Detecting change in patient outcomes in a rural ambulatory rehabilitation service: the responsiveness of Goal Attainment Scaling and the Lawton Scale.

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 ...

Source: Australian Health Review - June 29, 2015 Category: Hospital Management Authors: Baggio L, Buckley DJ Tags: Aust Health Rev Source Type: research