Paper
Wednesday, July 11, 2007
Older Adults' Use of Goals for Pain Management
Gail C. Davis, EdD and Terri L. White, RN, MS, FNP-C. College of Nursing, Texas Woman's University, Denton, TX, USA
| Learning Objective #1: discuss the positive outcomes for older adults who integrate goal setting into their pain management. |
| Learning Objective #2: explain the use of goal attainment scaling. |
Individual goal setting is an important part of the self-management essential for managing chronic pain. The major purpose of this study was to test the feasibility of using individual goal setting as part of a 4-month pain management intervention for adults age 65 or older living independently in residential settings. Seventeen individuals with an average age of 79.29 years (SD = 7.87) who experienced arthritis-related chronic pain volunteered to participate. Participation involved 3 weekly 1-hour group meetings focused on discussion of pain management strategies. These were followed by an individual goal-setting meeting at week 4; phone calls at weeks 5, 8, and 12; and a second individual meeting for goal attainment evaluation at week 16. Each participant set 2 goals, using goal attainment scaling (GAS), to be met by the time of the last meeting. As appropriate for this scaling methodology, each person also projected levels of goal attainment: expected (0), much less than expected (-2), somewhat less than expected (-1), somewhat more than expected (+1), and much more than expected (+2). These levels would then be used for evaluation. The Principal Investigator (P.I.) and Research Assistant (R.A.) met with the individuals as they set goals and when they evaluated their attainment of these goals 3 months later. The interrater reliability of the ratings between the P.I. and R.A. was 100%. Findings suggest that older adults can successfully participate in setting individualized goals and projecting possible attainment levels. Thirteen of the 17 participants either met or exceeded their goals when the scores of their two goals were averaged together. Participants’ expectations of how well they could manage their pain (t = -2.74, p = .015) also improved. These findings suggest that including goal setting as part of a pain management intervention is feasible and promotes positive outcomes.