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González-Herrera A, Pujol-Ribera E, Esteva M, Ruiz-Marcos L, March S. Colorectal cancer: a qualitative study of coping strategies used by survivors, with associated social determinants. Arch Public Health 2023; 81:111. [PMID: 37331995 DOI: 10.1186/s13690-023-01104-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 05/06/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Colorectal cancer survivors have to develop coping strategies during the diagnosis and survivorship period. This study aims to identify coping strategies in patients with colorectal cancer, in particular the differences between coping strategies during the disease and throughout survival. It also aims to investigate the impact of some social determinants on coping strategies and critically reflect on the influence of positive psychology. METHODS Qualitative study with in-depth interviews of a purposive sample of 21 colorectal cancer survivors in Majorca (Spain), developed between 2017-2019. Data was analysed using interpretive thematic analysis. RESULTS We observed different coping strategies during the stages of disease and survival. However, striving toward acceptance and adaptation when facing difficulties and uncertainty, predominate in both stages. Confrontational attitudes are also considered important, as well as encouraging positive rather than negative feelings, which are considered unhelpful and to be avoided. CONCLUSIONS Although coping during illness and survival can be classified into common categories (problem and emotion-centred strategies), the challenges of these stages are faced differently. Age, gender and the cultural influence of positive psychology strongly influence both stages and strategies.
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Affiliation(s)
| | - Enriqueta Pujol-Ribera
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Gerència Territorial de Barcelona, Institut Català de La Salut, Barcelona, Spain
| | - Magdalena Esteva
- Primary Care Research Unit, Majorca Department of Primary Care, Baleares Health Service (IbSalut), Palma, Majorca, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Majorca, Spain.
| | - Lorena Ruiz-Marcos
- Faculty of Political Sciences and Sociology, Complutense University of Madrid, Pozuelo de Alarcón, Madrid, Spain
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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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Van Bost G, Van Damme S, Crombez G. Goal reengagement is related to mental well-being, life satisfaction and acceptance in people with an acquired brain injury. Neuropsychol Rehabil 2019; 30:1814-1828. [PMID: 31030643 DOI: 10.1080/09602011.2019.1608265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE After an acquired brain injury (ABI), the achievement of previous life goals may no longer be feasible. This study examined whether self-reported disengagement from previous goals and reengagement towards new, more feasible goals, are associated with higher quality of life (QOL) and life satisfaction. We also examined whether acceptance mediated these relationships. METHODS Eighty-two individuals (18-68 years of age) with an ABI completed a battery of questionnaires. We investigated the relations between goal disengagement and reengagement on the one hand, and general QOL, disease-specific QOL, life satisfaction and acceptance, on the other hand. Rehabilitation psychologists provided estimates of self-awareness and the extent of motor, communicative and cognitive impairment. RESULTS Goal reengagement, but not goal disengagement, was positively associated with mental QOL and life satisfaction, after statistically controlling for demographic and impairments. Acceptance mediated the relationship between goal reengagement on the one hand, and mental QOL and life satisfaction, on the other hand. CONCLUSION After an ABI, reengagement in feasible goals is more important in explaining mental well-being and life satisfaction than disengagement from unattainable goals. Interventions aimed at identifying and pursuing new, feasible goals may be more helpful than strategies focusing on the loss of blocked goals.
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Affiliation(s)
- Gunther Van Bost
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium.,CAR Ter Kouter Deinze, Deinze, Belgium
| | - Stefaan Van Damme
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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Van Damme S, Kindt S, Crombez G, Goubert L, Debruyne J. The relation between goal adjustment, goal disturbance, and mental well-being among persons with multiple sclerosis. Psychol Health 2019; 34:645-660. [PMID: 30688085 DOI: 10.1080/08870446.2018.1556272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE This study investigated the role of goal adjustment, i.e. disengaging from blocked goals and reengaging into alternative goals, in mental well-being and goal disturbance in persons with multiple sclerosis (MS). DESIGN A cross-sectional design was used with self-report data from questionnaires and Personal Project Analysis (PPA). MAIN OUTCOME MEASURES Dependent variables were mental well-being, indicated by depression/anxiety (HADS; Hospital Anxiety and Depression Scale) and mental functioning (SF-36; Short Form Health Survey), and goal disturbance, indicated by goal manageability and goal interference (PPA). Independent variables were patient-reported physical impairment (SF-36) and goal disengagement and reengagement (GAS; Goal Adjustment Scale). RESULTS Higher goal reengagement was associated with better mental well-being, but unrelated to goal disturbance. Goal disengagement only showed a negative association with anxiety. High disengagement was associated with lower goal interference but only for those also scoring high on reengagement. Goal adjustment did not buffer the effects of physical impairment on mental well-being and goal disturbance. Contrary to expectations, higher goal reengagement increased the association between physical impairment and goal interference. CONCLUSION Although goal reengagement is associated with better mental well-being in persons with MS, it might also strengthen the perceived effect of physical impairment on goal interference.
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Affiliation(s)
- Stefaan Van Damme
- a Department of Experimental-Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Sara Kindt
- a Department of Experimental-Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Geert Crombez
- a Department of Experimental-Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Liesbet Goubert
- a Department of Experimental-Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Jan Debruyne
- b Department of Neurology , Ghent University Hospital , Ghent , Belgium
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Lyons KD, Newman RM, Kaufman PA, Bruce ML, Stearns DM, Lansigan F, Chamberlin M, Bartels SJ, Whipple J, Hegel MT. Goal Attainment and Goal Adjustment of Older Adults During Person-Directed Cancer Rehabilitation. Am J Occup Ther 2018; 72:7202205110p1-7202205110p8. [PMID: 29426388 DOI: 10.5014/ajot.2018.023648] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE In this pilot study of a home-based occupational therapy intervention intended to reduce disability and improve quality of life, our objective was to identify rates of goal attainment and patterns of goal adjustment of participants. METHOD Thirty older adults with cancer were randomized to the intervention arm, and 24 participants identified goals and completed the six-session intervention. An exploratory content analysis of qualitative and quantitative session data was performed. RESULTS Participants set 63 6-wk goals and attained 62% of them. Most of the goals addressed walking (28%), sedentary leisure (24%), exercising (16%), or instrumental activities of daily living (14%). When 6-wk goals were not attained (n = 24), there were 10 instances of goal disengagement and 14 instances of goal reengagement. CONCLUSION Although most participants were able to meet their goals, many also changed their goals and priorities after reflection and attempts to resume or initiate meaningful activities.
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Affiliation(s)
- Kathleen Doyle Lyons
- Kathleen Doyle Lyons, ScD, OTR/L, is Assistant Professor, Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, and Scientist, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH;
| | - Robin M Newman
- Robin M. Newman, OTD, OTR/L, CLT, is Clinical Assistant Professor, Department of Occupational Therapy, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA
| | - Peter A Kaufman
- Peter A. Kaufman, MD, is Associate Professor, Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH, and Associate Professor, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Martha L Bruce
- Martha L. Bruce, PhD, is Professor, Department of Psychiatry and The Dartmouth Institute of Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, NH
| | - Diane M Stearns
- Diane M. Stearns, MSN, APRN, is Lead Nurse Practitioner, Hematology/Oncology, Norris Cotton Cancer Center, Lebanon, NH, and Instructor, Department of Medicine, Geisel School of Medicine, Hanover, NH
| | - Frederick Lansigan
- Frederick Lansigan, MD, is Assistant Professor, Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH, and Director of Clinical Trials in Hematology, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Mary Chamberlin
- Mary Chamberlin, MD, is Assistant Professor, Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH, and Assistant Professor, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Stephen J Bartels
- Stephen J. Bartels, MD, MS, is Professor, Department of Psychiatry, The Dartmouth Institute of Health Policy and Clinical Practice, and Professor, Department of Community and Family Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH
| | - Jessica Whipple
- Jessica Whipple, MS, OTR/L, was Project Coordinator, Department of Psychiatry, Dartmouth College, Hanover, NH, at the time of the study
| | - Mark T Hegel
- Mark T. Hegel, PhD, is Professor, Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, and Professor, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH
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Müller F, Tuinman MA, Janse M, Almansa J, Sprangers MAG, Smink A, Ranchor AV, Fleer J, Hagedoorn M. Clinically distinct trajectories of fatigue and their longitudinal relationship with the disturbance of personal goals following a cancer diagnosis. Br J Health Psychol 2017. [DOI: 10.1111/bjhp.12253] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Fabiola Müller
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Marrit A. Tuinman
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Moniek Janse
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Josué Almansa
- Division of Community and Occupational Medicine; Department of Health Sciences; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Mirjam A. G. Sprangers
- Department of Medical Psychology; Academic Medical Center; University of Amsterdam; The Netherlands
| | - Ans Smink
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Adelita V. Ranchor
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Joke Fleer
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology; University Medical Center Groningen; University of Groningen; The Netherlands
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Magnuson A, Wallace J, Canin B, Chow S, Dale W, Mohile SG, Hamel LM. Shared Goal Setting in Team-Based Geriatric Oncology. J Oncol Pract 2016; 12:1115-1122. [PMID: 27624949 DOI: 10.1200/jop.2016.013623] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
We present the case of a 92-year-old man, MH, who was given a diagnosis of colorectal cancer. His primary care physician, surgeon, geriatric oncologist, and family members all played important roles in his care. MH's case is an example of a lack of explicit shared goal setting by the health care providers with the patient and family members and how that impeded care planning and health. This case demonstrates the importance of explicitly discussing and establishing shared goals in team-based cancer care delivery early on and throughout the care process, especially for older adults. Each individual member's goals should be understood as they fit within the overarching shared team goals. We emphasize that shared goal setting and alignment of individual goals is a dynamic process that must occur several times at critical decision points throughout a patient's care continuum. Providers and researchers can use this illustrative case to consider their own work and contemplate how shared goal setting can improve patient-centered care and health outcomes in various team-based care settings. Shared goal setting among team members has been demonstrated to improve outcomes in other contexts. However, we stress, that little investigation into the impact of shared goal setting on team-based cancer care delivery has been conducted. We list immediate research goals within team-based cancer care delivery that can provide a foundation for the understanding of the process and outcomes of shared goal setting.
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Affiliation(s)
- Allison Magnuson
- University of Rochester; SCOREboard, Rochester, NY; The University of Chicago, Chicago, IL; and Wayne State University School of Medicine, Detroit, MI
| | - James Wallace
- University of Rochester; SCOREboard, Rochester, NY; The University of Chicago, Chicago, IL; and Wayne State University School of Medicine, Detroit, MI
| | - Beverly Canin
- University of Rochester; SCOREboard, Rochester, NY; The University of Chicago, Chicago, IL; and Wayne State University School of Medicine, Detroit, MI
| | - Selina Chow
- University of Rochester; SCOREboard, Rochester, NY; The University of Chicago, Chicago, IL; and Wayne State University School of Medicine, Detroit, MI
| | - William Dale
- University of Rochester; SCOREboard, Rochester, NY; The University of Chicago, Chicago, IL; and Wayne State University School of Medicine, Detroit, MI
| | - Supriya G Mohile
- University of Rochester; SCOREboard, Rochester, NY; The University of Chicago, Chicago, IL; and Wayne State University School of Medicine, Detroit, MI
| | - Lauren M Hamel
- University of Rochester; SCOREboard, Rochester, NY; The University of Chicago, Chicago, IL; and Wayne State University School of Medicine, Detroit, MI
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