Goal attainment scaling as a measure of clinically important change in nursing-home patients.

OBJECTIVES To assess the feasibility, validity and responsiveness of an individualized measure--goal attainment scaling-in long-term care. DESIGN Prospective descriptive study. SETTING One academic and three community-based long-term care facilities. SUBJECTS 53 nursing-home patients seen in consultation between July 1996 and June 1997. INTERVENTION Specialized geriatric medicine consultation. MAIN OUTCOME MEASURES Effect size and relative efficiency of the Barthel index, hierarchical assessment of balance and mobility, global deterioration scale, axis 8 (behaviour) of the brief cognitive rating scale, cumulative illness rating scale and the goal attainment scale. RESULTS Mean goal attainment scale at follow-up was 46+/-7. The goal attainment scale was the most responsive measure, with an effect size of 1.29 and a relative efficiency of 53.7. The goal attainment scale did not correlate well with the other measures (-0.22 to 0.17). CONCLUSION Goal attainment scaling is a feasible and responsive measure in long-term care. Although fewer problems in nursing-home patients than elderly inpatients are susceptible to intervention, clinically important goals can be achieved in this population.