goals and outcome measures Flashcards
what is the reason for goal setting?
-recommended in the guidelines in neuro rehab
-patient entered goals - ensure to consider the patient rather than just the condition
-motivation for patient
-inspires a sense of autonomy in patients
-evaluate and monitor how treatment is going
-ensure everything is at an appropriate level of difficulty for the patients
-spending time discussing with patient what matters to them and what they would like to work towards - this helps to build rapport
what are examples of some barriers to goal setting in rehab?
-patients cognitive or speech impairments
-staff shortage
-time constraints for staff
-poor mood eg depression and anxiety
-physical weakness, wellness and fatigue
-unrealistic expectations
-therapists can overestimate how much they have included the pts
what is anosognosia?
when people are not aware of their own deficits- this could be a big barrier for goal setting
what impact does involving family, carers or NOK in goal setting?
it has been reported to enhance their understanding of their roles in achieving the established goals, to help patients be more realistic and to help develop awareness of their functional limitations
what are examples of methods of goal setting?
-problem oriented
-needs based
-impairement based
-patient centered
-therapist controlled
-therapist led
what are examples of goal setting skills?
-assess patient needs and abilities - physical, cognitive and emotional needs through assessments and identifying strengths and weaknesses
-set SMART goals
-monitor and modify goals
-incorporate patient and family in goal setting
-outcome evaluation - evaluate the success of the rehab program by measuring outcomes against initial goals
describe the ICF framework
-this is called the international classification of functioning, disability and health made by the WHO
-body structures & functions - how the body works and is there any impairment?
-activities - what activities are limited? eg walking, eating, dressing
-participation - what areas of life are affected eg social events, hobbies
also environmental factors eg family support, relationships and personal factors eg coping strategies, personality traits,
what is an outcome measure?
an instrument or scale that provides a clear method of testing or rating a part of your assessment
what are examples of benefits of using an outcome measure in stroke rehab?
-gives more info about the extent of a particular deficit
-gives more info about ability
-facilitates communication with colleagues and the MDT
-helps direct management
-useful in goal setting
-useful for handovers with staff
what are some examples of stroke outcome measures?
-modified ashwortth scale
-motor assessment scale
-berg balance assessment
-TUG
-10m walk test
-9 hole peg test
-rivermead motor assessment
-functional indolence measure
-functional ambulation category
-SARA- scale for the assessment and rating of ataxia
-mobility scale for acute stroke (MSAS)
What are examples of general gait and balance outcome measures (not stroke specific)?
-berg balance scale
-TUG
-10m walk test
-6 min walk test
what are examples of activity level outcome measures for the UL?
-frenchay arm test - 5 tasks
-nine hole peg test
what are examples of outcome measures used for ADLs and participation?
-barthel index
-nottingham EADL scale
