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Scobbie L, Thomson K, Pollock A, Evans J. Goal adjustment by people living with long-term conditions: A scoping review of literature published from January 2007 to June 2018. Neuropsychol Rehabil 2021; 31:1314-1345. [PMID: 32525446 DOI: 10.1080/09602011.2020.1774397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Long-term health conditions can limit achievement of personal goals. We aimed to map and synthesize definitions of goal adjustment, theoretical underpinnings, associations with recovery and supportive interventions for adults with long-term conditions. We searched multiple databases (January 2007-June 2018) and identified peer-reviewed research relating to goal adjustment. Data were charted, mapped and synthesized using content analysis and descriptive summaries. Two stakeholder consultations informed the review. Ninety-one articles were included. A range of long-term conditions were represented including cancer (22%), stroke (12%) and mixed neurological conditions (8%). Goal adjustment was one available option when faced with unattainable goals; other options were goal disengagement and goal re-engagement. Most studies were quantitative (58%), reporting mainly positive associations between goal adjustment, disengagement, reengagement and recovery. The Dual Process Model, Goal Adjustment Model and Self-Regulation Theory were most cited underpinning models/theory. Five interventions were identified; only one (self-system therapy) was evaluated in a randomized controlled trial. Our review provides original and significant insights into goal adjustment definitions, theoretical underpinnings and association with recovery. Effective interventions to support goal adjustment, disengagement and reengagement are lacking. This research-practice gap warrants attention to ensure people with long-term conditions are optimally supported when facing unattainable goals.
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Affiliation(s)
- Lesley Scobbie
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Katie Thomson
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Alex Pollock
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Jonathan Evans
- Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
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López-Martínez AE, Ramírez-Maestre C, Serrano-Ibáñez ER, Ruiz-Párraga GT, Peters ML, Esteve R. Using vignettes to assess the contribution of goal adjustment in the adaptation to chronic musculoskeletal pain. Qual Life Res 2020; 29:2137-2148. [PMID: 32236774 DOI: 10.1007/s11136-020-02487-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE The quality of life of individuals with chronic musculoskeletal pain partly depends on their capacity to adjust their personal goals. Vignettes have been rarely used to assess this ability. Therefore, this study aimed to test the relationships between vignettes assessing different goal strategies and chronic pain adaptation (i.e., daily functioning, pain-related impairment, and psychological well-being). METHODS The sample comprised 258 individuals with chronic musculoskeletal pain who completed a series of questionnaires and vignettes. The vignettes presented a short description of a situation in which a person with chronic pain experienced a threat to a valued domain-specific goal and had to choose a possible goal management solution (i.e., goal persistence, flexibility reengagement, and disengagement). Hierarchical regression analyses were used to predict chronic pain adaptation using the selected vignette strategies as predictors. RESULTS After controlling for age, sex, pain intensity, and the responses to the dispositional goal management scales, persistence, reengagement, and disengagement goal strategies presented in the case scenarios predicted daily functioning (p < .001). Persistence, flexibility, disengagement (p < .001), and reengagement (p < .05) predicted pain-related impairment. Persistence, disengagement (p < .001), and flexibility (p < .05) predicted psychological well-being scores. CONCLUSION The use of vignettes could be useful to assess goal adjustment because this methodology enables respondents to provide more context-specific responses. The results of this approach could be used to improve clinical practice aimed at helping people with chronic musculoskeletal pain to better cope with this health condition.
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Affiliation(s)
- Alicia E López-Martínez
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Facultad de Psicología, Universidad de Málaga, Campus de Teatinos, 29071, Málaga, S/N, Spain.
| | - Carmen Ramírez-Maestre
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Facultad de Psicología, Universidad de Málaga, Campus de Teatinos, 29071, Málaga, S/N, Spain
| | - Elena R Serrano-Ibáñez
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Facultad de Psicología, Universidad de Málaga, Campus de Teatinos, 29071, Málaga, S/N, Spain
| | - Gema T Ruiz-Párraga
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Facultad de Psicología, Universidad de Málaga, Campus de Teatinos, 29071, Málaga, S/N, Spain
| | - Madelon L Peters
- Department of Psychology and Neuroscience, Clinical Psychological Science, Behavioural Medicine, Maastricht University, Maastricht, The Netherlands
| | - Rosa Esteve
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Instituto de Investigaciones Biomédicas de Málaga (IBIMA), Facultad de Psicología, Universidad de Málaga, Campus de Teatinos, 29071, Málaga, S/N, Spain
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Ramírez-Maestre C, Esteve R, López-Martínez AE, Serrano-Ibáñez ER, Ruiz-Párraga GT, Peters M. Goal Adjustment and Well-Being: The Role of Optimism in Patients with Chronic Pain. Ann Behav Med 2019; 53:597-607. [PMID: 30184082 PMCID: PMC6546937 DOI: 10.1093/abm/kay070] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background Chronic pain directly or indirectly interferes with valued personal goals. Goal adjustment plays a central role in patients’ adaptation. Studies on the relationship between optimism and goal regulation have shown that people with high dispositional optimism adjust their goals in a flexible way, and that flexible goal adjustment promotes quality of life. Purpose The aim of this study was to analyze the relationship among optimism, goal adjustment, and adaptation in patients with chronic pain. Methods A sample of 258 patients with chronic musculoskeletal pain completed questionnaires on optimism, reengagement, disengagement, flexibility, tenacity, rumination, purpose in life, well-being, pain intensity, daily functioning, and impairment. Results Structural equation modeling analysis showed that optimism had a positive association with reengagement, flexibility, and tenacity, and a negative association with disengagement. Disengagement was positively associated with rumination, whereas reengagement, flexibility, and tenacity were associated with higher levels of purpose in life, which were strongly associated with adaptation in patients with chronic pain. Conclusions This study supports the conclusions of previous research on the role of goal adjustment as a mediator variable between optimism and well-being.
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Affiliation(s)
- Carmen Ramírez-Maestre
- Universidad de Málaga, Andalucía Tech, Instituto de Investigación Biomédica de Málaga (IBIMA), Facultad de Psicología, Málaga, Spain
| | - Rosa Esteve
- Universidad de Málaga, Andalucía Tech, Instituto de Investigación Biomédica de Málaga (IBIMA), Facultad de Psicología, Málaga, Spain
| | - Alicia E López-Martínez
- Universidad de Málaga, Andalucía Tech, Instituto de Investigación Biomédica de Málaga (IBIMA), Facultad de Psicología, Málaga, Spain
| | - Elena R Serrano-Ibáñez
- Universidad de Málaga, Andalucía Tech, Instituto de Investigación Biomédica de Málaga (IBIMA), Facultad de Psicología, Málaga, Spain
| | - Gema T Ruiz-Párraga
- Universidad de Málaga, Andalucía Tech, Instituto de Investigación Biomédica de Málaga (IBIMA), Facultad de Psicología, Málaga, Spain
| | - Madelon Peters
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, MD Maastricht, Netherlands
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Arends RY, Bode C, Taal E, Van de Laar MAFJ. A goal management intervention for patients with polyarthritis and elevated levels of depressive symptoms: a quasiexperimental study. Disabil Rehabil 2018; 42:957-966. [PMID: 30453793 DOI: 10.1080/09638288.2018.1513086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Goal was to establish whether an intervention that aims to increase goal management competencies is effective in decreasing elevated levels of depressive symptoms and increasing well-being in patients with polyarthritis.Materials and methods: Eighty-five persons with polyarthritis and elevated levels of depressive symptoms participated in the goal management intervention consisting of six group-based meetings. A quasiexperimental design with baseline measurement, follow-up at 6 months and a reference group of 151 patients from an observational study was applied. Primary outcome was depression; secondary outcomes were anxiety, purpose in life, positive affect, satisfaction with participation, goal management strategies, and arthritis self-efficacy. A linear mixed model procedure was applied to evaluate changes in outcomes.Results: No improvement was found for depressive symptoms and no changes were found for the secondary outcomes, except for positive affect that improved in the intervention group. This increase was mediated by an increase in goal adjustment. Furthermore, goal maintenance decreased and self-efficacy for other symptoms increased in the intervention group.Conclusion: This study indicates that interventions designed to aid patients with arthritis with goal management skills are potentially helpful for increasing positive affect, although further studies are needed.Implications for rehabilitationPeople with polyarthritis have to manage their disease in combination with possibly conflicting roles and personal goals, resulting in an ongoing process of finding equilibrium in a constantly changing situation.Based on a person-focused view, the program Right on Target focused on coping with threatened activities and life goals due to arthritis.The program consisted of six group-based meetings led by a trained nurse and a personal trajectory wherein participants were stimulated to try out various behavioral options related to an own threatened activity in concordance with their personal goals.The program seemed effective in increasing flexible goal adjustment and self-efficacy and participants experienced more positive affect directly after the program and at 6-month follow-up.
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Affiliation(s)
- Roos Y Arends
- Department of Psychology, Health & Technology, Arthritis Centre Twente, University of Twente, Enschede, The Netherlands
| | - Christina Bode
- Department of Psychology, Health & Technology, Arthritis Centre Twente, University of Twente, Enschede, The Netherlands
| | - Erik Taal
- Department of Psychology, Health & Technology, Arthritis Centre Twente, University of Twente, Enschede, The Netherlands
| | - Mart A F J Van de Laar
- Department of Psychology, Health & Technology, Arthritis Centre Twente, University of Twente, Enschede, The Netherlands.,Department for Rheumatology, Arthritis Centre Twente, Medisch Spectrum Twente, Enschede, The Netherlands
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Östlund G, Björk M, Thyberg I, Valtersson E, Sverker A. Women's situation-specific strategies in managing participation restrictions due to early rheumatoid arthritis: A gender comparison. Musculoskeletal Care 2018; 16:251-259. [PMID: 29316201 DOI: 10.1002/msc.1225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 11/09/2017] [Accepted: 11/12/2017] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The present study explored how women describe their use of situation-specific strategies when managing rheumatoid arthritis (RA). The aim was also to compare women's strategies with those of men, and see the extent to which they used the same strategies. METHODS The data were collected using semi-structured interviews based on the critical incident technique. The sample consisted of women with early rheumatic arthritis (n = 34), and the results were compared with data reported in a previous study on men (n = 25) from the same cohort. The patient-described participation restrictions due to RA were firstly linked to the domains of the International Classification of Functioning, Disability and Health (ICF). The different strategies used were then categorized. The study was approved by the Research Ethics Committee of the Faculty of Health Sciences, Linköping University, Sweden. RESULTS The study found that women used four situation-specific strategies: adjustment, avoidance, interaction and acceptance. The same strategies had been found previously in interviews with men with RA. Women and men used these strategies to a similar extent in the ICF domains of mobility; major life arenas; domestic life; interpersonal interactions and relationships; and community, social and civic life. However, some differences were found, relating to the reported activities in self-care and domestic life, in which women reported using strategies to a greater extent than men. CONCLUSIONS Women and men used four types of situation-specific strategies in managing RA; adjustment, avoidance, interaction and acceptance. These situation-specific strategies provide useful knowledge, in terms of multidisciplinary rehabilitation and for patients' significant others.
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Affiliation(s)
- Gunnel Östlund
- Division of Social Work, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Mathilda Björk
- Department of Rheumatology and Department of Social and Welfare studies, Linköping University, Linköping, Sweden
| | - Ingrid Thyberg
- Departments of Rheumatology and Clinical & Experimental Medicine, Linköping University, Linköping, Sweden
| | - Eva Valtersson
- Departments of Activity and Health and Medical & Health Sciences, Linköping University, Linköping, Sweden
| | - Annette Sverker
- Departments of Activity and Health and Medical & Health Sciences, Linköping University, Linköping, Sweden
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Arends RY, Bode C, Taal E, Van de Laar MA. A mixed-methods process evaluation of a goal management intervention for patients with polyarthritis. Psychol Health 2016; 32:38-60. [DOI: 10.1080/08870446.2016.1240173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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