.003.
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Logan, Benignus, Dev Jegatheesan, Andrea Viecelli, Elaine Pascoe, and Ruth Hubbard. "Goal attainment scaling as an outcome measure for randomised controlled trials: a scoping review." BMJ Open 12, no. 7 (July 2022): e063061. http://dx.doi.org/10.1136/bmjopen-2022-063061.
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Objectives(1) Identify the healthcare settings in which goal attainment scaling (GAS) has been used as an outcome measure in randomised controlled trials. (2) Describe how GAS has been implemented by researchers in those trials.DesignScoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews approach.Data sourcesPubMed, CENTRAL, EMBASE and PsycINFO were searched through 28 February 2022.Eligibility criteriaEnglish-language publications reporting on research where adults in healthcare settings were recruited to a randomised controlled trial where GAS was an outcome measure.Data extraction and synthesisTwo independent reviewers completed data extraction. Data collected underwent descriptive statistics.ResultsOf 1,838 articles screened, 38 studies were included. These studies were most frequently conducted in rehabilitation (58%) and geriatric medicine (24%) disciplines/populations. Sample sizes ranged from 8 to 468, with a median of 51 participants (IQR: 30–96). A number of studies did not report on implementation aspects such as the personnel involved (26%), the training provided (79%) and the calibration and review mechanisms (87%). Not all trials used the same scale, with 24% varying from the traditional five-point scale. Outcome attainment was scored in various manners (self-report: 21%; observed: 26%; both self-report and observed: 8%; and not reported: 45%), and the calculation of GAS scores differed between trials (raw score: 21%; T score: 47%; other: 21%; and not reported: 66%).ConclusionsGAS has been used as an outcome measure across a wide range of disciplines and trial settings. However, there are inadequacies and inconsistencies in how it has been applied and implemented. Developing a cross-disciplinary practical guide to support a degree of standardisation in its implementation may be beneficial in increasing the reliability and comparability of trial results.PROSPERO registration numberCRD42021237541.
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Murata, Lisa, Jaime Jones, Alexandra Baines, Carrie Robertson, and Karen Daley. "M243. EFFECTIVENESS AND SATISFACTION WITH A SCHIZOPHRENIA RECOVERY DAY PROGRAM." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S228. http://dx.doi.org/10.1093/schbul/sbaa030.555.
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Abstract Background Schizophrenia is a complex disorder typically defined by the presence of positive symptoms that include hallucinations, delusions, and disorganisation in speech and behaviour, negative symptoms of avolition and social withdrawal, and a decline in functioning. Despite an ability to treat clinical symptoms, functional recovery in schizophrenia remains poor. The Recovery Day Program at the Royal Ottawa Mental Health Centre is a multi-disciplinary intervention tailored to help people living with schizophrenia attain recovery goals, lead more satisfying lives, engage in activities, develop a social network and assist in community reintegration. Eligibility criteria are: 18 years of age or older, meet DSM V criteria for Schizophrenia Spectrum illness, have clinical needs that cannot be met in the community, have housing, require intensive recovery support/integration into community, be able to engage in day hospital programming and develop recovery goals. Maximum number of day clients in Day Program is 20. Client admissions began in June 2016. As of November 2019, there have been 50 admissions with 29 discharges. Age range of clients was 20–60 years (mean 36.5). Clients were invited to provide feedback on their experience with the Day Program for program evaluation and improvement of service. Methods A qualitative and quantitative evaluation of functional outcomes and patient satisfaction was conducted. Measures were administered at admission and discharge: The Illness Management and Recovery Scale (IMRS), a custom-generated activity and goal attainment scale, Quality of Life Scale, The World Health Organization Disability Assessment Schedule 2.0, the Modified Global Assessment of Functioning Scale and the Clinical Global Impression Scale. The Ontario Perception of Care Survey for Mental Health and Addictions (OPOC) was administered during a two month period from January 2019. Results Discharge results were available for 29 individuals out of 50 admissions. Clients identified goals in areas including vocational, social, educational, symptom management, optimizing independence, minimizing substance use, managing finances and stable housing; group and individual interventions targeted these areas. Interventions occur at the hospital and in the community. Results of the activity summary identify significant change in community integration in the following areas: employment (admission 5% and discharge 47%), unpaid/volunteer work (admission 11% and discharge 42%), course or study (admission 0% and discharge 32%), social/recreation/group activities (admission 63% and discharge 100%). Results show a significant increase in IMRS scores over time. Goal achievement was statistically significant according to the goal attainment scale (mean at intake 3.4 and at discharge 8.6). Results show that goal importance did not change over time. Open ended questions about day programming were added to the OPOC. Of 15 respondents, the average length of time in the Program was 16 months. Majority of respondents attended as much as they liked, while those unable to attend as much as they wanted, identified that increased attendance may have been helpful to achieving their goals. Discussion Overall, clients were very satisfied with services provided. There were significant achievements in goal attainment over time with targeted interventions provided in functional domains including employment, unpaid/volunteer work, course of study and social/recreation activities. Our data suggest that a medium term, intensive day program increases functional outcomes and personal satisfaction for individuals with a Schizophrenia Spectrum disorder. Further study would be important to assess how these changes are sustained over time.
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Kettlewell, Jade, Roshan das Nair, and Kate Radford. "A systematic review of personal smart technologies used to improve outcomes in adults with acquired brain injuries." Clinical Rehabilitation 33, no. 11 (July 29, 2019): 1705–12. http://dx.doi.org/10.1177/0269215519865774.
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Objective: This review aimed to determine the effectiveness of personal smart technologies on outcomes in adults with acquired brain injury. Data sources: A systematic literature search was conducted on 30 May 2019. Twelve electronic databases, grey literature databases, PROSPERO, reference list and author citations were searched. Methods: Randomised controlled trials were included if personal smart technology was used to improve independence, goal attainment/function, fatigue or quality of life in adults with acquired brain injury. Data were extracted using a bespoke form and the TIDieR checklist. Studies were graded using the PEDro scale to assess quality of reporting. Meta-analysis was conducted across four studies. Results: Six studies met the inclusion criteria, generating a total of 244 participants. All studies were of high quality (PEDro ⩾ 6). Interventions included personal digital assistant, smartphone app, mobile phone messaging, Neuropage and an iPad. Reporting of intervention tailoring for individual needs was inconsistent. All studies measured goal attainment/function but none measured independence or fatigue. One study ( n = 42) reported a significant increase in memory-specific goal attainment ( p = 0.0001) and retrospective memory function ( p = 0.042) in favour of the intervention. Another study ( n = 8) reported a significant increase in social participation in favour of the intervention ( p = 0.01). However, our meta-analyses found no significant effect of personal smart technology on goal attainment, cognitive or psychological function. Conclusion: At present, there is insufficient evidence to support the clinical benefit of personal smart technologies to improve outcomes in acquired brain injury. Researchers need to conduct more randomised studies to evaluate these interventions and measure their potential effects/harms.
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Lannin, Natasha A., Louise Ada, Coralie English, Julie Ratcliffe, Steven G. Faux, Mithu Palit, Senen Gonzalez, et al. "Effect of Additional Rehabilitation After Botulinum Toxin-A on Upper Limb Activity in Chronic Stroke." Stroke 51, no. 2 (February 2020): 556–62. http://dx.doi.org/10.1161/strokeaha.119.027602.
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Background and Purpose— The aim of this trial was to determine the effect of additional upper limb rehabilitation following botulinum toxin-A for upper limb activity in chronic stroke. Methods— We conducted a multicenter phase III randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis. One hundred forty stroke survivors who were scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke >3 months ago, who had completed formal rehabilitation and had no significant cognitive impairment. Experimental group received botulinum toxin-A plus evidence-based movement training while the control group received botulinum toxin-A plus a handout of exercises. Primary outcomes were goal attainment (Goal Attainment Scaling) and upper limb activity (Box and Block Test) at 3 months (end of intervention). Secondary outcomes were spasticity, range of motion, strength, pain, burden of care, and health-related quality of life. Results— In terms of goal attainment, the experimental group scored the same (mean difference, 2 T-score [95% CI, −2 to 7]) as the control group on the Goal Attainment Scale. In terms of upper limb activity, by 3 months the experimental group moved blocks at the same speed (mean difference, 0.00 blocks/s [95% CI, −0.02 to 0.01]) as the control group on the Box and Block Test. There were no differences between groups on any secondary outcome except strength, in favor of the experimental group (mean difference, 1.4 kg [95% CI, 0.2–2.7]). Conclusions— Findings suggest that additional intensive upper limb rehabilitation following botulinum toxin-A in chronic stroke survivors with a disabled upper limb is not effective. Registration— URL: https://www.clinicaltrials.gov . Unique identifier: ACTRN12615000616572.
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Moss, Sara A., and Jennifer S. Cheavens. "Commitment is Not Enough: A Longitudinal Investigation of Goal Commitment, Confidence, and Depressive Symptoms in Personal Goal Pursuit." Journal of Social and Clinical Psychology 38, no. 4 (April 2019): 301–20. http://dx.doi.org/10.1521/jscp.2019.38.4.301.
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Introduction: Symptoms of depression are associated with difficulty achieving personal goals. Empirical investigations suggest that depressed individuals do not differ from healthy controls in their commitment to personal goals (i.e., goal commitment), though they express less confidence in their abilities to achieve goals (i.e., goal-related confidence). Despite the relevance of motivational constructs, including goal commitment and confidence, to both depression and goal striving, there is a dearth of research examining these variables as they relate to depressive symptoms and goal progress across time. Method: To address this gap, we tracked the goal pursuits of 139 undergraduate participants oversampled for elevated symptoms of depression at a large, Midwestern university at three time-points. Participants completed a baseline assessment that included The Center for Epidemiologic Studies—Depression Scale (CES-D; Radloff, 1977) and a free-response goal-setting activity. They were asked to report goal progress and re-rate commitment and confidence for any not-yet-attained goals 2 weeks later and, finally, to report on goal attainment at a 2-month follow-up. Results: As predicted, the association between depressive symptoms and concurrently-reported goal commitment was not significant. However, less goal progress and early decreases in goal commitment and confidence reported at 2-week follow-up acted as indirect paths through which baseline depressive symptoms predicted poor longer-term goal outcomes. Discussion: Future investigators could experimentally test the associations between these variables to better understand the ways in which manipulating one aspect of goal striving might causally influence the others.
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Massimo, Lauren, Sean Lydon, Alexander Miller, Katya Rascovsky, and Dawn Mechanic-Hamilton. "ActiviDaily: Turning Apathy Into Action in Neurodegenerative Disease." Innovation in Aging 4, Supplement_1 (December 1, 2020): 802. http://dx.doi.org/10.1093/geroni/igaa057.2909.
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Abstract Impairment of goal-directed behavior (GDB), often labeled apathy, is a common behavioral symptom in dementia. ActiviDaily is a novel mobile app that engages both patients and caregivers to increase GDB to improve everyday function. ActiviDaily targets key components of GDB (motivation, planning and initiation) and individualizes patient goals. Pilot testing in twelve patient/caregiver dyads occurred over 4 weeks of app use. Measures of behavior, everyday functioning, and psychological distress were assessed in a pre-post design. Goal Attainment Scaling (GAS) was used to establish individualized goals and measure progress on a standard scale. GAS showed that 79% of participants’ goals were met at or above expectations. Caregiver depression and stress were significantly reduced. There was also a reduction in ratings of patient apathy. ActiviDaily is an innovative intervention that individualizes treatment of apathy and has the potential to increase independence in day-to-day life and decrease caregiver burden.
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Fournier, Jean, Patrick Gaudreau, Pascale Demontrond-Behr, Jérome Visioli, Jacques Forest, and Sue Jackson. "French translation of the Flow State Scale-2: Factor structure, cross-cultural invariance, and associations with goal attainment." Psychology of Sport and Exercise 8, no. 6 (November 2007): 897–916. http://dx.doi.org/10.1016/j.psychsport.2006.07.007.
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Beker, Josephine, and Tina DeAngelis. "Life Skill Development and its Impact on Perceived Stress, Employment and Education Pursuits: A Study of Young Adults with a History of Homelessness and Trauma." Student Journal of Occupational Therapy 2, no. 2 (June 15, 2021): 15–27. http://dx.doi.org/10.46409/001.xvoh2735.
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An occupational therapy educational training group for young adults in permanent supported housing was developed, implemented and evaluated with pre-post outcome measures including Goal Attainment Scaling (GAS) and the Perceived Stress Scale-10 (PSS-10). The study explored stress levels and employment-related goals of individuals who have aged out of the foster care system and may also have had a history of chronic homelessness and trauma. Results demonstrated a trend towards significance in perceived stress 9Z=1.689, p=0.91) with 7 of 8 participants surpassing the expected outcome according to GAS. Limitations included a small convenience sample (n=8), inconsistent attendance and use of self-report measures.
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Park, Jeong Euy, Chern-En Chiang, Muhammad Munawar, Gia Khai Pham, Apichard Sukonthasarn, Anastacio R. Aquino, Kah Lin Khoo, and Hon Wah Raymond Chan. "Lipid-lowering treatment in hypercholesterolaemic patients: the CEPHEUS Pan-Asian survey." European Journal of Preventive Cardiology 19, no. 4 (March 7, 2011): 781–94. http://dx.doi.org/10.1177/1741826710397100.
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Background: Treatment of hypercholesterolaemia in Asia is rarely evaluated on a large scale, and data on treatment outcome are scarce. The Pan-Asian CEPHEUS study aimed to assess low-density lipoprotein cholesterol (LDL-C) goal attainment among patients on lipid-lowering therapy. Methods: This survey was conducted in eight Asian countries. Hypercholesterolaemic patients aged ≥18 years who had been on lipid-lowering treatment for ≥3 months (stable medication for ≥6 weeks) were recruited, and lipid concentrations were measured. Demographic and other clinically relevant information were collected, and the cardiovascular risk of each patient was determined. Definitions and criteria set by the updated 2004 National Cholesterol Education Program guidelines were applied. Results: In this survey, 501 physicians enrolled 8064 patients, of whom 7281 were included in the final analysis. The mean age was 61.0 years, 44.4% were female, and 85.1% were on statin monotherapy. LDL-C goal attainment was reported in 49.1% of patients overall, including 51.2% of primary and 48.7% of secondary prevention patients, and 36.6% of patients with familial hypercholesterolaemia. The LDL-C goal was attained in 75.4% of moderate risk, 55.4% of high risk, and only 34.9% of very high-risk patients. Goal attainment was directly related to age and inversely related to cardiovascular risk and baseline LDL-C. Conclusion: A large proportion of Asian hypercholesterolaemic patients on lipid-lowering drugs are not at recommended LDL-C levels and remain at risk for cardiovascular disease. Given the proven efficacy of lipid-lowering drugs in the reduction of LDL-C, there is room for further optimization of treatments to maximize benefits and improve outcomes.
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Bieling, Peter J., Aaron T. Beck, and Gregory K. Brown. "Stability and Change of Sociotropy and Autonomy Subscales in Cognitive Therapy of Depression." Journal of Cognitive Psychotherapy 18, no. 2 (April 2004): 135–48. http://dx.doi.org/10.1891/jcop.18.2.135.65962.
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Sociotropy and autonomy have been demonstrated to be a diathesis for depression as well as predictors of treatment outcome. There are few studies, however, that have investigated whether these vulnerability factors change with cognitive therapy (CT) and are associated with outcome in CT. Also, it appears that the autonomy construct may have both positive and negative content and it is important to examine these two aspects of autonomy in treatment. In this study, depressed outpatients (N = 149) were followed from intake to the 12th session of CT. The treatment outcome variables included depression (Beck Depression Inventory), hopelessness (Beck Hopelessness Scale), and sociotropy and autonomy (Sociotropy-Autonomy Scale [SAS]). Using a repeated measures analysis, depression symptoms and hopelessness decreased significantly over time. Both subscales of sociotropy, preference for affiliation and fear of criticism and rejection, were positively associated with depression at intake, and decreased significantly over time in those who responded to treatment. However, independent goal attainment, one subscale of autonomy, increased significantly over sessions and was associated with treatment response. The second subscale of autonomy, sensitivity to others’ control, demonstrated no change. The results suggest that independent goal attainment may be an indicator of psychological health. Implications for future research using the SAS and its subscales in treatment and vulnerability research are described.
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Pool, Dayna, and Catherine Elliott. "Kindy Moves: a protocol for establishing the feasibility of an activity-based intervention on goal attainment and motor capacity delivered within an interdisciplinary framework for preschool aged children with cerebral palsy." BMJ Open 11, no. 8 (August 2021): e046831. http://dx.doi.org/10.1136/bmjopen-2020-046831.
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IntroductionPreschool aged children with cerebral palsy (CP) and like conditions are at risk of performing below their peers in key skill areas of school readiness. Kindy Moves was developed to support school readiness in preschool aged children with CP and like conditions that are dependent on physical assistance and equipment throughout the day. The primary aims are to determine the feasibility of motor-based interventions that are functional and goal directed, adequately dosed and embedded into a play environment with interdisciplinary support to optimise goal-driven outcomes.Methods and analysisForty children with CP and like conditions aged between 2 and 5 years with a Gross Motor Function Classification System (GMFCS) level of III–V or equivalent, that is, dependent on physical assistance and equipment will be recruited in Western Australia. Participants will undertake a 4-week programme, comprised three, 2-hour sessions a week consisting of floor time, gross motor movement and play (30 min), locomotor treadmill training (30 min), overground walking in gait trainers (30 min) and table-top activities (30 min). The programme is group based with 3–4 children of similar GMFCS levels in each group. However, each child will be supported by their own therapist providing an interdisciplinary and goal directed approach. Primary outcomes of this feasibility study will be goal attainment (Goal Attainment Scale) and secondary outcomes will include Canadian Occupational Performance Measure, 10 metre walk test, Children’s Functional Independence Measure, Sleep Disturbance Scale, Infant and Toddler Quality of Life Questionnaire, Peabody Developmental Motor Scale and Gross Motor Function Measure. Outcomes will be assessed at baseline, post intervention (4 weeks) and retention at the 4-week follow-up.Ethics and disseminationEthical approval was obtained from Curtin University Human Ethics Committee (HRE2019-0073). Results will be disseminated through published manuscripts in peer-reviewed journals, conference presentations and public seminars for stakeholder groups.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12619000064101p).
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Zhang, Xinyu, Jianping Ren, Chaojie Liu, Mengyan He, Lixian Ren, and Zhen Lv. "Evaluating Traditional Chinese Medicine Interventions on Chronic Low Back Pain Using Goal Attainment Scaling." Evidence-Based Complementary and Alternative Medicine 2020 (November 28, 2020): 1–10. http://dx.doi.org/10.1155/2020/8854927.
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Background. Extensive studies have been conducted to evaluate the pain relief effect of traditional Chinese medicine (TCM) interventions on patients with low back pain, including in China. However, there is a dearth in the literature documenting the diverse goals of TCM interventions, let alone the overall effect of such interventions. In this study, the goal attainment scaling (GAS) method was adopted to evaluate individualised TCM interventions on chronic low back pain. Methods. A pre-post intervention study was conducted on patients with chronic low back pain who received individualised TCM interventions in community health services. The study was undertaken in three community health centres in Hangzhou of China. A total of 165 eligible patients were invited, and 150 participated in the study, including 136 who completed both pre- and postintervention surveys. Each participant was asked to identify three to five intended goals from a pool of 26 outcome indicators and their corresponding expectations of these goals prior to the TCM interventions. Their conditions were rated against the selected indicators on a self-report five-point Likert scale before and after the TCM interventions, respectively. Gaps between the actual conditions and the expected goals were summed up for each participant and converted into a standardised GAS score, with a higher score indicating higher achievements, and 50 indicting patient expectations were met. Linear regression models were established to determine the factors associated with the pre-post GAS changes after adjustment for variations in other variables. Results. On average, an increase of 14.99 (SD = 9.81) in the GAS scores was achieved. This resulted in a mean GAS score of 48.33 (SD = 9.74) after the TCM interventions, falling slightly short (<2) of patient expectations. The multivariate linear regression models revealed that local residents, the retired, and those who perceived lower professional competency of their attending doctors had a smaller increase in the GAS scores after adjustment for variations in other variables. Conclusion. The individualised TCM interventions can help patients with low back pain to achieve their expected goals as measured by the GAS. Further studies are needed to better understand how patients set up their goals and the professional competency requirements to meet patient expectations.
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Wong, Kayla Carissa, Beron W. Z. Tan, Jasper W. K. Tong, and Mei Yoke Chan. "The Role of Music Therapy for Children Undergoing Cancer Treatment in Singapore." Healthcare 9, no. 12 (December 20, 2021): 1761. http://dx.doi.org/10.3390/healthcare9121761.
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The aim of this study was to explore the benefits of music therapy (MT) for children with cancer over the course of their treatment in an acute paediatric hospital setting in Singapore. Twenty-five children undergoing cancer treatment received MT sessions as part of a multidisciplinary team rehabilitation intervention from March 2017 to January 2020. A total of 37 individualised goals were developed by the music therapist for the cohort. Goals were scored via the Goal Attainment Scale at 3-month intervals up to 1 year. Descriptive statistics and correlation analysis were used to evaluate the findings. The rate of goal achievement was 89.2% over 180 MT sessions (M = 7.20, SD = 6.45). Children diagnosed with brain tumours had the highest frequency of MT sessions (M = 9.11, SD = 7.79). Most of the goals targeted the regulation of mood and morale through music. There was a positive correlation found between goals and sessions (rs = 0.56, p = 0.004). Age of the children was not correlated with the number of sessions received (rs= −0.19, p = 0.354). MT has been found to be an accessible and effective intervention in addressing functional and emotional goals for children across all ages who are undergoing cancer treatment.
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Lannin, Natasha A., Louise Ada, Coralie English, Julie Ratcliffe, and Maria Crotty. "Effect of adding upper limb rehabilitation to botulinum toxin-A on upper limb activity after stroke: Protocol for the InTENSE trial." International Journal of Stroke 13, no. 6 (March 19, 2018): 648–53. http://dx.doi.org/10.1177/1747493018765228.
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Rationale Although clinical practice guidelines recommend that management of moderate to severe spasticity include the use of botulinum toxin-A in conjunction with therapy, there is currently no evidence to support the addition of therapy. Aims To determine the effect and cost-benefit of adding evidence-based movement training to botulinum toxin-A. Sample size estimate A total of 136 participants will be recruited in order to be able to detect a between-group difference of seven points on the Goal Attainment Scale T-score with 80% power at a two-tailed significance level of 0.05. Methods and design The InTENSE trial is a national, multicenter, Phase III randomized trial with concealed allocation, blinded assessment and intention-to-treat analysis. Stroke survivors who are scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke greater than three months ago, who have completed formal rehabilitation and have no significant cognitive impairment will be randomly allocated to receive botulinum toxin-A plus evidence-based movement training or botulinum toxin-A alone. Study outcomes The primary outcomes are goal attainment (Goal Attainment Scaling) and upper limb activity (Box and Block Test) at three months (end of intervention) and at 12 months (beyond the intervention). Secondary outcomes are spasticity, range of motion, strength, pain, burden of care and health-related quality of life. Direct costs, personal costs and health system costs will be collected at 12 months. Discussion The results of the InTENSE trial are anticipated to directly influence intervention for moderate to severe spasticity after stroke. Trial Registration ANZCTR12615000616572.
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Rita, Carli Madalena, and Sarah L. Smith. "Preliminary Effectiveness of the Healthy Families Flourish Program for Families With a Child With Autism Spectrum Disorder." American Journal of Occupational Therapy 76, Supplement_1 (July 1, 2022): 7610510229p1. http://dx.doi.org/10.5014/ajot.2022.76s1-po229.
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Abstract Date Presented 04/01/2022 Researchers piloted the Healthy Families Flourish Program, a 10-session telehealth coaching intervention to support family occupational participation and health. Researchers measured outcomes pre- and postintervention via Goal Attainment Scaling and the Family Adaptability and Cohesion Evaluation Scale for families with a child with autism spectrum disorder. Findings provide preliminary evidence for family-level OT services to augment traditional child-focused interventions. Primary Author and Speaker: Carli Madalena Rita Additional Authors and Speakers: Sarah L. Smith
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Chien, J., W. T. Chang, Z. Y. Wee, H. S. Goh, I. Gan, C. B. Yong, A. Pang, N. C. Mohd Rais, and M. Chun. "A Pilot Study on the Use of Goal Attainment Scale (GAS) for Pharmacy Medication Reviews in the Geriatric Oncology Clinic." Journal of Geriatric Oncology 13, no. 8 (October 2022): S36. http://dx.doi.org/10.1016/s1879-4068(22)00330-7.
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Rockwood, Kenneth, Susan E. Howlett, Deborah Hoffman, Rachel Schindler, and Arnold Mitnitski. "Clinical meaningfulness of Alzheimer's Disease Assessment Scale-Cognitive subscale change in relation to goal attainment in patients on cholinesterase inhibitors." Alzheimer's & Dementia 13, no. 10 (March 21, 2017): 1098–106. http://dx.doi.org/10.1016/j.jalz.2017.02.005.
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Clare, Linda, Aleksandra Kudlicka, Jan R. Oyebode, Roy W. Jones, Antony Bayer, Iracema Leroi, Michael Kopelman, et al. "Goal-oriented cognitive rehabilitation for early-stage Alzheimer’s and related dementias: the GREAT RCT." Health Technology Assessment 23, no. 10 (March 2019): 1–242. http://dx.doi.org/10.3310/hta23100.
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BackgroundCognitive rehabilitation (CR) is an individualised, person-centred intervention for people with mild to moderate dementia that addresses the impact of cognitive impairment on everyday functioning.ObjectivesTo determine whether or not CR is a clinically effective and cost-effective intervention for people with mild to moderate Alzheimer’s disease or vascular or mixed dementia, and their carers.DesignThis multicentre randomised controlled trial compared CR with treatment as usual (TAU). Following a baseline assessment and goal-setting to identify areas of everyday functioning that could be improved or better managed, participants were randomised (1 : 1) via secure web access to an independent randomisation centre to receive either TAU or CR and followed up at 3 and 9 months post randomisation.SettingCommunity.ParticipantsParticipants had anInternational Classification of Diseases, Tenth Edition, diagnosis of Alzheimer’s disease or vascular or mixed dementia, had mild to moderate cognitive impairment (Mini Mental State Examination score of ≥ 18 points), were stable on medication if prescribed, and had a family carer who was willing to contribute. The exclusion criteria were people with a history of brain injury or other neurological disorder and an inability to speak English. To achieve adequate power, we needed 350 people to complete the trial, with 175 people in each trial arm.InterventionCognitive rehabilitation consisted of 10 therapy sessions over 3 months, followed by four maintenance sessions over 6 months, delivered in participants’ homes. The therapists were nine occupational therapists and one nurse.Outcome measuresThe primary outcome was self-reported goal attainment at 3 months. Goal attainment was also assessed at 9 months. Carers provided independent ratings of goal attainment at both time points. The secondary outcomes were participant quality of life, mood, self-efficacy and cognition, and carer stress, health status and quality of life. The assessments at 3 and 9 months were conducted by researchers who were blind to the participants’ group allocation.ResultsA total of 475 participants were randomised (CR arm,n = 239; TAU arm,n = 236), 427 participants (90%) completed the trial and 426 participants were analysed (CR arm,n = 208, TAU arm,n = 218). At 3 months, there were statistically significant large positive effects for participant-rated goal attainment [mean change in the CR arm: 2.57; mean change in the TAU arm: 0.86; Cohen’sd = 0.97, 95% confidence interval (CI) 0.75 to 1.19], corroborated by carer ratings (Cohen’sd = 1.11, 95% CI 0.89 to 1.34). These effects were maintained at 9 months for both the participant ratings (Cohen’sd = 0.94, 95% CI 0.71 to 1.17) and the carer ratings (Cohen’sd = 0.96, 95% CI 0.73 to 1.20). There were no significant differences in the secondary outcomes. In the cost–utility analyses, there was no evidence of cost-effectiveness in terms of gains in the quality-adjusted life-years (QALYs) of the person with dementia (measured using the DEMentia Quality Of Life questionnaire utility score) or the QALYs of the carer (measured using the EuroQol-5 Dimensions, three-level version) from either cost perspective. In the cost-effectiveness analyses, by reference to the primary outcome of participant-rated goal attainment, CR was cost-effective from both the health and social care perspective and the societal perspective at willingness-to-pay values of £2500 and above for improvement in the goal attainment measure. There was no evidence on the cost-effectiveness of the self-efficacy measure (the Generalized Self-Efficacy Scale) from either cost perspective.LimitationsPossible limitations arose from the non-feasibility of using observational outcome measures, the lack of a general measure of functional ability and the exclusion of people without a carer or with rarer forms of dementia.ConclusionsCognitive rehabilitation is clinically effective in enabling people with early-stage dementia to improve their everyday functioning in relation to individual goals targeted in the therapy sessions.Future workNext steps will focus on the implementation of CR into NHS and social care services and on extending the approach to people with rarer forms of dementia.Trial registrationCurrent Controlled Trials ISRCTN21027481.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 23, No. 10. See the NIHR Journals Library website for further project information.
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Karhula, Maarit, and Tuija Heiskanen. "Kantavatko tules-kuntoutuksessa asetetut tavoitteet?" Kuntoutus 43, no. 1 (March 20, 2020): 7–21. http://dx.doi.org/10.37451/kuntoutus.95528.
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Kelan järjestämien tuki- ja liikuntaelinsairaus (tules) -kuntoutuskurssien toteutusta ja toimivuutta, asiakaslähtöisyyttä ja kuntoutujan roolia sekä kuntoutuksen vaikutuksia kuntoutujan arkeen tarkasteltiin Kelan MUUTOS-hankkeen tules-kuntoutuksen tutkimuksessa. Tässä artikkelissa syvennetään tutkimuksen yhtä keskeistä teemaa, kuntoutuksen ja kuntoutumisen tavoitteiden asettamista ja tavoitteen saavuttamista tukevaa kuntoutus- ja kuntoutumisprosessia. Artikkelin tavoitteena on kuvata, millaisia tavoitteita tules-kuntoutuksessa on, miten tavoitteet ohjaavat kuntoutusta ja kuntoutumista sekä miten hyvin tavoitteet saavutettiin kuntoutuksen aikana. Monimenetelmällisen tutkimuksen aineistoina olivat kuntoutujille ja palveluntuottajille suunnatut kyselyt, kuntoutujien ja palveluntuottajien ryhmähaastattelut sekä kuntoutujien Omat tavoitteeni -lomakkeet. Kuntoutujien kyselyyn vastasi 1839 kuntoutujaa, joista laitosmuotoiseen kuntoutukseen oli osallistunut 1441 kuntoutujaa ja avomuotoiseen kuntoutukseen 398 kuntoutujaa. Palveluntuottajien kyselyyn vastasi 26 palveluntuottajaa. Kuntoutujien ja palveluntuottajien ryhmähaastatteluja toteutettiin molempia 10. Kuntoutujien omat tavoitteet -lomakkeita analysoitiin 75, ja niissä oli yhteensä 161 tavoitetta. Määrälliset ja laadulliset aineistot analysoitiin ensin erikseen ja tämän jälkeen teemoittain yhdistettiin ja luotiin monimenetelmällisen aineiston perusteella tulkinnat.Tavoitteet painottuvat fyysisen toimintakyvyn edistämiseen, työelämään nivoutuvia tavoitteita asetetaan vähän. Tavoitteet ohjaavat kuntoutuskurssien sisältöjen rakentumista vaihtelevasti. Avomuotoiseen kuntoutukseen osallistuneet kuntoutujat saavuttivat tavoitteensa keskimäärin hieman heikommin (T-lukuarvo 46) kuin laitosmuotoiseen kuntoutukseen osallistujat (T-lukuarvo 49). Tavoitteet koetaan tärkeäksi osaksi kuntoutusprosessia. Kuntoutujien omien tavoitteiden tulisi kuitenkin ohjata nykyistä selkeämmin kuntoutujien toimintaa koko kuntoutusprosessin ajan. Tavoitteiden työelämäyhteyttä tulisi vahvistaa, jotta kuntoutujien tavoitteet kiinnittyisivät vahvemmin työelämään ja tules-kuntoutuskurssit tukisivat työkykyä nykyistä enemmän.
AbstractDo client’s own goals guide MDSs rehabilitation process?The multi-perspective information on the implementation of Kela (the Social Insurance Institution of Finland)-provided musculoskeletal disorders (MSDs) rehabilitation courses, the client’s role in the rehabilitation, and the effects of rehabilitation on the person’s everyday life were produced in the MSDs rehabilitation study. This article deepens one theme of the study, the goals of the rehabilitation and the rehabilitation process, which support achieving the goals. The aim of the article is to describe what kind of goals MDSs rehabilitation exist, how goals guide rehabilitation, and how goals were achieved during rehabilitation. The study applied mixed methods and a multi-perspective approach. The data included questionnaires and group interviews of rehabilitees and rehabilitation professionals, combined with the rehabilitees’ Goal Attainment Scale (GAS) forms. A total of 1,839 respondents answered the questionnaire for rehabilitees, with 1,441 respondents having taken part in inpatient rehabilitation and 398 in outpatient rehabilitation. The service providers’ questionnaire yielded 26 responses. In addition, ten group interviews were conducted both with rehabilitees, and with service providers. A total of 75 personal goal forms were analysed, presenting 161 goals.Promoting physical functioning was the most frequent goal, only few goals related to work life. There was variation of how the goals of the rehabilitation courses guide the content of the courses. The goals were achieved weaker in the outpatient rehabilitation (t-score 46) than in inpatient rehabilitation (t-score 49). Goal-oriented activities were considered important, but the rehabilitees’ personal goals should better guide their own activities throughout the process. Furthermore, the connection of the rehabilitation to the working life should be strengthened. If the goals are linked more closely to work, they would support working capacity to a greater extent than currently.Keywords: musculoskeletal disorders (MSDs) rehabilitation, Goal Attainment Scale, mixed methods, goals of the rehabilitation
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An, byeung-Tae, and Jee-Woon Jung. "Study of GAS(Goal Attainment Scale) and FAC(Functional Ambulation Category) Correlation on Dynamic Balance and Trunk Balance in Stroke Patients." Korean Society of Medicine & Therapy Science 13, no. 1 (June 30, 2021): 37–42. http://dx.doi.org/10.31321/kmts.2021.13.1.37.
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Siu, Henry Yu-Hin, Nicole Steward, Jessica Peter, Laurel Cooke, Donald M. Arnold, and David Price. "A novel primary-specialist care collaborative demonstration project to improve the access and health care of medically complex patients." Chronic Illness 13, no. 3 (October 19, 2016): 151–70. http://dx.doi.org/10.1177/1742395316674541.
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Objective Medically complex patients experience fragmented health care compounded by long wait times. The MedREACH program was developed to improve access and overall system experience for medically complex patients. Program description MedREACH is a novel primary–tertiary care collaborative demonstration program that features community nursing outreach, community specialist outreach, and a multi-specialty consultation clinic. Methods All 179 patients, referring primary care clinicians, and specialists involved were eligible to participate. Patient and clinician feedback were elicited by feedback surveys. Process measures were evaluated by participant retrospective chart reviews. Community nursing outreach patients completed the Goal Attainment Scale. Results Forty-eight patients and 22 clinicians consented to the feedback survey. About 75% of patients were seen within 2 weeks of referral. Patients spent an average of 3, 1.63, and 1.2 visits with the nursing outreach, multi-specialty clinic, and specialist outreach, respectively. Patients indicated a better medical experience, health enablement, and goals attainment. Family physicians felt more supported in the community management of medically complex patients and, overall, physicians felt MedREACH could improve collaborative care for medically complex patients. Qualitative analysis of clinician responses identified the need for increased mental health services. Discussion MedREACH demonstrates a patient-centered link between primary and tertiary care that could improve health care access and overall experience.
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Krawitz, Roy. "A Prospective Psychotherapy Outcome Study." Australian & New Zealand Journal of Psychiatry 31, no. 4 (August 1997): 465–73. http://dx.doi.org/10.3109/00048679709065066.
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Objective: To assess the outcome of 31 patients treated in a day and semi-residential psychotherapy setting. Method: Patients had moderate to severe personality difficulties and were referred when current therapy was insufficient or because of the severity of their problems. Eighty-one percent had a Cluster C and 19% a Cluster B (Borderline) Personality Disorder diagnosis (DSM-III-R). Therapy was psychodynamically and feminist-informed and included a sociopolitical dimension. Rating scales used were the Symptom Checklist 90, Goal Attainment Scale, Global Assessment Scale and measures of health resource usage, which were completed pre-treatment, post-treatment and at 4-, 12- and 24-month follow-up. Results: Mean duration of therapy was 4 months (68 therapy days). All clinical rating scales demonstrated marked improvements following treatment (p < 0.0001) which were sustained at 2-year follow-up. There were also improvements of health resource usage. Conclusions: The results document the clinical efficacy of psychotherapy in this setting, provide support for the philosophy of practice, and suggest that psychotherapy outcome can be evaluated at reasonable financial cost in many settings.
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Kizilcec, René F., and Geoffrey L. Cohen. "Eight-minute self-regulation intervention raises educational attainment at scale in individualist but not collectivist cultures." Proceedings of the National Academy of Sciences 114, no. 17 (April 10, 2017): 4348–53. http://dx.doi.org/10.1073/pnas.1611898114.
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Academic credentials open up a wealth of opportunities. However, many people drop out of educational programs, such as community college and online courses. Prior research found that a brief self-regulation strategy can improve self-discipline and academic outcomes. Could this strategy support learners at large scale? Mental contrasting with implementation intentions (MCII) involves writing about positive outcomes associated with a goal, the obstacles to achieving it, and concrete if–then plans to overcome them. The strategy was developed in Western countries (United States, Germany) and appeals to individualist tendencies, which may reduce its efficacy in collectivist cultures such as India or China. We tested this hypothesis in two randomized controlled experiments in online courses (n = 17,963). Learners in individualist cultures were 32% (first experiment) and 15% (second experiment) more likely to complete the course following the MCII intervention than a control activity. In contrast, learners in collectivist cultures were unaffected by MCII. Natural language processing of written responses revealed that MCII was effective when a learner’s primary obstacle was predictable and surmountable, such as everyday work or family obligations but not a practical constraint (e.g., Internet access) or a lack of time. By revealing heterogeneity in MCII’s effectiveness, this research advances theory on self-regulation and illuminates how even highly efficacious interventions may be culturally bounded in their effects.
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Resnick, Barbara. "INTERVENTION FIDELITY IN THE FAMILY-CENTERED FUNCTION-FOCUSED CARE INTERVENTION." Innovation in Aging 6, Supplement_1 (November 1, 2022): 96–97. http://dx.doi.org/10.1093/geroni/igac059.384.
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Abstract This session will provide a description of the treatment fidelity (TF) plan from the Family-centered Function-focused Care (Fam-FFC) trial. Components of the TF plan, measures, procedures for implementation, and findings will be presented, and discussed within the context of the COVID-19 pandemic. The components of the Fam-FFC TF plan and results include: 1) Delivery based on completion of the steps in Fam-FFC ; 2) Receipt based on evidence of Staff knowledge of Fam-FFC (percentage of nursing staff that demonstrated test scores above 80%); 3) Enactment based on achievement of goals using the Goal Attainment Scale ; completion of the Fam-Path Audit of bedside goals and treatment plans, post-acute follow-up and plan update ; and evidence of Fam-FFC based on the Fam-FFC Behavior Checklist (80% staff performance of Fam-FFC). The TF plan demonstrated evidence of delivery, receipt and enactment of study activities. Findings will be used to develop an implementation trial.