Article
Patient goals in early post-acute geriatric rehabilitation – is attainment of goals an indicator for an improvement in overall functioning?
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Published: | September 6, 2007 |
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Background: Timely goal setting in close collaboration with the patient is essential to rehabilitation success. In this context the relevance of goal attainment for an evaluation of outcome is of interest to clinical practice. The objective of this study was to identify goals of aged patients in early post-acute geriatric rehabilitation using the International Classification of Functioning, Disability and Health (ICF) and to examine their attainment in relation to functioning.
Methods: A prospective multicentre cohort study in early post-acute geriatric rehabilitation facilities. A semi-structured questionnaire was used to identify patient goals and to assess functioning from patient’s and health professionals perspectives. Patient’s statements were translated into the ICF terminology following a standardized linking procedure. We calculated a residualized change score to identify those patients who improved more than statistically expected from the baseline value, controlled for length of inpatient stay. Bivariate analyses and logistic regression were used to identify an association among goal attainment and improvement in functioning.
Results: 209 patients gave 476 statements. 346 (72.7 %) of them were linked to 58 different ICF categories and 5 different chapters. ‘Walking’, ‘getting rid of pain’, regaining ‘autonomy’, ‘returning home’ and improvement of the ‘general condition’ could be identified as the most important aspects from the patient perspective. Bivariate analyses showed significant association between goal attainment and improvement in functioning. Multivariable analysis identified length of inpatient hospitalization and goal attainment as significant predictors for an improvement in functioning.
Conclusions: The ICF can be used as a helpful tool to identify and structure patients’ statements about their goals in geriatric rehabilitation. Attainment of subjectively set goals can indicate improvement in overall functioning. The results underline that involving the patient in the rehabilitation planning process is essential for clinical practice and might result in an improved outcome.