The Application of Goal Attainment Scaling in Chronic Pain Settings

Abstract

Although the multidimensional nature of chronic pain has been recognized since the 1960s, pain management continues to reflect a biomedical model for many chronic pain patients. The application of a biopsychosocial approach would be aided by measurement tools that reflect the multidimensional nature of pain, facilitate interdisciplinary care planning, and focus treatment on the consequences of pain that are important to patients. Goal Attainment Scaling (GAS) is an individualized health outcome measure that is suitable for health problems that warrant a multidimensional and individualized approach to treatment planning and outcome measurement. This paper describes the use of GAS as a treatment and research tool in cancer pain, pediatric pain, work-related nonmalignant pain, and geriatric pain. Unlike the typical process where goals are not explicitly stated, GAS allows goals to be stated in a systematic measurable manner that is relevant and meaningful for each patient, and that can guide individual treatment planning. GAS is an appropriate technique for guiding and monitoring the treatment of individual chronic pain patients, and may provide a useful tool for evaluating chronic pain programs.

Goal attainment scaling in paediatric rehabilitation: a critical review of the literature

“…Some examples are studies evaluating a comprehensive day-treatment programme, 13 botulinum toxin A (BTX-A) treatment, 14 lower-extremity amputations, 15 and pain management programmes. 16,17 These studies support the hypothesis that in the field of rehabilitation medicine, GAS provides a more responsive measure than other, more conventional outcome measures (such as the Barthel Index or the Locomotor Capabilities Index).…”

Goal Setting Education and Counseling Practices of Diabetes Educators

“…The rise in FPG with weight loss suggests that the initial reduction in energy intake decreased FPG, rather than the weight loss. 34 Participants that maintained a FPG less than 108 mg/dL for one year after the initial three month period continued to lose 3% IBW on average during this time. This weight loss outcome also supports the benefits of the diabetes diet.…”

“…35 At the end of three months, a greater reduction in blood glucose was achieved by participants with a higher initial FPG and who lost more weight. 34 Results showed that on average, participants that presented with a FPG of 180 to 216 mg/dL needed to lose 28% of IBW to achieve FPG of less than 108 mg/dL. These results were positive; however, the most effective implementation methods for achieving such results are unclear.…”

“…Participants were on average overweight (mean = 130±26% of ideal body weight, IBW). 34 During the initial three month diet therapy, each participant had monthly visits with a diabetes educator; most often with a dietitian and a doctor. 35 The initial three month diet for all participants was approximately 50% carbohydrate, low in saturated fat, and moderately high in fiber.…”

“…This weight loss outcome also supports the benefits of the diabetes diet. 34 Another prospective, randomized, and controlled clinical trial assessed the effectiveness of MNT in 179 type 2 diabetes patients. Intervention participants were randomly chosen from two different diabetes treatment centers.…”