Goal attainment scaling in evaluating a multidisciplinary pain management programme

• Published in: Clinical rehabilitation 2002-12, Vol.16 (8), p.871-877
• Main Authors: Fisher, K, Hardie, R J
• Format: Article
• Language: English
• Subjects: Achievement; Adult; Biological and medical sciences; Control; Endpoint Determination; Female; Goals; Humans; Interdisciplinary approach; Male; Medical sciences; Miscellaneous; Pain; Pain - rehabilitation; Pain Measurement; Patient Care Planning; Patient Care Team; Physical Therapy Modalities; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation units; Therapeutic value; Treatment Outcome; Walking
• ISSN: 0269-2155; 1477-0873
• DOI: 10.1191/0269215502cr554oa

Objective: To examine the value of Goal Attainment Scaling (GAS) as a therapeutic tool and an outcome measure in a rehabilitation programme in the management of chronic pain. Design: A prospective observational study. Setting: A 15-day pain management programme, day case or residential, in an NHS Regional rehabilitation centre. Subjects: One hundred and forty-nine consecutive patients enrolled during a 15-month period. Interventions: Multidisciplinary structured educational programme of physiotherapy, occupational therapy and clinical psychology. Main outcome measures: GAS; timed tests of physical mobility measures; McGill Pain Questionnaire (MPQ); Pain Intensity Numerical Rating Scale (NRS); Oswestry low back pain Disability Questionnaire (ODQ); General Health Questionnaire (GHQ); Pain and Impairment Relationship Scale (PAIRS). GAS and physiotherapy measures were compared with baseline data at enrolment and at discharge 15 days later. At six-month follow-up all measures were repeated. Results: significant improvements at discharge were found for GAS, and physiotherapy measures. One hundred and twelve patients returned for review at six months, when improvements were maintained for GAS, sit/stand, Pain, ODQ and GHQ. GAS was shown to be a valid measure of ability, correlating significantly with walking improvement and somewhat less with a therapist-defined measure, suggesting some ability to discriminate. Conclusions: The improvement measured by GAS showed that patients were enabled by the programme to achieve personally valued goals over a six-month period and to improve on these more than on other more conventional outcome measures.