Feasibility of Goal Attainment Scaling as an Outcome Measure for Patients with Chronic Low Back Pain receiving Physical Therapy

目标达成量表作为接受物理治疗的慢性腰痛患者的结果衡量指标的可行性

• 批准号: 9565764
• 负责人: Douglas Haladay
• 金额: $ 5.54万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-05-01 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9565764
• 关键词: Feasibility; Goal; Attainment; Scaling; Outcome

Project Summary Background: Clinical outcomes used for patients with low back pain (LBP), often fail to incorporate patient-centeredness and may not fully reflect the scope of a patient’s individual needs. Goal Attainment Scaling (GAS), where patients initiate and identify his/her particular goal(s), may better reflect goals that are important for individual treatment success. GAS has been inadequately developed and validated for patients with chronic LBP receiving physical therapy. Objectives/Specific Aims: The primary objective of this proposal is to establish feasibility in a pilot test that develops a reliable and valid application of GAS for patients with chronic LBP receiving physical therapy. Specific Aim 1: To develop a new application of GAS procedures to be used by physical therapists treating patients with chronic LBP. Design: Pilot prospective cohort study. Population: For phase 1, we will recruit 30 adults with a history of non-specific chronic LBP. For phase 2, we will recruit 30 patients with chronic LBP seeking physical therapy from the USF Morsani Center for Advanced Healthcare. Methods: In Phase 1, we will conduct a qualitative study, centered on grounded theory by conducting focus groups of patients with chronic LBP to identify an inventory of goals, which will be used to generate a series of questions to assist the patient in generating goals in Phase 2. In Phase 2, we will pilot-test GAS in patients with chronic LBP to determine its feasibility in a clinical setting. Numerical Rating Scale (NRS), Oswestry Disability Index (ODI), Minimum Dataset, and GAS will be obtained prior to and following care. Two physical therapists will administer GAS along with usual care for each patient prior to and following care. A third physical therapist will observe the outcome collection to establish feasibility, fidelity, and reliability.Data Analysis: Sub-aim 1a: Following the transcription of field notes, participant views will be examined to identify emerging themes and an interpretive analysis will be performed to explain the findings. The researchers will analyze those themes and researcher triangulation will be used to establish validity, or trustworthiness. Sub-aim 1b: Descriptive data for all variables will be calculated. GAS process, feasibility, and fidelity, will be evaluated by measuring the time to administer GAS, checklist adherence, and nature of the goals identified. Inter-rater reliability and criterion validity of GAS scores will be assessed using a Spearman rank correlations to examine the association between two independent examiners and between GAS and ODI scores, respectively. Responsiveness will be assessed by comparing standardized response means (SRMs) for the NRS, ODI, and GAS, while Chi square analyses will be used to determine if differences exist between the tests. Impact: GAS will enhance the measurement of outcomes for not only patients with chronic LBP, but for other patients receiving physical therapy, thereby improving the patient-centered care and ultimately the quality of life for patients.

项目摘要 背景：用于腰痛（LBP）患者的临床结局，通常未能纳入 这是以病人为中心的，可能不能完全反映病人的个人需求。目标达成 患者发起并确定其特定目标的缩放（GAS）可能更好地反映 对个体化治疗的成功至关重要。GAS的开发和验证不充分， 接受物理治疗的慢性LBP患者。目标/具体目标： 这个建议是要在一个试点测试中建立可行性，以开发一个可靠和有效的GAS应用 对于接受物理治疗的慢性LBP患者。具体目标1：开发一种新的 物理治疗师治疗慢性LBP患者时使用的GAS程序。设计：飞行员 前瞻性队列研究。人群：对于第1阶段，我们将招募30名有非特异性 慢性LBP对于第二阶段，我们将招募30名慢性LBP患者， USF Morsani Center for Advanced Healthcare。方法：在第1阶段，我们将进行定性研究， 以扎根理论为中心，通过对慢性LBP患者进行焦点小组调查， 目标，将用于生成一系列问题，以帮助患者在阶段中生成目标 2.在第2阶段，我们将在慢性LBP患者中进行GAS的试点测试，以确定其在临床环境中的可行性。 将获得数字评定量表（NRS）、奥斯韦斯特里残疾指数（ODI）、最小数据集和GAS 在护理之前和之后。两名物理治疗师将对每名患者进行沿着GAS和常规护理 在护理之前和之后。第三个物理治疗师将观察结果收集，以建立可行性， 数据分析：次级目标1a：在记录实地记录之后， 将审查意见，以确定新出现的主题，并进行解释性分析， 解释调查结果。研究人员将分析这些主题和研究人员三角测量将被使用 以建立有效性或可信度。子目标1b：将计算所有变量的描述性数据。 将通过测量GAS管理时间、检查表来评价GAS过程、可行性和保真度 坚持和确定的目标的性质。GAS评分的评分员间信度和标准效度将 使用斯皮尔曼等级相关性进行评估，以检查两个独立 考官和GAS和ODI分数之间。响应性将通过以下方式进行评估： 比较NRS、ODI和GAS的标准化响应均值（SRM），而卡方分析 将用于确定测试之间是否存在差异。影响：GAS将增强 不仅测量慢性LBP患者的结局，而且测量其他接受物理治疗的患者的结局。 治疗，从而改善以患者为中心的护理，并最终改善患者的生活质量。