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- Title
Rehabilitation goals towards the end of life: what matters to people with advanced disease in hospice care?
- Authors
Ashford, S.; Maddocks, M.; Fettes, L.; Higginson, I. J.; Gao, W.; Turner-Stokes, L.
- Abstract
Background: Rehabilitation is a key component of palliative care. We aimed to (1) determine the timescale and nature of patient identified rehabilitation goals; (2) identify the overall level of goal attainment; and (3) understand which patient, service, and goal-related factors affect goal attainment. Method: Adults with advanced progressive disease attending 10 UK hospices set rehabilitation goals with staff who had received standardized training. Goals were mapped onto World Health Organisation - International Classification of Function, disability and health (WHO-ICF) codes and categorized according to impairment, activity, or participation. Goal attainment was evaluated in two ways: (1) as a binary outcome and (2) using change in T-score. Results/Findings: A total of 355 patients (190 females, mean (SD) age 70 (11) years) took part. The group set 632 individual goals (range per patient 1-4) spanning 13 WHO-ICF domains. Goals had a median (range) timescale of 28 (1196) days. Twenty-five per cent of goals had a primary focus on impairment, 52% on activity, and 23% on participation. Goals frequently related to mobility (WHO-ICF code d4, n = 113); general tasks and demands (d2, n = 99); community, social, and civic life (d9, n = 97); mental functions (bl, n = 95); and self-care (d5, n = 67). A total of 302 out of 632 goals (47.8%) were attained with a mean change in Goal Attainment Scale (GAS) test (T)-score of 8.6 points (95% CI 7.6-9.7). Factors positively associated with attainment were inpatient setting (P < 0.001), short (≤14 days) goal timeframe (P = 0.009), and minor difficulty level as perceived by staff (P = 0.005). Conclusion: Patients with advanced progressive disease, receiving hospice care, can set and attain functional goals including near the end of life. Most goals focus on retaining independence in life activities and situations, often by managing symptoms and emotions.
- Subjects
ENGLAND; HOSPICE care; CONFERENCES &; conventions; GOAL (Psychology); PATIENTS; REHABILITATION; PSYCHOLOGY
- Publication
Clinical Rehabilitation, 2018, Vol 32, Issue 10, p1407
- ISSN
0269-2155
- Publication type
Abstract
- DOI
10.1177/0269215518784346