Improvement scaling (rehabilitation version) - A new approach to measuring progress of patients in achieving their individual rehabilitation goals

被引:19
作者
Smith, A
Cardillo, JE
Smith, SC
Amezaga, AM
机构
[1] VA Med Ctr, Res Off 151, Reno, NV 89520 USA
[2] Univ Nevada, Sch Med, Dept Psychiat & Behav Sci, Reno, NV 89557 USA
[3] Hometown Hlth, Reno, NV USA
关键词
D O I
10.1097/00005650-199803000-00010
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
OBJECTIVES: Accurate measurement of clinically relevant change in individual patients undergoing rehabilitation has been an elusive goal. Simple, clinically meaningful, patient-centered measures of individual patient change are urgently needed. The purpose of this research was the development and testing of Improvement Scaling (Rehabilitation Version)(IMS), a new approach to measuring the progress that rehabilitation patients make during treatment. METHODS: Research and clinical staff developed the 65 IMS scales and applied them to all admissions to an an inpatient rehabilitation unit. Date were collected on 292 consecutively admitted rehabilitation patients who were aged 50 or older. An Improvement Score indicates the degree to which each patient achieves the expected level of outcome on his or her unique set of IMS goals. Improvement scores were compared to Goal Attainment Scores and to scores from more traditionl measures. Interrater reliability was assessed. RESULTS: IMS scores correlated r=.78 with comparable Goal Attainment Scores. IMS and Goal Attainment Scores had the same pattern of correlations with other measures. Interrater reliability of IMS scores was r=.91. CONCLUSIONS: IMS appears to be a practical, reliable, valid, and clinically useful technique for measuring individual patient change. What is needed now is replication and more information on factors which may influence IMS scores. Versions of IMS are being developed for home health care and mental health. Applications of IMS for quality assurance, quality improvement, and documentation of patient change for third parties is discussed.
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页码:333 / 347
页数:15
相关论文
共 32 条
[1]  
[Anonymous], ARCH PHYS MED REHAB
[2]  
[Anonymous], GOAL ATTAINMENT SCAL
[3]  
APPLEGATE WB, 1990, NEW ENGL J MED, V322, P1207
[4]  
BROOKS DN, 1987, NEUROBEHAVIORAL RECO, P57
[5]  
BRUELL JH, 1960, ARCH PHYS MED REHAB, P565
[6]  
CARDILLO JE, 1994, GOAL ATTAINMENT SCAL
[7]   TRAINING IN THE USE OF GOAL ATTAINMENT SCALING [J].
CHOATE, R ;
SMITH, A ;
CARDILLO, JE ;
THOMPSON, L .
COMMUNITY MENTAL HEALTH JOURNAL, 1981, 17 (02) :171-181
[8]  
COLLINS LM, 1991, BEST METHODS ANAL CH
[9]   EVALUATION OF GOAL ATTAINMENT IN GERIATRIC SETTINGS [J].
CORNBLETH, T .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1978, 26 (09) :404-407
[10]   HOW WE SHOULD MEASURE CHANGE - OR SHOULD WE [J].
CRONBACH, LJ .
PSYCHOLOGICAL BULLETIN, 1970, 74 (01) :68-80