본문 바로가기
KERD
논문KCI 등재

환자중심 목표설정이 아급성기 뇌졸중 환자의재활치료 성과에 미치는 영향

The Effect of Patient-Centered Goal Setting on Rehabilitation Outcomes in Patients With Subacute Stroke

박민희|원종임|안창만
한국전문물리치료학회 (Korean Research Society of Physical Therapy)|2018.02|한국전문물리치료학회지 (Physical Therapy Korea)|제25권 제1호|pp. 31-38|DOI https://doi.org/10.12674/ptk.2018.25.1.031

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

ParticipationStroke.Goal attainment scaleModified Barthel indexPatient-centered goalRivermead mobility index
주제분류물리치료학

초록

Background: Patient-centered care has recently become highly recommended, because it can improve health outcomes more effectively than problem-oriented care. The goal attainment scale (GAS) is one of the methods used for patient-centered care. It was originally developed as an outcome measurement tool, but it can also be used as a therapeutic intervention when setting quantifiable patient-centered goals. Objects: We sought to identify the effect of setting patient-centered goals on rehabilitation outcomes in patients with subacute stoke using GAS. Methods: Overall, 46 subjects with subacute stroke were divided into experimental (n1=23) and control (n2=23) groups. Subjects in both groups attended physical therapy sessions five times a week for four weeks. Those in the experimental group set goals using goal-attainment scaling. The mobility of each subject was evaluated using the Rivermead mobility index (RMI); daily-living activities, using the K-modified Barthel index (K-MBI); participation, using the Hopkins rehabilitation-engagement rating scale (HRERS); satisfaction, using the patient-satisfaction scale (PSS). Results: Subjects in the experimental group experienced more significant increases in RMI, HRERS, and PSS than those in the control group (p<.05, p<.05 and p<.01, respectively). After four weeks, GAS scores of the experimental group had increased more significantly than those of baseline (p<.01). Conclusion: Setting patient-centered goals is effective in improving the mobility and satisfaction of patients with subacute stoke. Setting patient-centered goals needs to be performed more frequently in clinical settings.

Abstract

Background: Patient-centered care has recently become highly recommended, because it can improve health outcomes more effectively than problem-oriented care. The goal attainment scale (GAS) is one of the methods used for patient-centered care. It was originally developed as an outcome measurement tool, but it can also be used as a therapeutic intervention when setting quantifiable patient-centered goals. Objects: We sought to identify the effect of setting patient-centered goals on rehabilitation outcomes in patients with subacute stoke using GAS. Methods: Overall, 46 subjects with subacute stroke were divided into experimental (n1=23) and control (n2=23) groups. Subjects in both groups attended physical therapy sessions five times a week for four weeks. Those in the experimental group set goals using goal-attainment scaling. The mobility of each subject was evaluated using the Rivermead mobility index (RMI); daily-living activities, using the K-modified Barthel index (K-MBI); participation, using the Hopkins rehabilitation-engagement rating scale (HRERS); satisfaction, using the patient-satisfaction scale (PSS). Results: Subjects in the experimental group experienced more significant increases in RMI, HRERS, and PSS than those in the control group (p<.05, p<.05 and p<.01, respectively). After four weeks, GAS scores of the experimental group had increased more significantly than those of baseline (p<.01). Conclusion: Setting patient-centered goals is effective in improving the mobility and satisfaction of patients with subacute stoke. Setting patient-centered goals needs to be performed more frequently in clinical settings.

참고문헌 (32)

  1. Bouwens SF, "Review of goal attainment scaling as a useful outcome measure in psychogeriatric patients with cognitive disorders", Dement Geriatr Cogn Disord, 26(6), pp.528~540 (2008)[DOI]
  2. Bovend'Eerdt TJ, "Writing SMART rehabilitation goals and achieving goal attainment scaling: A practical guide", Clin Rehabil, 23(4), pp.352~361 (2009)[DOI]
  3. Bovend'Eerdt TJ, "Agreement between two different scoring procedures for goal attainment scaling is low", J Rehabil Med, 43(1), pp.46~49 (2011)[DOI]
  4. Carroll JG, "In the "medical home" adult primary care setting, practitioners are seeing an increasing emphasis on patient involvement in setting the goals of care", Qual Manag Health Care, 20(2), pp.87~88 (2011)[DOI]
  5. Cott CA, "Client-centered rehabilitation: What is it and how do we measure it?", Physiotherapy, 94, pp.89~90 (2008)[DOI]
  6. Coulter A, "Effectiveness of strategies for informing, educating, and involving patients", BMJ, 335(7609), pp.24~27 (2007)[DOI]
  7. Grant M, "Goal Attainment Scaling in brain injury rehabilitaation: Strengths, limitations and recommendations for future applications", Neuropsychol Rehabil, 24(5), pp.661~677 (2014)[DOI]
  8. Holliday RC, "A survey of goal-setting methods used in rehabilitation", Neurorehabil Neural Repair, 19(3), pp.227~231 (2005)[DOI]
  9. Hsueh IP, "Comparison of psychometric properties of three mobility measures for patients with stroke", Stroke, 34(7), pp.1741~1745 (2003)[DOI]
  10. Hurn J, "Goal setting as an outcome measure: A systematic review", Clin Rehabil, 20(9), pp.756~772 (2006)[DOI]
  11. Khan F, "Use of goal attainment scaling in inpatient rehabilitation for persons with multiple sclerosis", Arch Phys Med Rehabil, 89(4), pp.652~659 (2008)[DOI]
  12. Kortte KB, "The Hopkins Rehabilitation Engagement Rating Scale: Development and psychometric properties", Arch Phys Med Rehabil, 88(7), pp.877~884 (2007)[DOI]
  13. Krasny-Pacini A, "Goal attainment scaling in rehabilitation: A literature-based update", Ann Phys Rehabil Med, 56(3), pp.212~230 (2013)[DOI]
  14. Kristensen HK, "The Importance of Patient Involvement in Stroke Rehabilitation", PLoS One, 11(6), pp.e0157149~ (2016)[DOI]
  15. Lenze EJ, "Significance of poor patient participation in physical and occupational therapy for functional outcome and length of stay", Arch Phys Med Rehabil, 85(10), pp.1599~1601 (2004)[DOI]
  16. Levack WM, "Goal setting and strategies to enhance goal pursuit for adult with acquired disability participating in rehabilitation", Cochrane Database Syst Rev, 20(7) (2015)
  17. Lewin SA, "Interventions for providers to promote a patient-centred approach in clinical consultations", Cochrane Database Syst Rev, (4) (2001)
  18. Locke, "Building a practically useful theory of goal setting and task motivation. A 35-year odyssey", Am Psychol, 57(9), pp.705~717 (2002)[DOI]
  19. Luker J, "Stroke survivors' experiences of physical rehabilitation: A systematic review of qualitative studies", Arch Phys Med Rehabil, 96, pp.1698~1708 (2015)[DOI]
  20. Monnin D, "Scale to measure patient satisfaction with physical therapy", Phys Ther, 82(7), pp.682~691 (2002)
  21. Ottenbacher KJ, "Goal attainment scaling as a method of clinical service evaluation", Am J Occup Ther, 44(6), pp.519~525 (1990)[DOI]
  22. Reid A, "Goal attainment scaling: Is it appropriate for stroke patients and their physiotherapists?", Physiotherapy, 84(3), pp.136~144 (1998)[DOI]
  23. Reuben DB, "Goal-oriented patient care-An alternative health outcomes paradigm", N Engl J Med, 366(9), pp.777~779 (2012)[DOI]
  24. Rockwood K, "Responsiveness of goal attainment scaling in a randomized controlled trial of comprehensive geriatric assessment", J Clin Epidemiol, 56(8), pp.736~743 (2003)[DOI]
  25. Schulman-Green DJ, "Goal setting as a shared decision making strategy among clinicians and their older patients", Patient Educ Couns, 63(1-2), pp.145~151 (2006)[DOI]
  26. Steenbeek D, "Responsiveness of Goal Attainment Scaling in comparison to two standardized measures in outcome evaluation of children with cerebral palsy", Clin Rehabil, 25(12), pp.1128~1139 (2011)[DOI]
  27. Sumsion T, "A review of evidence on the conceptual elements informing client-centred practice", Can J Occup Ther, 73(3), pp.153~162 (2006)[DOI]
  28. Toto PE, "Goal attainment scaling(GAS) in geriatric primary care: A feasibility study", Arch Gerontol Geriatr, 60, pp.16~21 (2015)[DOI]
  29. Turner-Stokes L, "Goal attainment scaling (GAS) in rehabilitation: A practical guide", Clin Rehabil, 23(4), pp.362~370 (2009)[DOI]
  30. Turner-Stokes L, "Goal attainment scaling: A direct comparison of alternative rating methods", Clin Rehabil, 24(1), pp.66~73 (2010)[DOI]
  31. Webb PM, "The effects of direct involvement in goal setting on rehabilitation outcome for persons with traumatic brain injuries", Rehabil Psychology, 39(3), pp.179~188 (1994)[DOI]
  32. Wressle E, "Improved client participation in the rehabilitation process using a client-centred goal formulation structure", J Rehabil Med, 34(1), pp.5~11 (2002)[DOI]

관련 논문AI추천

Usefulness of Goal Attainment Scaling in Intensive Stroke Rehabilitation During the Subacute Stage김민영, Jaehoon Sim, Jongmoon Kim, Joonhyun Park, Youngsu Jung대한재활의학회 · Annals of Rehabilitation Medicine2020 · 제44권 제3호뇌졸중 환자의 재활참여가 기능회복에 미치는 영향원종임한국전문물리치료학회 · 한국전문물리치료학회지2020 · 제27권 제1호뇌졸중 환자의 재활동기 평가도구에 관한 체계적 문헌고찰박강현, 이은영대한신경계작업치료학회 · 재활치료과학2023 · 제12권 제2호과제지향적 자세조절 훈련이 아급성기 뇌졸중 환자의 자세조절 및 균형과 일상생활 수행능력에 미치는 영향강태우, 김태윤특수교육재활과학연구소 · 특수교육재활과학연구2016 · 제55권 제2호Effect of a Caregiver’s Education Program on Stroke Rehabilitation김상근, 김이진, 김창환, 김태현, 이의창, 정한영, 좌경림, 한희준, 홍상은대한재활의학회 · Annals of Rehabilitation Medicine2017 · 제41권 제1호재가방문재활 프로그램이 만성 뇌졸중 환자의 일상생활활동과 자기효능감 및 삶의 질에 미치는 영향사공 봉, 이하영특수교육재활과학연구소 · 특수교육재활과학연구2015 · 제54권 제3호

이 간행물의 다른 논문 (7건)

허리둘레변화 감지의 실시간 되먹임을 통한 의도적인 복근수축이 요추관 협착증 환자의 골반경사와 기능적 능력 그리고 신경근 조절에 미치는 영향최종덕, 성재현, 김창범pp. 1-11정상 아동과 뇌성마비 아동의 감소된 횡격막움직임 및 호흡 기능의 비교심재훈, 강민수, 강선영pp. 12-21옆으로 누워 엉덩관절 벌림운동 시 복부드로우-인, 복부브레이싱, 골반압박벨트가 중간볼기근과 몸통 근육의 활성도에 미치는 영향김동우, 김태호pp. 22-30만성 뇌졸중 환자의 낙상 예측을 위한 버그균형 척도와 플러턴 어드밴스드 균형 척도의 비교김소정, 남택길, 김경모, 김준섭, 강정하, 김인섭pp. 39-46주짓수 선수의 허리 통증 유무에 따른 엉덩관절 돌림 가동범위 비교경문수, 김시현, 박규남, 양성준pp. 47-52
원문 보기