The use of goal attainment scaling in neuropsychological rehabilitation in multiple sclerosis

Abstract

Purpose: The overall objective was to apply the goal attainment scaling (GAS) in neuropsychological rehabilitation in multiple sclerosis (MS). The specific aims were to evaluate whether (1) GAS-rated goals are attained; (2) attaining goals is related to standardized rehabilitation outcome measures; and (3) GAS-rated goals can be mapped to the International Classification of Functioning, Disability, and Health (ICF). Method: 56 relapsing-remitting MS patients received neuropsychological rehabilitation conducted once a week for 13 consecutive weeks. The attainment of GAS-rated personal goals and the association between achievement of goals and standardized rehabilitation outcome were evaluated. Moreover, GAS-rated goals were mapped to the ICF. Results: Median (interquartile range) GAS attainment T-score was 56.0 (50.0–62.0); 88.8% of personal goals set were fully achieved. The attainment of goals was not significantly associated with the outcome in majority of the standardized measures. Of the 182 meaningful concepts identified in the goals, 181 could be mapped to the ICF. Conclusions: GAS seems to be an appropriate outcome measure in neuropsychological rehabilitation in MS. GAS-rated personal goals were well achieved, and GAS was found to tap changes not covered with standardized outcome measures.

Implications for Rehabilitation

• GAS seems to be an appropriate outcome measure in neuropsychological rehabilitation in MS.

• GAS-rated personal goals were well achieved, and GAS was found to tap changes in the areas not covered with standardized outcome measures.

• GAS seems to offer a possibility to take into account the specific needs of each individual patient.

• The ICF can be used to classify goals in neuropsychological rehabilitation in MS.

• Goals
• goal attainment scaling
• International Classification of Functioning, Disability and Health
• multiple sclerosis
• rehabilitation

Acknowledgements

We thank all of our patients for their time and interest in this study. Marjatta Musikka-Siirtola is thanked for the training related to the ICF and the mapping of the goals to the ICF. Mervi Ranta and Anna Ikonen are warmly thanked for the neuropsychological assessments and Arja Lilja for the neuropsychological rehabilitation given to the patients.

Declaration of interest

The authors report no conflict of interest.

This study was funded by the Social Insurance Institution of Finland, which is gratefully acknowledged.