Abstract
Purpose of the study: The aim of this study was to develop an individualised assessment tool capable of defining clinically meaningful change within areas identified by each patient as important.
Background: Much work has been dedicated to identifying a definition of successful outcome in LBP. However, what is important to the patient is often not considered, or is poorly assessed. Goals that are important to the individual enhance self-engagement, and can serve as strong motivators of action in rehabilitation. Goal Scaling is a method which enables patients to systematically identify individualised goals, to quantify their achievement, and may provide a valid outcome of genuine importance to the patient.
Methods: A semi-structured interview was developed around the principles of goal attainment scaling, but modified to elicit patient identified individualised goals that incorporate a marker of “minimum important change” within each scale. Patients also completed measures on disability and global change in condition, and were followed-up for six months.
Results: Thirty-five patients referred to a specialised LBP clinic took part in this pilot study. Patients were able to identify specific realistic goals, and understood the concept of minimal important change within their chosen goal areas. At six months, goal attainment scores were responsive to change, associated with disability and global change in condition, and able to distinguish between “improvers” and “non-improvers”.
Conclusion: Goal scaling provided useful additional information about the problems associated with, and the progress of patients with LBP. Work on a self-complete version for use in clinical trials is underway.
Correspondence should be addressed to SBPR at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
