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Goal-based measurement in paediatric settings: implications for practice
  1. Jenna Jacob1,
  2. Julian Edbrooke-Childs1,2,
  3. Halina Flannery3,
  4. Terry Y Segal4,
  5. Duncan Law2,5
  1. 1Child Outcomes Research Consortium, Anna Freud Centre, London, UK
  2. 2Clinical, Educational and Health Psychology, UCL, London, UK
  3. 3Psychological Medicine, University College London Hospitals NHS Foundation Trust, London, UK
  4. 4Paediatric Department, University College London Hospitals NHS Foundation Trust, London, UK
  5. 5MindMonkey Associates, London, UK
  1. Correspondence to Dr Jenna Jacob, Child Outcomes Research Consortium, Anna Freud Centre, London, N1 9JH, UK; jenna.jacob{at}annafreud.org

Abstract

There is an observed link between physical illness and mental health difficulties and an increased likelihood of mental health difficulties in young people with chronic health conditions. The main outcome focus in paediatric settings is on physical health outcomes and functioning. In terms of functioning, the focus is on quality of life, measures of emotional well-being and perceptions of personal change, which are likely to be multifaceted and vary between patients. To complement standardised and diagnostically based measures, goal-based outcome measurement may be considered. The aim of this paper is to build on previous research, to provide a reflective commentary based on the authors’ clinical and research experience in the use and interpretation of goal-based outcomes, to address what using goal-based measures for outcome purposes in these settings means practically. Examples are provided to demonstrate the importance of considering meaningful outcomes of importance to young people and how professionals may presume that physical ‘recovery’ is the goal of treatment, but what recovery means to that young person may be very nuanced. Further key considerations and suggested phrasing are given to introduce and work with young people’s goals.

  • paediatrics
  • child health services
  • mental health
  • psychology

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Footnotes

  • Twitter @JennaMBJacob, @halinaflannery, @terryheller1

  • Contributors JEC and JJ conceived the research. JJ, JEC, HF, TYS and DL drafted and reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests JJ and DL have produced guidance on the goal and goal-based outcomes tool (GBO). DL developed the GBO, trains people in its use and advocates for the clinical utility of idiographic tools. JJ and JEC currently work on the CORC project, which encourages the use of idiographic goal-based measures.

  • Provenance and peer review Commissioned; externally peer reviewed.