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PubMedDate not supplied

Staff nurse performance. Effects of goal-setting and performance feedback.

Goal-setting and performance feedback have motivated improved performance in various occupational groups for over 30 years. During the current time of staffing cutbacks and increased patient acuity, the nurse administrator has growing concern for the morale of the nursing staff. In this study, goal-setting and performance feedback, used in conjunction with a performance appraisal session, were successful in improving the performance of staff nurses. The author outlines the implications for head nurse training.

Adult↗
PubMed1979

Developing reimbursable clinical pharmacy programs: a goal-oriented approach.

Using a goal-oriented approach, a model for achieving third-party reimbursement for clinical pharmaceutical services is proposed. Within the framework of this model, the discussion includes: (1) determination of the hospital pharmacy mission, goals and objectives; (2) classification of clinical services into eight categories to establish the reimbursement potential for each service; (3) development of a clinical service protocol, techniques to establish charges and stages involved in communicating with the parties affected by the clinical services; and (4) methodologies for evaluating program outcome.

Evaluation Studies as Topic↗
PubMed1979

A mathematical model of speedskating performance improvement for goal setting and program evaluation.

An analysis of world class performance improvement over chronological time was used to develop mathematical curves of performance for each speedskating event. The equations were calculated using an unconstrained non-linear least squares iterative curve-fitting technique. A non-linear model was selected to satisfy the principle of diminishing returns, that is, it is more difficult to achieve a unit of performance improvement as performance approaches the theoretical limits of man. Minimum criteria of acceptance for each curve were: 1) the coefficient of determination must be 0.90; 2) the year 2000 predicted value must be less than the current world record; and 3) the curve must be progressive, i.e. satisfy the principle of diminishing returns. Satisfactory curves were calculated for seven of the eight male and female events studied. A four year Olympic cycle was noted and a definite change in performance trend was identified as occurring in the mid 1960's. The calculated mathematical curves can be used in three applications: 1) setting objective individual goals and evaluating these goals; 2) evaluating and comparing training programs on successive years; and 3) evaluating total programs.

Female↗
PubMed1983

Learning goals during initial rehabilitation hospitalization.

While learning theory and various clinical applications play an increasingly significant role in the design and delivery of rehabilitation services, data to determine the extent that teaching/learning are integral to rehabilitation goals are lacking. Medical records of 20 first admission spinal cord injured patients were analyzed for the proportion of teaching/learning goals, plans, and activities entered by professional disciplines on the rehabilitation team. A classification system for medical chart entries was devised for this purpose. Results indicated that 65% of the total chart entries reflected teaching/learning or attempts to accelerate or decelerate specific behaviors. Across professional disciplines nursing showed the highest proportion of chart entries focused on patient teaching/learning. Present findings support recent trends toward systematic and more sophisticated application of learning theory and technology, and suggest that professional preparation of rehabilitation personnel should include training in how to teach and how to facilitate skill acquisition.

Adolescent↗
PubMed1982

Career goals and expectations of men and women pharmacy residents.

Personal and professional characteristics of men and women hospital pharmacy residents were studied to identify differences that could affect future hospital pharmacy practice. Residents in 111 ASHP-accredited pharmacy residency programs received a survey containing questions on demographic information, reasons for selecting a residency, areas of professional interest, postresidency career goals, responsibilities to home and family, and advantages and disadvantages associated with gender. Of 286 residents receiving questionnaires, 226 responded; the percentages of men and women responding corresponded to the ratio of men and women in hospital pharmacy residencies. While men and women expressed educational goals that were not significantly different, more men than women had earned or were in the process of earning advanced degrees. No significant differences were evident between men's and women's plans for marriage and children, but 73% of the women indicated that they would take time out from their practice to raise children, compared with only 9% of the men. The majority of residents did not think their gender affected them in their residency programs, but in professional interactions more men saw gender as an advantage and more women as a disadvantage. Significantly more than women aspired to be hospital pharmacy directors. The results suggest that men are obtaining advanced training closer to the time they graduate from pharmacy school and that in the future women competing for promotions may be older than men competing for comparable positions. Those planning pharmacy staffing should consider the needs of women, and men, who expect to take time out from their careers for family responsibilities and possibly seek part-time positions when they return to the work force.

Adult↗
PubMedDate not supplied

Combining behavior management and mutual goal setting to reduce physical dependency in nursing home residents.

The effectiveness of three nursing approaches in fostering self-care behaviors in elderly nursing home residents was compared. The study was conducted in three intermediate care nursing homes. Each home was randomly assigned to one of three conditions: a combination of behavior modification and mutual goal setting (Condition 1), mutual goal setting only (Condition 2), and routine nursing care (Condition 3). Seventy-nine subjects completed the study. In-service training was provided to nursing staff in Conditions 1 and 2 but not in Condition 3. Over a period of 22 weeks, nursing staff encouraged subjects to do parts of their morning activities of daily living (ADLs) independently. When the groups were compared on self-care behaviors at the end of the 22 weeks, subjects who received the combination treatment performed significantly more self-care behaviors than those in the other two groups.

Activities of Daily Living↗
PubMed1994

Use of goal attainment scaling in brain injury in a rehabilitation hospital.

We report a study of the measurement properties of goal attainment (GA) scaling when used in the rehabilitation of brain injury patients. GA scaling is an individualized measurement technique with mathematical properties allowing for calculation of summary scores with a normal distribution. The present study examined 16 inpatients, 13 of whom had suffered a traumatic brain injury. In addition to GA scaling, standardized measures were employed to address issues such as content validity and construct validity. GA scaling change scores correlated highly (r = 0.81) with clinical judgment of efficacy and modestly with standard performance measures. A high level of inter-rater reliability was found between admission (r = 0.92) and discharge (r = 0.94) scores. GA scaling seems to be a feasible method of evaluating rehabilitation in brain injury patients, with promising measurement properties. The goals set are extremely meaningful to the patient and rehabilitation team, providing valuable feedback throughout the rehabilitation course.

Activities of Daily Living↗
PubMed1993

The Human Genome Project. History, goals, and progress to date.

This article presents an overview of the Human Genome Project. The goals of the program are outlined; the genetic, physical, and DNA sequence maps that will be its products are defined; the brief origins of the project are traced; the management structure of the US Human Genome Project, in which the Department of Energy and the National Institutes of Health participate as partners, is outlined; international dimensions are discussed; the excellent progress to date with respect to each of the eight scientific goals is reported; and the projected impact of the project on biology and medicine is discussed.

Chromosome Mapping↗
PubMed1996

[Individual therapy goals: on outcome documentation of inpatient psychotherapy from the patient and therapist viewpoint].

The results of a study evaluation in practicability of two newly developed documentation forms are presented. Examined are 82 inpatient treatment episodes in an already published clinical concept with different treatment settings. Parallel versions of the forms were completed by patients and therapists. The 'Erge-Doku-A-Form' allows for the naming of up to five therapy goals determined at the beginning of therapy and evaluated in relation to their achieved quality at the end of therapy. The 'Erge-Doku-B-Form' describes a variety of problem areas as well as questions related to medication and changes induced by therapy. Surprising there were a high number of 230 Individual Therapy Goals (ITG) by patients and 262 ITG by therapists which could be arranged into 89 content categories and 5 main categories. Outcome measurement shows different results. There was a significant relationship between the 'well-being', the impression of 'satisfying treatment' at the end of the inpatient period and 'success in the main ITG'. The documentation forms presented here allow an outcome-measurement depending on differential indications.

Adult↗
PubMed1997

Comparative results of goal oriented therapy for erectile dysfunction.

PURPOSE: Goal oriented therapy for erectile dysfunction, based on a complete education of the couple, was offered to 460 patients. The short-term and long-term results of the first and second treatments selected were compared. MATERIALS AND METHODS: From September 1991 to March 1995, 460 patients with erectile dysfunction were evaluated and treated prospectively. The success of treatment, selected by the patient or couple, was defined as the ability to achieve and maintain good erections for successful coitus for at least 1 year after the start of therapy. Sexual satisfaction of the couple was required to confirm a successful outcome. RESULTS: The preferred first line of treatment by 322 patients was pharmacotherapy, with intracavernous injections being the second most selected therapy (80% success rate). However, there was a high long-term dropout rate for intracavernous injections. Approximately 70% of the patients were lost to followup or refused further treatment. CONCLUSIONS: Overall, this prospective study showed that goal oriented therapy is initially highly successful. However, the long-term high dropout rate and dissatisfaction of the couple cast doubt about the efficacy of the present treatment options.

Adult↗
PubMed1997

[Personal values and goal orientations of chronically ill adolescents and young adults].

For all those involved in the care of the chronically ill, to provide support in a professional manner implies to strive for a comprehensive understanding of the specific coping strategies in the light of the individual person's priorities. Coping research has yet to present a systematic analysis of personal values, goals and expectations of the chronically ill. The reader is invited to approach the topic by a review of the relevant literature and presentation of our own study on the classification of individual values and goals in 164 chronically ill adolescents and young adults (cystic fibrosis, Crohn's disease, haemophilia). Regarding personal values, the responses by the young patients were allocated to three main categories: pursuit of social contacts, striving for acceptance of the disease, the striving for joyful and intense living. Finally the relevance of personal values for appropriately coping with a serious illness is discussed.

Adaptation, Psychological↗
PubMedDate not supplied

[The motivational dominant and goal-directed behavior].

The experimental studies of motivational dominants of thirst and hunger and "polarization" motor dominant as well as the analysis of formation of the I- and II-type conditioned responses lead to the conclusion that discontinuation of a motivational dominant plays a key role in goal-directed behavior. The activation of backward connections between corresponding centers forms the basis for realization of goal-directed behavior.

Animals↗
PubMed2005

Health in the developing world: achieving the Millennium Development Goals.

The Millennium Development Goals depend critically on scaling up public health investments in developing countries. As a matter of urgency, developing-country governments must present detailed investment plans that are sufficiently ambitious to meet the goals, and the plans must be inserted into existing donor processes. Donor countries must keep the promises they have often reiterated of increased assistance, which they can easily afford, to help improve health in the developing countries and ensure stability for the whole world.

Advisory Committees↗
PubMed2000

The lipid treatment assessment project (L-TAP): a multicenter survey to evaluate the percentages of dyslipidemic patients receiving lipid-lowering therapy and achieving low-density lipoprotein cholesterol goals.

OBJECTIVE: To determine the percentage of patients in the multicenter Lipid Treatment Assessment Project receiving lipid-lowering therapy who are achieving low-density lipoprotein cholesterol (LDL-C) goals as defined by National Cholesterol Education Program (NCEP) guidelines. METHODS: Adult patients with dyslipidemia, who had been receiving the same lipid-lowering therapy for at least 3 months, were assessed at investigation sites. Lipid levels were determined once in each patient at the time of enrollment. The primary end point was the success rate, defined as the proportion of patients who achieved their LDL-C target level as specified by NCEP guidelines. RESULTS: A total of 4888 patients from 5 regions of the United States were studied. Of these, 23% had fewer than 2 risk factors for coronary heart disease (CHD) and no evidence of CHD (low-risk group), 47% had 2 or more risk factors and no evidence of CHD (high-risk group), and 30% had established CHD. Overall, only 38% of patients achieved NCEP-specified LDL-C target levels; success rates were 68% among low-risk patients, 37% among high-risk patents, and 18% among patients with CHD. Drug therapy was significantly (P< or =.001) more effective than nondrug therapy in all patient risk groups. However, many patients treated with lipid-lowering drugs did not achieve LDL-C target levels. CONCLUSIONS: Large proportions of dyslipidemic patients receiving lipid-lowering therapy are not achieving NCEP LDL-C target levels. These findings indicate that more aggressive treatment of dyslipidemia is needed to attain goals established by NCEP guidelines.

Adult↗
PubMedDate not supplied

Quality assessment of a collaborative approach for decreasing drug-related morbidity and achieving therapeutic goals.

BACKGROUND: Collaboration between physicians and pharmacists is one approach to address drug-related morbidity and achieve therapeutic goals. A collaborative practice of pharmaceutical care has been used in the Fairview Clinics System of Minneapolis-St Paul since 1999. METHODS: The quality of therapeutic determinations made by pharmacists within this collaborative practice of pharmaceutical care was studied by a 12-member panel of physicians and pharmacists who used randomly selected patient records. This was a quality improvement and care process validation component of a study evaluating the effects of drug therapy management in patients receiving prepaid medical assistance. An implicit review process was used to evaluate the clinical credibility of therapeutic determinations made by pharmaceutical care practitioners. RESULTS: A total of 5780 drug therapy problems were resolved for 2524 patients receiving pharmaceutical care. The rate of therapeutic goals achieved increased from 74% at the time of patients' initial pharmaceutical care encounters to 89% at patients' latest encounters. In this quality assessment analysis panel members performed a total of 4779 evaluations of clinical decisions. Panelists indicated agreement with the evaluations in 94.2% of cases, expressed a neutral opinion in 3.6% of cases, and disagreed in 2.2% of cases. Intraclass correlation coefficients ranged from 0.73 to 0.85. CONCLUSIONS: The decisions made by pharmaceutical care practitioners working in collaboration with physicians to provide drug therapy management services are clinically credible based on the evaluations and comments of a peer review panel. This study provides information on the quality of care provided by pharmacists when collaborating with physicians to provide drug therapy management services.

Cooperative Behavior↗
PubMed2006

Achieving target cholesterol goals after stroke: is in-hospital statin initiation the key?

BACKGROUND: National advisories recommend statin therapy as an element of secondary prevention for patients with ischemic stroke or transient ischemic attack of atherosclerotic origin. Statins are of proven benefit in persons at high risk of vascular disease. OBJECTIVES: To evaluate the effects of in-hospital initiation of statins on 3-month treatment adherence rates and achievement of national guideline target cholesterol goals. METHODS: Data were collected in consecutively encountered patients with ischemic stroke or transient ischemic attack admitted to a university hospital stroke service beginning September 1, 2002. Patients were included in the study if they were not receiving a statin before admission and had an indication for statin therapy. Adherence to statin treatment and achievement of national guideline target cholesterol goals were assessed 3 months after discharge. RESULTS: From September 1, 2002, through April 30, 2005, 92 (17%) of 552 individuals met the study criteria. Hospital initiation of statin therapy yielded high rates of adherence (93% [86/92]), lowered mean low-density lipoprotein cholesterol levels from 120 to 78 mg/dL (3.1 to 2.0 mmol/L; P<.001), and increased the proportion of patients with low-density lipoprotein cholesterol levels lower than 100 mg/dL (2.6 mmol/L) from 36% to 88% (P<.001) at 3 months. CONCLUSIONS: Statin initiation during hospitalization for an ischemic cerebrovascular event is associated with high rates of adherence to treatment, lowering of low-density lipoprotein cholesterol levels, and higher rates of achieving national cholesterol guidelines.

Adult↗
PubMed1998

Study of behavioral phenotypes: goals and methodological considerations.

The study of behavioral phenotypes associated with genetic syndromes has gained increasing momentum over the past two decades. In this paper, the definition of behavioral phenotypes is presented and the complexities and obstacles to progress in this field are summarized. Also described are the goals of such investigations, including the need for syndrome delineation, provision of guidance for clinical management, contributions to understanding brain-behavior relations, advancements in developmental theory, and gaining understanding of the genetic bases of behavior. Methodological issues addressed in relation to such goals include the need for cross-disciplinary collaboration, concerns regarding sampling methods and comparison group selection, and developmental considerations. The complexity of cognitive abilities, the limitations of existing tests and measures, and ways of approaching the study of behavior are discussed. A final comment concerns the potential risks of research in behavioral phenotypes.

Behavioral Symptoms↗
PubMed1998

Late-life depression and functional disability: the role of goal-focused group psychotherapy.

This study compares the efficacy of two time-limited group psychotherapies for depression and functional disability in late life. Goal-focused group psychotherapy (GFGP) utilized focused psychoeducation and skills training to assist each patient in the achievement of individualized goals. Reminiscence therapy (RT) emphasized individual life review to facilitate discussion. Subjects (N = 13), ages 55 and above, with major depression were randomly assigned to one of the two groups. Most were receiving antidepressant treatment. All had failed to achieve full remission. Whereas both treatment groups improved in depressed mood and disability, GFGP subjects had a far greater change in depressive symptomatology and also improved in the areas of hope, hopelessness, anxiety and social functioning.

Aged↗