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Abstract #153804

Jae Eun Lee, Dr PH and Dobrivoje S. Stokic, MD. Methodist Rehabilitation Center, 1350 E. Woodrow Wilson, Jackson, MS 39216, 601-364-3582, JaeLee@MMRCREHAB.ORG

Goal-setting is an essential component of rehabilitation practice yet limited evidence exists about the contributing factors and effectiveness. We retrospectively analyzed Functional Independence Measure (FIM) data, an 18-item burden of care instrument, from 3,441 patients admitted to our rehabilitation center. The aim was to compare FIM scores (range 1-7) for the goals set on admission with FIM scores on admission and discharge, and determine the impact of diagnostic groups, socio-demographic status, and medical complexity.

Higher average goals (≥1.5 admission scores) were set for mobility, lower body dressing, and bladder management. Lower average goals (≤1.0) were set for eating, climbing stairs, and cognitive items. Logistic regression models, controlling for severity of disability, found that significantly (p<0.05) higher goals were set for younger patients and those with brain and spinal cord injuries, whereas lower goals (p<0.01) were set for stroke and medically complicated patients. At discharge, 68% of patients achieved >15 goals but 9% <9 goals. Goal-attainment was higher for cognitive items, eating, and climbing stairs, and lower for sphincter management and tub transfer. Significantly (p<0.001) higher prevalence of meeting/exceeding goals was found for younger and orthopedic patients, whereas stroke and medically complicated patients less likely achieved set goals.

Our preliminary results indicate discrepancies between goals set and admission status across functional independence activities and identify age and diagnosis as contributing factors. Predictably, the expectation set on admission are inversely related to the goals met at discharge, however, the goal attainment is strongly influenced by age, diagnosis, and medical complexity of patients.

Learning Objectives:

• Describe the pattern of goal planning process on the 18 FIM items. Evaluate which functions are highly expected to be improved. 2.Identify the most difficult and easiest functions to be achieved.
• Discuss demographic and medical condition factors associated with goal-planning and goal-achievement. Determine importance of the severity of disability in goal-planning and goal-achievement.

Keywords: Disability, Practice-Based Research

Related Web page: www.mmrcrehab.org

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.