a Regional Hyper-acute Rehabilitation Unit , Northwick Park Hospital , London , UK.
b Department of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care , King's College London , London , UK.
Disabil Rehabil. 2019 Aug;41(16):1925-1930. doi: 10.1080/09638288.2018.1451927. Epub 2018 Mar 20.
Goal-classification of person-centred goals, using Goal Attainment Scaling for leg spasticity treatment. The study was conducted in two phases: phase I, a retrospective review to evaluate categories of goal set in routine clinical practice. Findings were used to design a goal classification system. Phase II, a multi-centre study to confirm the goal categories. Goals set ( = 270) were analysed from data collected at three centres in the UK (one centre for phase I). Goal categories were mapped onto the domains of the World Health Organisation, International Classification of Functioning Disability and Health. One hundred and twenty seven participants were recruited in two cohorts: phase I: 63; phase II: 64. Goal categories using both cohorts were assigned to two domains, each subdivided into three key goal categories: : body structure impairment 121 (44%): (a) pain/discomfort 34 (12%), (b) involuntary movements 20 (7%), and (c) range of movement/contracture prevention 67 (25%). : activity function 149 (56%): (a) passive function (ease of caring for the affected limb) = 89 (33%), (b) active function (transfers) 26 (10%), and (c) active function (mobility) 27 (10%), other = 7 (3%). Patients individual leg spasticity goals can be grouped into six categories and two domains, which will assist clinicians, patients and cares in setting and evaluating goals in practice. Implications for Rehabilitation Six goal areas used in clinical goal setting for leg spasticity management were identified, under the two domains: (1) body structure impairment: pain, involuntary movements, and range of movement and (2) activities/function: passive function (ease of caring), active function - transfers or standing and active function - mobility. Categorisation of goals is consistent on repeated evaluation and across different clinical services. Using clinical goals for leg spasticity treatment is an effective method to identify treatment priorities.
以目标达成度评量分类以人為中心的目标，用于治疗腿部痉挛。本研究分為两个阶段：第一阶段，回顾性审查评估常规临床实践中设定的目标类别。研究结果被用来设计一个目标分类系统。第二阶段，一项多中心研究，旨在确认目标类别。在英国的三个中心（第一阶段的一个中心）收集的数据中分析了设定的目标（ = 270）。目标类别映射到世界卫生组织、国际功能、残疾和健康分类的领域。在两个队列中招募了 127 名参与者：第一阶段：63；第二阶段：64。使用两个队列的目标类别被分配到两个领域，每个领域进一步细分为三个关键目标类别：身体结构损伤 121（44%）：（a）疼痛/不适 34（12%），（b）不随意运动 20（7%），和（c）运动范围/挛缩预防 67（25%）。活动功能 149（56%）：（a）被动功能（方便照顾受影响的肢体） = 89（33%），（b）主动功能（转移）26（10%），和（c）主动功能（移动）27（10%），其他 7（3%）。患者腿部痉挛的个别目标可以分为六个类别和两个领域，这将帮助临床医生、患者和护理人员在实践中设定和评估目标。对康复的启示在腿部痉挛管理的临床目标设定中确定了六个目标领域，分为两个领域：（1）身体结构损伤：疼痛、不随意运动和运动范围，（2）活动/功能：被动功能（方便照顾），主动功能-转移或站立和主动功能-移动。目标的分类在重复评估和不同的临床服务中是一致的。使用治疗腿部痉挛的临床目标是确定治疗重点的有效方法。
