Patient goals in post-acute geriatric rehabilitation--goal attainment is an indicator for improved functioning

Abstract

Objective: To identify goals of older patients in geriatric rehabilitation and to measure their improvement in overall functioning.

Design: A prospective multi-centre cohort study.

Methods: A semi-structured questionnaire was used to identify patient goals and to assess improvement in overall functioning from patients' and health professionals' perspectives. Patients' goals were linked to the International Classification of Functioning, Disability and Health (ICF). Using a residualized change score, we identified patients who improved more than statistically expected.

Results: A total of 209 patients gave 476 statements. Of these, 346 (72.7%) statements were linked to 58 different ICF categories. More than 90% of the ICF categories were part of the comprehensive geriatric ICF Core Set. "Walking", "getting rid of pain", "autonomy" and "returning home" were the most frequently reported goals. Multivariable analysis identified shorter length of inpatient stay and goal attainment to be significant predictors for an improvement in overall functioning from the patients' perspective.

Conclusion: The ICF can be used to identify and structure patients' goals in geriatric rehabilitation. The association between goal attainment and improved overall functioning underlines the necessity of considering the patients' perspective in the rehabilitation process.