Patient and provider perspectives on using goal attainment scaling in care planning for older adults with complex needs

Clair, Catherine A; Sandberg, Shana F.; Scholle, Sarah Hudson; Willits, Jacqueline; Jennings, Lee A.; Giovannetti, Erin R.

doi:10.1186/s41687-022-00445-y

Cited by 5 publications

(2 citation statements)

References 30 publications

(43 reference statements)

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“…GAS is a patient-centred outcome measure tool for assessing the degree to which a patient’s individual treatment goals have been attained [ 26 ]. It offers a structured approach to setting goals and measuring goal achievement [ 27 ], while maintaining a patient-centred approach [ 18 ]. GAS takes into account that most patients have more than one goal and that goals vary in importance to the individual patient and their caregiver, as well as in difficulty in achieving each goal [ 1 , 12 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Selecting Goals and Target Muscles for Botulinum Toxin A Injection Using the Goal Oriented Facilitated Approach to Spasticity Treatment (GO-FAST) Tool

Jacinto,

Balbert,

Bensmail

et al. 2023

Toxins

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The objective of this article is to introduce the GO-FAST Tool (developed by the Toxnet group) to clinicians working in the field of neurological rehabilitation, specifically post-stroke spasticity management. The concepts utilized in the Tool and described in this article can be broadly grouped into five topics: the principles of patient-centred goal-setting; an algorithm for setting SMART (specific, measurable, attainable, realistic, and timed) treatment goals; goal-related target muscles and botulinum toxin type A dose determinants; goal attainment follow-up, scoring, and interpretation; and the multimodal approach to spasticity management. The Tool can enhance clinical practice by providing guided assistance with goal-setting and target muscle selection for botulinum toxin type A treatment. It also provides support with the follow-up evaluation of goal attainment and calculation of treatment success. The Tool is designed to be used by clinicians with varying levels of expertise in the field of neurological rehabilitation and post-stroke spasticity management, from those who are new to the field to those with many years of experience. A case study is presented in the Results Section of the article to illustrate the utility of the Tool in setting SMART treatment goals in the management of patients with post-stroke spasticity.

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Section: Discussionmentioning

confidence: 99%

Selecting Goals and Target Muscles for Botulinum Toxin A Injection Using the Goal Oriented Facilitated Approach to Spasticity Treatment (GO-FAST) Tool

Jacinto,

Balbert,

Bensmail

et al. 2023

Toxins

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“…GAS was first introduced by Kiresuk and Sherman in 1968 to evaluate outcomes in a mental health setting [ 7 ]. Since then, it has been successfully adapted for use in many other domains, including stroke rehabilitation [ 8 , 9 ], drug trials [ 2 ], back pain [ 10 ], rehabilitation [ 3 ], communication disorders [ 11 ], and in other older adults with dementia [ 1 ], and complex needs [ 12 ]. There is growing evidence that GAS is sensitive to change and can capture clinically meaningful changes that often are ignored or are not elicited by standardized tests [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

A systematic review of goal attainment scaling implementation practices by caregivers in randomized controlled trials

Cheema,

Dunn,

Chapman

et al. 2024

J Patient Rep Outcomes

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Background Goal attainment scaling (GAS), an established individualized, patient-centred outcome measure, is used to capture the patient’s voice. Although first introduced ~60 years ago, there are few published guidelines for implementing GAS, and almost none for its use when caregivers GAS is implemented with caregiver input. We conducted a systematic review of studies that implemented GAS with caregiver input; and examined variations in GAS implementation, analysis, and reporting. Methods Literature was retrieved from Medline, Embase, Cochrane, PsycInfo and CINAHL databases. We included randomized controlled trials (published between 1968 and November 2022) that used GAS as an outcome measure and involved caregiver input during goal setting. Results Of the 2610 studies imported for screening, 21 met the inclusion criteria. Most studies employed GAS as a primary outcome. The majority (76%) had children as study participants. The most common disorders represented were cerebral palsy, developmental disorders, and dementia/Alzheimer’s disease. The traditional five-point GAS scale, with levels from −2 to +2, was most often implemented, with −1 level typically being the baseline. However, most studies omitted essential GAS details from their reports including the number of goals set, number of attainment levels and whether any training was given to GAS facilitators. Conclusions GAS with caregiver input has been used in a limited number of randomized controlled trials, primarily in pediatric patients and adults with dementia. There is a variability in GAS implementation and many crucial details related to the specifics of GAS implementation are omitted from reports, which may limit reproducibility. Here we propose catalog that may be utilized when reporting research results pertaining to GAS with caregivers to enhance the application of this patient-centered outcome measure.

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Using Progress Feedback to Enhance Treatment Outcomes: A Narrative Review

de Jong,

Douglas,

Wolpert

et al. 2024

Adm Policy Ment Health

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We face increasing demand for greater access to effective routine mental health services, including telehealth. However, treatment outcomes in routine clinical practice are only about half the size of those reported in controlled trials. Progress feedback, defined as the ongoing monitoring of patients’ treatment response with standardized measures, is an evidence-based practice that continues to be under-utilized in routine care. The aim of the current review is to provide a summary of the current evidence base for the use of progress feedback, its mechanisms of action and considerations for successful implementation. We reviewed ten available meta-analyses, which report small to medium overall effect sizes. The results suggest that adding feedback to a wide range of psychological and psychiatric interventions (ranging from primary care to hospitalization and crisis care) tends to enhance the effectiveness of these interventions. The strongest evidence is for patients with common mental health problems compared to those with very severe disorders. Effect sizes for not-on-track cases, a subgroup of cases that are not progressing well, are found to be somewhat stronger, especially when clinical support tools are added to the feedback. Systematic reviews and recent studies suggest potential mechanisms of action for progress feedback include focusing the clinician’s attention, altering clinician expectations, providing new information, and enhancing patient-centered communication. Promising approaches to strengthen progress feedback interventions include advanced systems with signaling technology, clinical problem-solving tools, and a broader spectrum of outcome and progress measures. An overview of methodological and implementation challenges is provided, as well as suggestions for addressing these issues in future studies. We conclude that while feedback has modest effects, it is a small and affordable intervention that can potentially improve outcomes in psychological interventions. Further research into mechanisms of action and effective implementation strategies is needed.

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Patient and provider perspectives on using goal attainment scaling in care planning for older adults with complex needs

Cited by 5 publications

References 30 publications

Selecting Goals and Target Muscles for Botulinum Toxin A Injection Using the Goal Oriented Facilitated Approach to Spasticity Treatment (GO-FAST) Tool

Selecting Goals and Target Muscles for Botulinum Toxin A Injection Using the Goal Oriented Facilitated Approach to Spasticity Treatment (GO-FAST) Tool

A systematic review of goal attainment scaling implementation practices by caregivers in randomized controlled trials

Using Progress Feedback to Enhance Treatment Outcomes: A Narrative Review

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