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Chu J, Tenenbaum JB, Schulz LE. In praise of folly: flexible goals and human cognition. Trends Cogn Sci 2024:S1364-6613(24)00059-7. [PMID: 38616478 DOI: 10.1016/j.tics.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 04/16/2024]
Abstract
Humans often pursue idiosyncratic goals that appear remote from functional ends, including information gain. We suggest that this is valuable because goals (even prima facie foolish or unachievable ones) contain structured information that scaffolds thinking and planning. By evaluating hypotheses and plans with respect to their goals, humans can discover new ideas that go beyond prior knowledge and observable evidence. These hypotheses and plans can be transmitted independently of their original motivations, adapted across generations, and serve as an engine of cultural evolution. Here, we review recent empirical and computational research underlying goal generation and planning and discuss the ways that the flexibility of our motivational system supports cognitive gains for both individuals and societies.
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Affiliation(s)
- Junyi Chu
- Massachusetts Institute of Technology, Cambridge, MA, USA; Harvard University, Cambridge, MA, USA.
| | | | - Laura E Schulz
- Massachusetts Institute of Technology, Cambridge, MA, USA
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Downer B, Wickliff M, Malagaris I, Li CY, Lee MJ. Achieving Functional Goals During a Skilled Nursing Facility Stay: A National Study of Medicare Beneficiaries. Am J Phys Med Rehabil 2024; 103:333-339. [PMID: 38112630 PMCID: PMC10947948 DOI: 10.1097/phm.0000000000002382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
OBJECTIVES The aims of the study are to describe the frequency that functional goals are documented on the Minimum Data Set and to identify resident characteristics associated with meeting or exceeding discharge goals. METHODS We selected Medicare fee-for-service beneficiaries admitted to a skilled nursing facility within 3 days of hospital discharge from October 1, 2018, to December 31, 2019 ( N = 1,228,913). The admission Minimum Data Set was used to describe the discharge goal scores for seven self-care and 16 mobility items. We used the eight self-care and mobility items originally included in a publicly reported quality measure to calculate total scores for discharge goals, admission performance, and discharge performance ( n = 371,801). RESULTS For all self-care items, more than 70% of residents had a goal score of 1-6 points documented on the admission Minimum Data Set. Chair/bed-to-chair transfer had the highest percentage of residents with a score of 1-6 points (77.1%) and walking up/down 12 steps had the lowest (23.2%). Approximately 44% of residents had a discharge performance score that met or exceeded their goal score. Older age, urinary incontinence, and cognitive impairment had the lowest odds of meeting or exceeding discharge goals. CONCLUSIONS Assessing a resident's functional goals is important to providing patient-centered care. This information may help skilled nursing facilities determine whether a resident has made meaningful functional improvements.
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Affiliation(s)
- Brian Downer
- Department of Population Health and Health Disparities. School of Public and Population Health, University of Texas Medical Branch, Galveston, TX
- Sealy Center on Aging. University of Texas Medical Branch, Galveston, TX
| | - Megan Wickliff
- Department of Population Health and Health Disparities. School of Public and Population Health, University of Texas Medical Branch, Galveston, TX
| | - Ioannis Malagaris
- Office of Biostatistics. University of Texas Medical Branch, Galveston, TX
| | - Chih-Ying Li
- Department of Occupational Therapy. School of Health Professions, University of Texas Medical Branch, Galveston, TX
| | - Mi Jung Lee
- Department of Nutrition, Metabolism, and Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch at Galveston, TX
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3
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Saunders B, More KR. Some habits are more work than others: Deliberate self-regulation strategy use increases with behavioral complexity, even for established habits. J Pers 2024. [PMID: 38450535 DOI: 10.1111/jopy.12926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE We tested the hypothesis that complex behaviors are commonly supported by self-regulation strategies, even when those behaviors are supported by strong instigation habits. BACKGROUND Goal-directed and habit-mediated processes arise from separable systems that have been suggested to seldomly interact. RESULTS Self-regulation strategy use was lower for habitually instigated simple behaviors compared to nonhabitually instigated simple behaviors. However, participants' use of self-regulation strategies increased with the increasing complexity of behaviors, even when complex behaviors were habitually instigated. The difference in the extent of strategy use between habitually and nonhabitually instigated actions was absent when behavioral complexity was particularly high. CONCLUSION These results point to a qualitative distinction-while simple behaviors may progress in a relatively automatic and unthinking manner, complex behaviors receive frequent support from self-regulation strategies, even if they are instigated habitually.
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Affiliation(s)
- Blair Saunders
- Division of Psychology, University of Dundee, Dundee, UK
| | - Kimberly R More
- Division of Psychology, University of Dundee, Dundee, UK
- Department for Health, University of Bath, Bath, UK
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Zhao M, Fong FTK, Whiten A, Nielsen M. Do children imitate even when it is costly? New insights from a novel task. Br J Dev Psychol 2024; 42:18-35. [PMID: 37800394 DOI: 10.1111/bjdp.12463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/12/2023] [Indexed: 10/07/2023]
Abstract
Children have a proclivity to learn through faithful imitation, but the extent to which this applies under significant cost remains unclear. To address this, we investigated whether 4- to 6-year-old children (N = 97) would stop imitating to forego a desirable food reward. We presented participants with a task involving arranging marshmallows and craft sticks, with the goal being either to collect marshmallows or build a tower. Children replicated the demonstrated actions with high fidelity regardless of the goal, but retrieved rewards differently. Children either copied the specific actions needed to build a tower, prioritizing tower completion over reward; or adopted a novel convention of stacking materials before collecting marshmallows, and developed their own method to achieve better outcomes. These results suggest children's social learning decisions are flexible and context-dependent, yet that when framed by an ostensive goal, children imitated in adherence to the goal despite incurring significant material costs.
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Affiliation(s)
- Mingxuan Zhao
- Early Cognitive Development Centre, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Frankie T K Fong
- Early Cognitive Development Centre, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
- Department of Comparative Cultural Psychology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Andrew Whiten
- School of Psychology and Neuroscience, University of St Andrews, St Andrews, UK
| | - Mark Nielsen
- Early Cognitive Development Centre, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
- Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
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5
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McLouth LE, Shelton BJ, Bursac V, Burris JL, Cheavens JS, Weyman K, Peterman AH, Corum L, Studts JL, Arnold SM. "Pathways": A hope-enhancing intervention for patients undergoing treatment for advanced lung cancer. Psychooncology 2024; 33:e6316. [PMID: 38446540 DOI: 10.1002/pon.6316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/14/2024] [Accepted: 02/22/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Observational data suggest hope is associated with the quality of life and survival of people with cancer. This trial examined the feasibility, acceptability, and preliminary outcomes of "Pathways," a hope intervention for people in treatment for advanced lung cancer. METHODS Between 2020 and 2022, we conducted a single-arm trial of Pathways among participants who were 3-12 weeks into systemic treatment. Pathways consisted of two individual sessions delivered during infusions and three phone calls in which participants discussed their values, goals, and goal strategies with a nurse or occupational therapist. Participants completed standardized measures of hope and goal interference pre- and post-intervention. Feasibility was defined as ≥60% of eligible patients enrolling, ≥70% of participants completing three or more sessions, ≥70% of participants completing post-assessments, and mean acceptability ratings ≥7 out of 10 on intervention relevance, helpfulness, and convenience. Linear regression fixed effects models with covariates modeled pre-post changes in complete case analysis and multiple imputation models. RESULTS Fifty two participants enrolled: female (59.6%), non-Hispanic White (84.6%), rural (75.0%), and with low educational attainment (51.9% high school degree or less). Except for enrollment (54%), feasibility and acceptability markers were surpassed (77% adherence, 77% retention, acceptability ratings ≥8/10). There was moderate improvement in hope and goal interference from pre-to post-intervention (d = 0.51, p < 0.05 for hope; d = -0.70, p < 0.005 for goal interference). CONCLUSIONS Strong feasibility, acceptability, and patient-reported outcome data suggest Pathways is a promising intervention to increase hope and reduce cancer-related goal interference during advanced lung cancer treatment.
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Affiliation(s)
- Laurie E McLouth
- Department of Behavioral Science, Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, Kentucky, USA
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
| | - Brent J Shelton
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
- Division of Cancer Biostatistics, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Vilma Bursac
- Department of Behavioral Science, Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Jessica L Burris
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
- Department of Psychology, University of Kentucky College of Arts and Sciences, Lexington, Kentucky, USA
| | | | - Kaitlyn Weyman
- Medical College of Wisconsin Affiliated Hospitals, Madison, Wisconsin, USA
| | - Amy H Peterman
- Department of Psychological Science, University of North Carolina-Charlotte, Charlotte, North Carolina, USA
| | - Lauren Corum
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
| | - Jamie L Studts
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Susanne M Arnold
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
- Division of Medical Oncology, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, Kentucky, USA
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Mohammadmoradi S, Hsu JJ, Matthews AT. Reflections on Belonging: ATVB Membership Committee Perspective. Arterioscler Thromb Vasc Biol 2024; 44:530-532. [PMID: 38235558 DOI: 10.1161/atvbaha.123.320137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Affiliation(s)
- Shayan Mohammadmoradi
- Saha Cardiovascular Research Center (S.M.), College of Medicine, University of Kentucky, Lexington
- Department of Molecular and Cellular Biochemistry (S.M.), College of Medicine, University of Kentucky, Lexington
| | - Jeffrey J Hsu
- Department of Medicine (Cardiology), David Geffen School of Medicine at University of California, Los Angeles (J.J.H.)
- Department of Medicine, Veteran Affairs Greater Los Angeles Healthcare System, CA (J.J.H.)
| | - Anberitha T Matthews
- Thoracic Oncology Research Group, Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN (A.T.M.)
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Miles NL, Abedini NC, Harris MH, Engelberg RA, Kross EK, Creutzfeldt CJ. Goals-of-Care Conversations After Stroke Survival. Stroke 2024; 55:e44-e45. [PMID: 38189121 PMCID: PMC10922777 DOI: 10.1161/strokeaha.123.046119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Affiliation(s)
- Nancy L. Miles
- University of Washington School of Medicine, Seattle, WA
| | - Nauzley C. Abedini
- University of Washington School of Medicine, Seattle, WA
- Cambia Palliative Care Center of Excellence at UW Medicine, Seattle WA
| | - Mark H. Harris
- University of California, Irvine School of Medicine, Irvine, CA
| | - Ruth A. Engelberg
- Cambia Palliative Care Center of Excellence at UW Medicine, Seattle WA
- University of Washington Department of Medicine, Seattle, WA
| | - Erin K. Kross
- Cambia Palliative Care Center of Excellence at UW Medicine, Seattle WA
- University of Washington Department of Medicine, Seattle, WA
| | - Claire J. Creutzfeldt
- Cambia Palliative Care Center of Excellence at UW Medicine, Seattle WA
- University of Washington Department of Neurology, Seattle, WA
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Hall AF, Browning M, Huys QJM. The computational structure of consummatory anhedonia. Trends Cogn Sci 2024:S1364-6613(24)00006-8. [PMID: 38423829 DOI: 10.1016/j.tics.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 03/02/2024]
Abstract
Anhedonia is a reduction in enjoyment, motivation, or interest. It is common across mental health disorders and a harbinger of poor treatment outcomes. The enjoyment aspect, termed 'consummatory anhedonia', in particular poses fundamental questions about how the brain constructs rewards: what processes determine how intensely a reward is experienced? Here, we outline limitations of existing computational conceptualisations of consummatory anhedonia. We then suggest a richer reinforcement learning (RL) account of consummatory anhedonia with a reconceptualisation of subjective hedonic experience in terms of goal progress. This accounts qualitatively for the impact of stress, dysfunctional cognitions, and maladaptive beliefs on hedonic experience. The model also offers new views on the treatments for anhedonia.
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Affiliation(s)
- Anna F Hall
- Applied Computational Psychiatry Lab, Mental Health Neuroscience Department, Division of Psychiatry and Max Planck Centre for Computational Psychiatry and Ageing Research, Queen Square Institute of Neurology, University College London, London, UK
| | - Michael Browning
- Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Trust, Oxford, UK
| | - Quentin J M Huys
- Applied Computational Psychiatry Lab, Mental Health Neuroscience Department, Division of Psychiatry and Max Planck Centre for Computational Psychiatry and Ageing Research, Queen Square Institute of Neurology, University College London, London, UK.
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Keetley R, Manning JC, Williams J, Stewart I, Radford K. Child and family health-related quality of life and participation outcomes and goals after acquired brain injury: a cross-sectional survey. Brain Inj 2024; 38:217-226. [PMID: 38363813 DOI: 10.1080/02699052.2024.2309244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/19/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE To explore longer-term health-related quality of life (HRQoL) and participation outcomes and goals of children and young people (CYP) with acquired brain injuries (ABI) and their families in a region of the UK and the impact of the COVID-19 pandemic. METHODS Cross-sectional survey of (5-18 CYP) and their parent-carers 12-43 months following ABI. Included measures of HRQoL, participation, family function and parental wellbeing and demographic and free text questions. RESULTS Ninety-five responses (30% response) were received. 67% of CYP were at risk of impaired HRQoL, 72% had severely impaired participation. 53% of parent-carers reported reduced HRQoL and family functioning, 37% of parent-carers screened positive for anxiety/depression. Relationships exist between CYP participation and HRQoL and parental HRQoL and family functioning. Goals were overwhelmingly activity and participation focused. Participants described the global impact of an ABI on the CYP and family as well as the additional impact of the COVID-19 pandemic on CYP and family wellbeing. CONCLUSION ABI significantly impacts CYP participation and both CYP and parent-carer wellbeing in the long-term, potentially further impacted by the COVID-19 pandemic. Rehabilitation interventions should address both participation and the psychological wellbeing of CYP with ABI and their parent-carers.
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Affiliation(s)
- Rachel Keetley
- Centre of Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, England
| | - Joseph C Manning
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, England
- School of Healthcare, University of Leicester, Leicestershire, England
| | - Jane Williams
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, England
| | - Iain Stewart
- Faculty of Medicine, Imperial College London, London, England
| | - Kathryn Radford
- Centre of Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham, UK
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Jiang D, Lay JC, Fung HH. Older adults experience better affective well-being in solitude: The moderating role of goal for conflict de-escalation. Appl Psychol Health Well Being 2024. [PMID: 38316523 DOI: 10.1111/aphw.12533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024]
Abstract
Older adults report greater affective well-being in solitude than younger adults, but prior findings are based on correlational designs. We aim to examine age differences in affective well-being in solitude using an experimental design and to examine conflict de-escalation as a potential mechanism. In Study 1, 207 participants were randomly assigned to either a solitude or a social interaction condition. In Study 2, 128 participants were randomly assigned to one of four conditions: solitude-escalation, solitude-de-escalation, interaction-escalation, and interaction de-escalation. After a 15-min solitude or social interaction period, they reported their affective experiences. In Study 1, older (vs. younger) adults reported more positive affect overall. This age-related difference was greater in the solitude (vs. social interaction) condition; older adults reported less negative affect than younger adults in the solitude, but not the social interaction, condition. In Study 2, older (vs. younger) participants reported more high-arousal positive affect in the solitude-escalation condition. This difference was not significant in conflict de-escalation conditions. Our studies provide causal evidence of the relationship between solitude and affective well-being and advance our understanding of motivations that explain why older adults maintain better affective well-being in solitude.
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Affiliation(s)
- Da Jiang
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong, China
| | - Jennifer C Lay
- Department of Psychology, The University of Exeter, Exeter, UK
| | - Helene H Fung
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
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Waddington H, Minnell H, Patrick L, van Der Meer L, Monk R, Woods L, Whitehouse AJO. Community perspectives on the appropriateness and importance of support goals for young autistic children. Autism 2024; 28:316-326. [PMID: 37203137 PMCID: PMC10851621 DOI: 10.1177/13623613231168920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
LAY ABSTRACT Researchers do not know much about what autistic adults, parents and professionals think about support goals for young autistic children. People's views of support goals might also be influenced by their beliefs about early support more generally. This survey involved 87 autistic adults, 159 parents of autistic children and 80 clinical professionals living in New Zealand and Australia. We asked participants questions about themselves and what they thought about early support for young autistic children in general. We then asked participants to rate whether different support goals were appropriate for young autistic children and, if they were appropriate, to rate their level of priority. We found that autistic adults, parents and professionals all rated goals about the adult changing to better support the child, reducing and replacing harmful behaviours and improving the child's quality of life as the highest priorities. They all rated goals about autism characteristics, play skills and academic skills as the lowest priorities. Compared to parents and/or professionals, autistic adults gave lower priority ratings for play skills, autism characteristics and participation goals. Autistic adults were also more likely to rate goals related to play skills and autism characteristics as inappropriate. While these three participant groups generally agreed on the order of priority of early support goals for young autistic children, autistic adults found goals related to autism characteristics, play and/or participation to be an even lower priority and less appropriate than parents and professionals.
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Affiliation(s)
| | | | | | - Larah van Der Meer
- Victoria University of Wellington, New Zealand
- Autism New Zealand, New Zealand
| | - Ruth Monk
- Autism New Zealand, New Zealand
- The University of Auckland, New Zealand
| | - Lisa Woods
- Victoria University of Wellington, New Zealand
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Cook HE, Garris LA, Gulum AH, Steber CJ. Impact of SMART Goals on Diabetes Management in a Pharmacist-Led Telehealth Clinic. J Pharm Pract 2024; 37:54-59. [PMID: 36052449 DOI: 10.1177/08971900221125021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Although there is evidence demonstrating successful implementation of SMART (specific, measurable, achievable, relevant, time-bound) goals in clinical settings, their impact on improving diabetes control has not been well-established. Objective: The primary objective was to determine the association between setting SMART goals and change in A1c among a Veteran population. Methods: This was an IRB-approved retrospective, case-control study. Patients with Type 2 diabetes mellitus (DM) managed virtually by a Clinical Pharmacy Specialist at a VA Community-Based Outpatient Clinic were eligible for inclusion. The electronic medical record was used to identify patients that set a SMART goal for DM management during the study timeframe. These patients were matched to a similar cohort of patients that did not set a SMART goal. Results: There were 100 patients included in the study. Goal A1c was achieved in 30% of patients in the SMART goal group compared with 24% of patients in the control group. There was a 1.2% reduction in A1c from baseline to 3 months in the SMART goal group vs .85% in the control group (P = .287). The mean number of medication changes per patient was 1.7 in the SMART goal group vs 2.1 in the control group (P = .174). Patients in the SMART goal group set an average of 1.5 SMART goals during the study period. Conclusion: Overall, patients that set SMART goals had clinically meaningful A1c lowering. Setting SMART goals for DM management in agreeable patients during diabetes telehealth visits may lead to fewer medication changes and improved diabetes control.
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Affiliation(s)
| | - Lindsay A Garris
- Durham VA Health Care System, Raleigh 3 VA Outpatient Clinic, Raleigh, NC, USA
| | - Alev H Gulum
- Durham VA Health Care System, Raleigh 1 VA Outpatient Clinic, Raleigh, NC, USA
| | - Carolyn J Steber
- Durham VA Health Care System, Raleigh 1 VA Outpatient Clinic, Raleigh, NC, USA
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Ancker JS, Benda NC, Zikmund-Fisher BJ. Do you want to promote recall, perceptions, or behavior? The best data visualization depends on the communication goal. J Am Med Inform Assoc 2024; 31:525-530. [PMID: 37468448 PMCID: PMC10797268 DOI: 10.1093/jamia/ocad137] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/27/2023] [Accepted: 07/08/2023] [Indexed: 07/21/2023] Open
Abstract
Data visualizations can be effective and inclusive means for helping people understand health-related data. Yet numerous high-quality studies comparing data visualizations have yielded relatively little practical design guidance because of a lack of clarity about what communicators want their audience to accomplish. When conducting rigorous evaluations of communication (eg, applying the ISO 9186 method), describing the process simply as evaluating "comprehension" or "interpretation" of visualizations fails to do justice to the true range of outcomes being studied. We present newly developed taxonomies of outcome measures and tasks that are guiding a large-scale systematic review of the health numbers communication literature. Using these taxonomies allows a designer to determine whether a specific data presentation format or feature supports or inhibits the desired audience cognitions, feelings, or behaviors. We argue that taking a granular, outcomes-based approach to designing and evaluating information visualization research is essential to deriving practical, actionable knowledge from it.
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Affiliation(s)
- Jessica S Ancker
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Natalie C Benda
- School of Nursing, Columbia University, New York, New York, USA
| | - Brian J Zikmund-Fisher
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
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14
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Evensen J, Soberg HL, Sveen U, Hestad KA, Moore JL, Bronken BA. Individualized goals expressed by patients undergoing stroke rehabilitation: an observational study. J Rehabil Med 2024; 56:jrm15305. [PMID: 38226892 PMCID: PMC10807545 DOI: 10.2340/jrm.v56.15305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/06/2023] [Indexed: 01/17/2024] Open
Abstract
OBJECTIVES To explore the rehabilitation goals measured with the Patient-Specific Functional Scale (PSFS) in patients undergoing acute and subacute stroke rehabilitation. In addition, to assess whether PSFS goals corresponded to impairments and activity limitations, as identified by standardized measures. DESIGN Observational study. PARTICIPANTS A total of 71 participants undergoing inpatient stroke rehabilitation. METHODS The PSFS goals were linked to second-level categories in the International Classification of Functioning, Disability and Health (ICF), using established linking rules. Frequencies of the linked ICF categories were calculated. Frequencies of participants with limitations in walking, activities of daily living (ADL), vision, language, and cognition, were calculated, along with goals in corresponding areas of functioning. RESULTS The participants' goals were linked to 50 second-level ICF categories, comprising areas such as walking and moving, ADL, language, vision, and cognition. The most frequent ICF categories were "Moving around in different locations" (n = 24), "Walking" (n = 23), "Toileting" (n = 16), "Hand and arm use (n = 12) and "Fine hand use (n = 12)". Of participants with limitations in walking, cognition, and vision, 85%, 10%, and 16%, respectively, had goals in these areas. CONCLUSION Participants' goals included walking, ADL, language, vision, and cognition. Few with impairments in cognition or vision had goals in these corresponding areas on the PSFS.
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Affiliation(s)
- Janne Evensen
- Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Gjøvik, Norway.
| | - Helene Lundgaard Soberg
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Unni Sveen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Knut A Hestad
- Department of Health and Nursing Sciences, Faculty of Health and Social Sciences, The Inland Norway University of Applied Sciences, Elverum, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
| | - Jennifer L Moore
- Regional Center of Knowledge Translation in Rehabilitation, Sunnaas Rehabilitation Hospital, Oslo/ Nesodden, Norway; Institute for Knowledge Translation, Carmel, IN, USA
| | - Berit Arnesveen Bronken
- Department of Health and Nursing Sciences, Faculty of Health and Social Sciences, The Inland Norway University of Applied Sciences, Elverum, Norway
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Kang E, Foster ER. Development of a goal setting and goal management system: Intervention Mapping. Front Rehabil Sci 2024; 4:1274191. [PMID: 38259874 PMCID: PMC10801041 DOI: 10.3389/fresc.2023.1274191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/13/2023] [Indexed: 01/24/2024]
Abstract
Background Although goal setting and goal management (GSGM) is a key component of chronic disease management and rehabilitation practice, there is currently no widely used evidence-based intervention system available. This paper describes the theoretical underpinnings and development of a new intervention called MyGoals. MyGoals is designed to guide occupational therapy (OT) practitioners to implement theory-based, client-engaged GSGM for adults with chronic conditions in community-based OT rehabilitation settings. Methods We first developed a planning team with two adults with chronic conditions, two clinicians, and two researchers. As a collaborative team, we co-developed MyGoals by following Intervention Mapping (IM) steps 1-4 and incorporating community-based participatory research principles to ensure equitable, ecologically valid, and effective intervention development. In the first step, the planning team conducted a discussion-based needs assessment and a systematic review of current GSGM practice to develop a logic model of the problem. In the second step, the planning team identified performance objectives, intervention target personal determinants, and change objectives, and created a logic model of change and matrics of change objectives. In the third step, the planning team designed MyGoals. Lastly, in the fourth step, the planning team produced, pilot-tested, and refined MyGoals. Results The ultimate goal of the MyGoals intervention is to enable clients to achieve personally meaningful rehabilitation goals. The planning team identified four target determinants (e.g., self-efficacy), six intervention activities (e.g., Education, Reflection, Find My Goals, Make My Goals, Make My Plans, My Progress), eight performance objectives (e.g., List potential goals), and 26 change objectives (e.g., Understand the importance of GSGM). Two pilot tests indicated that MyGoals is feasible for clients and identified areas for improvement. Based on the feedback, minor refinements were made to the MyGoals intervention materials. Conclusions We completed rigorous and collaborative IM to develop MyGoals. Establishing the theoretical and developmental foundation for MyGoals sets the groundwork for high-quality, evidence-based GSGM. Future studies on effectiveness and implementation are necessary to refine, translate, and scale MyGoals in rehabilitation practice.
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Affiliation(s)
- Eunyoung Kang
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States
| | - Erin R. Foster
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
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16
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Thompson ED, Pohlig RT, McCartney KM, Hornby TG, Kasner SE, Raser-Schramm J, Miller AE, Henderson CE, Wright H, Wright T, Reisman DS. Increasing Activity After Stroke: A Randomized Controlled Trial of High-Intensity Walking and Step Activity Intervention. Stroke 2024; 55:5-13. [PMID: 38134254 PMCID: PMC10752299 DOI: 10.1161/strokeaha.123.044596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/09/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Physical inactivity in people with chronic stroke profoundly affects daily function and increases recurrent stroke risk and mortality, making physical activity improvements an important target of intervention. We compared the effects of a high-intensity walking intervention (FAST), a step activity monitoring behavioral intervention (SAM), or a combined intervention (FAST+SAM) on physical activity (ie, steps/day). We hypothesized the combined intervention would yield the greatest increase in steps/day. METHODS This assessor-blinded multisite randomized controlled trial was conducted at 4 university/hospital-based laboratories. Participants were 21 to 85 years old, walking without physical assistance following a single, unilateral noncerebellar stroke of ≥6 months duration, and randomly assigned to FAST, SAM, or FAST+SAM for 12 weeks (2-3 sessions/week). FAST training consisted of walking-related activities at 70% to 80% heart rate reserve, while SAM received daily feedback and goal setting of walking activity (steps/day). Assessors and study statistician were masked to group assignment. The a priori-determined primary outcome and end point was a comparison of the change in steps/day between the 3 intervention groups from pre- to post-intervention. Adverse events were tracked after randomization. All randomized participants were included in the intent-to-treat analysis. RESULTS Participants were enrolled from July 18, 2016, to November 16, 2021. Of 2385 participants initially screened, 250 participants were randomized (mean [SE] age, 63 [0.80] years; 116 females/134 males), with 89 assigned to FAST, 81 to SAM, and 80 to FAST+SAM. Steps/day significantly increased in both the SAM (mean [SE], 1542 [267; 95% CI, 1014-2069] P<0.001) and FAST+SAM group (1307 [280; 95% CI, 752-1861] P<0.001) but not in the FAST group (406 [238; 95% CI, -63 to 876] P=0.09). There were no deaths or serious study-related adverse events. CONCLUSIONS Only individuals with chronic stroke who completed a step activity monitoring behavioral intervention with skilled coaching and goal progression demonstrated improvements in physical activity (steps/day). REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT02835313.
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Affiliation(s)
- Elizabeth D Thompson
- Department of Physical Therapy (E.D.T., K.M.M., H.W., T.W., D.S.R.), University of Delaware, Newark
| | - Ryan T Pohlig
- Biostatistics Core (R.T.P.), University of Delaware, Newark
| | - Kiersten M McCartney
- Department of Physical Therapy (E.D.T., K.M.M., H.W., T.W., D.S.R.), University of Delaware, Newark
| | - T George Hornby
- Department of Physical Medicine and Rehabilitation, Indiana University, Indianapolis (T.G.H., C.E.H.)
| | - Scott E Kasner
- Perelman School of Medicine, University of Pennsylvania, Philadelphia (S.E.K.)
| | | | - Allison E Miller
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO (A.E.M.)
| | - Christopher E Henderson
- Department of Physical Medicine and Rehabilitation, Indiana University, Indianapolis (T.G.H., C.E.H.)
| | - Henry Wright
- Department of Physical Therapy (E.D.T., K.M.M., H.W., T.W., D.S.R.), University of Delaware, Newark
| | - Tamara Wright
- Department of Physical Therapy (E.D.T., K.M.M., H.W., T.W., D.S.R.), University of Delaware, Newark
| | - Darcy S Reisman
- Department of Physical Therapy (E.D.T., K.M.M., H.W., T.W., D.S.R.), University of Delaware, Newark
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Rosenberg MA. Deep Learning and Biased Prediction: More Questions Than Answers? Circ Heart Fail 2024; 17:e011368. [PMID: 38126237 PMCID: PMC10842806 DOI: 10.1161/circheartfailure.123.011368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Affiliation(s)
- Michael A Rosenberg
- Division of Cardiology, Cardiac Electrophysiology Section and Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora
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18
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Gupta AD, Baguley I, Estell J, Geffon S, Goh K, Rawicki B, de Graaf S, Olver J. Statement of the Rehabilitation Medicine Society of Australia and New Zealand for the therapeutic use of botulinum toxin A in spasticity management. Intern Med J 2024; 54:178-182. [PMID: 38267377 DOI: 10.1111/imj.16300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/19/2023] [Indexed: 01/26/2024]
Abstract
The Rehabilitation Medicine Society of Australia and New Zealand advocates the safe, effective and evidence-based use of botulinum toxin type A for spasticity management. The process requires appropriate training, alongside considerable knowledge and skills, to maximise efficacy. The processes before and after injection contribute to effectiveness. The gold standard of managing spasticity is for assessment by a multidisciplinary specialist team, deriving patient-centric goals, and designing an injection protocol to match these goals. The patient and/or carers are considered part of the decision-making team. Postinjection therapy and measurement of goal achievement are highly recommended as part of the wider holistic approach to management. The Society believes treatment failures can be minimised by following clear clinical guidelines.
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Affiliation(s)
- Anupam Datta Gupta
- Central Adelaide Local Health Network, Queen Elizabeth Hospital (SA), University of Adelaide, Adelaide, South Australia, Australia
| | - Ian Baguley
- Brain Injury Rehabilitation Service, Westmead Rehabilitation Hospital, Sydney, New South Wales, Australia
| | - John Estell
- Department of Rehabilitation Medicine, St George Hospital, Sydney, New South Wales, Australia
| | - Saul Geffon
- Queensland Rehabilitation Specialists, Brisbane, Queensland, Australia
| | - Kong Goh
- Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Barry Rawicki
- Masada Hospital Consulting Rooms, Melbourne, Victoria, Australia
| | - Stephen de Graaf
- Epworth Rehabilitation Camberwell, Melbourne, Victoria, Australia
| | - John Olver
- Epworth Rehabilitation Clinical Institute, Melbourne, Victoria, Australia
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19
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Andersdotter Sandström A, Fjellman-Wiklund A, Sandlund M, Eskilsson T. Patients with stress-induced exhaustion disorder and their experiences of physical activity prescription in a group context. Glob Health Action 2023; 16:2212950. [PMID: 37314383 DOI: 10.1080/16549716.2023.2212950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Physical activity is a useful means to improve symptoms and memory performance to some extent in individuals with stress-induced exhaustion disorder. Individuals in this group commonly do not need to reach the recommended levels of physical activity. Developing methods to support physical activity as a lasting behaviour is important. OBJECTIVE The aim of the study was to explore the processes involved when using physical activity prescription as part of rehabilitation in a group context for individuals with stress-induced exhaustion disorder. METHOD A total of 27 individuals with stress-induced exhaustion disorder participated in six focus groups. The informants underwent a multimodal intervention including prescription of physical activity. The physical activity prescription had a cognitive behaviour approach and included information about physical activity, home assignments and goal setting. The data was analysed with grounded theory method using constant comparison. RESULTS The analysis of the data was developed into the core category 'trying to integrate physical activity into daily life in a sustainable way', and three categories: 'acceptance of being good enough', 'learning physical activity by doing' and 'advocation for physical activity in rehabilitation'. The informants identified that during the physical activity prescription sessions they learned what physical activity was, what was 'good enough' in terms of dose and intensity of physical activity, and how to listen to the body's signals. These insights, in combination with performing physical activity during home assignments and reflecting with peers, helped them incorporate physical activity in a new and sustainable way. A need for more customised physical activity with the ability to adjust to individual circumstances was requested. CONCLUSION Prescription of physical activity in a group context may be a useful method of managing and adjusting physical activity in a sustainable way for individuals with stress-induced exhaustion disorder. However, identifying people who need more tailored support is important.
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Affiliation(s)
- Anna Andersdotter Sandström
- Department of Public Health and Clinical Medicine, Sustainable Health and Medicine, Umeå University, Umeå, Sweden
| | | | - Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Therese Eskilsson
- Department of Public Health and Clinical Medicine, Sustainable Health and Medicine, Umeå University, Umeå, Sweden
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
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20
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Prusiński T. Personality disorder type only sometimes matters: An exploration of patient's personality disorder as a source of variance in early therapeutic alliance. Clin Psychol Psychother 2023. [PMID: 38149525 DOI: 10.1002/cpp.2943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE The study aimed to analyse personality disorders among patients in the early phase of psychotherapy as a source of variance in the quality of the emerging alliance. METHODS The sample consisted of 131 individual psychotherapy patients with borderline (BPD), narcissistic (NPD), dependent (DPD) and obsessive-compulsive (OCPD) personality disorders and 131 psychotherapists. Different sources of alliance estimation were included. Therapeutic alliance was operationalized on several dimensions. The hypothesis was tested using an independent samples one-way analysis of variance. RESULTS The study revealed a significant effect of personality disorder type on early therapeutic alliance quality. BPD patients rated their early alliance the lowest compared to NPD, DPD and OCPD patients. This trend was dominant and replicated regardless of who rated the alliance and which dimension of alliance was estimated. CONCLUSIONS NPD, DPD and OCPD patients have better initial therapeutic alliances than BPD patients, and their alliances do not differ significantly. BPD patients build weaker alliances, and what poses a challenge for them is not only developing a strong and close bond but also conceptualizing goals and reaching agreement on tasks.
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Affiliation(s)
- Tomasz Prusiński
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
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21
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Martínez JL, Maner JK. Shorter Goals for the Faster Life: Childhood Unpredictability Is Associated With Shorter Motivational Time Horizons. Pers Soc Psychol Bull 2023:1461672231216821. [PMID: 38146692 DOI: 10.1177/01461672231216821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Models of adaptive calibration provide an overarching theoretical framework for understanding the developmental roots of psychological and behavioral outcomes in adulthood. An adaptive calibration framework was used to examine an important dimension of motivation: goal timing. Across two studies, we saw mixed support for the hypothesis that unpredictability experienced in childhood would be negatively associated with the time horizons people use to set their goals, such that people who reported experiencing more unpredictability in their childhood tended to set goals on relatively shorter time horizons. The association was observed based on independent ratings of goal timing, but not based on participants' self-reported ratings of goal timing, and was statistically mediated by people's tendency to consider the short- versus long-term future consequences of their actions. These studies isolate a key component of childhood adversity-unpredictability-potentially underlying the time horizons people use to set, prioritize, and pursue their goals.
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22
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Bertelsen KA, Varghese FP, Park A. Entrepreneurship and Criminal Justice Populations: A Social Cognitive Perspective. Int J Offender Ther Comp Criminol 2023:306624X231219204. [PMID: 38130183 DOI: 10.1177/0306624x231219204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
A criminal record limits employment opportunities of those released from prison. Entrepreneurship, or starting one's own business venture, has been suggested as a way to overcome the employment barriers of a criminal record, given that many justice-involved persons have entrepreneurship experiences, often through illegal ventures. Sparse research has investigated how legal or illegal business experience translates to legal entrepreneurship attitudes. Using social cognitive career theory-career theory (SCCT), and concepts from the Risk Need Responsivity (RNR) model, the role of illegal and legal business exposure were investigated. Findings indicated that both legal and illegal business exposure had a positive influence on entrepreneurship goals through entrepreneurship self-efficacy and entrepreneurship outcome expectations. Legal experiences had a stronger influence. Criminal thinking, a significant risk factor for return to criminal behavior, was investigated in its role in entrepreneurship attitudes. Findings indicated that criminal thinking had an indirect effect on entrepreneurship goals through entrepreneurship self-efficacy.
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Affiliation(s)
| | | | - Anna Park
- University of Central Arkansas, Conway, USA
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23
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Virk A, Treacy PJ, Thanigasalam R, Leslie S. What are the Most Important Objectives of Patients Undergoing Radical Prostatectomy? A Narrative Review. Res Rep Urol 2023; 15:563-569. [PMID: 38145157 PMCID: PMC10748635 DOI: 10.2147/rru.s444033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/06/2023] [Indexed: 12/26/2023] Open
Abstract
Purpose This study aimed to evaluate what objectives are most important to men undergoing radical prostatectomy to allow treating physicians to personalize perioperative counselling and improve patient quality of life outcomes. Materials and Methods A predefined search protocol of the Medline and Embase databases was performed from database inception to May 2023. The search was limited to English language and full text. All articles with a specific consideration of patient objectives, preferences or reasons for decision to undergo radical prostatectomy were included for review. Results Ten articles out of 375 screened met inclusion criteria for review. All 10 articles utilized a qualitative design and originated across 5 countries across the developed world. A common theme of men placing importance on having their tumor physically removed was found. Methodologies allowing free response beyond predefined categories identified a breadth of considerations including personal circumstance, personal belief and current function in the decision-making process. An investigation on radical prostatectomy performed robotically found some men placed preference on the quicker treatment time with surgery compared to radiation therapy, reflective of shorter recovery times with the robotic approach. Conclusion Variability in results across studies highlights the heterogeneity in patient preferences. Directed investigation of patient objectives with an open-ended questioning approach would personalize the perioperative experience and may improve patient satisfaction and quality of life outcomes.
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Affiliation(s)
- Amandeep Virk
- Department of Uro-Oncology, Chris O’Brien Lifehouse, Sydney, NSW, Australia
| | - Patrick-Julien Treacy
- The Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Ruban Thanigasalam
- Department of Uro-Oncology, Chris O’Brien Lifehouse, Sydney, NSW, Australia
- The Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Scott Leslie
- Department of Uro-Oncology, Chris O’Brien Lifehouse, Sydney, NSW, Australia
- The Institute of Academic Surgery at Royal Prince Alfred Hospital, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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24
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Ratner K, Gladstone JR, Zhu G, Li Q, Estevez M, Burrow AL. Purpose and goal pursuit as a self-sustaining system: Evidence of daily within-person reciprocity among adolescents in self-driven learning. J Pers 2023. [PMID: 38108114 DOI: 10.1111/jopy.12911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/16/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Despite long-standing assumptions that a sense of purpose in life and goal pursuit are mutually supportive, empirical evidence of their reciprocity remains deficient. In the context of a unique out-of-school time program that empowers youth to pursue passions through self-driven learning, we examined whether purpose and one aspect of goal pursuit-perceptions of goal progress-work together to sustain themselves and each other over time. METHOD Adolescents (N = 321) completed daily surveys throughout program enrollment (Menrollment = 69.09 days). Through dynamic structural equation modeling, we derived within-person patterns of day-to-day prediction as well as individual differences in these patterns. RESULTS We found purpose and perceived goal progress exhibited significant daily inertia (i.e., autoregressive prediction) and reciprocity (i.e., cross-lagged prediction) at the within-person level. We also found initial evidence suggesting (a) tighter reciprocity was related to greater perceived goal progress overall and (b) people with greater purpose inertia may rely less on making goal progress to sustain momentum. CONCLUSIONS With evidence of daily purpose-progress reciprocity, the field can look forward to replicating this work in other contexts, diving deeper into interesting patterns of within-person dynamics, and developing interventions to support youth striving.
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Affiliation(s)
- Kaylin Ratner
- Department of Educational Psychology, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Jessica R Gladstone
- Department of Educational Psychology, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Gaoxia Zhu
- Learning Sciences and Assessment, National Institute of Education at Nanyang Technological University, Singapore, Singapore
| | - Qingyi Li
- Department of Psychology, Cornell University, Ithaca, New York, USA
- School of Social Work, California State University, Chico, Chico, California, USA
| | | | - Anthony L Burrow
- Department of Psychology, Cornell University, Ithaca, New York, USA
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25
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Bland MD, Holleran CL, Newman CA, Fahey M, Nordahl TJ, DeAngelis TR, Ellis TD, Reisman DS, Earhart GM, Lang CE. ICF classification of therapeutic goals for outpatient episodes of neurorehabilitation in post-stroke and Parkinson disease. Disabil Rehabil 2023:1-7. [PMID: 38059563 DOI: 10.1080/09638288.2023.2290201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/28/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE To understand therapeutic priorities, a secondary data analysis on a retrospective cohort was conducted to classify rehabilitation goals according to the International Classification of Functioning, Disability, and Health (ICF). MATERIALS AND METHODS Therapeutic goals from an initial outpatient physical or occupational therapy evaluation for patients post-stroke or with Parkinson disease, were classified into Level 1 of the ICF. Goals in the Activity and Participation component were further sub-classified as activity capacity or activity performance (self-report or direct) in daily life. RESULTS 776 goals across 104 participants were classified into Level 1 of the ICF. The majority, 73% (563/776) were classified as Activity and Participation, 20% (155/776) as Body Function and 2% (17/776) as Environmental Factors. Fifty-two percent (400/776) of all goals were classified as activity capacity and 21% (163/776) as activity performance in daily life, with 21% (160/776) of goals measuring self-report activity performance in daily life and less than 1% (3/776) of goals measuring direct activity performance in daily life. CONCLUSIONS While the majority of therapeutic goals were classified into the Activity and Participation component, less than 1% of goals measured direct activity performance in daily life. If people seek outpatient rehabilitation to improve functioning in their real-world environment, therapeutic goal setting should reflect this.
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Affiliation(s)
- Marghuretta D Bland
- Program in Physical Therapy, WA University School of Medicine, St. Louis, MO
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | - Carey L Holleran
- Program in Physical Therapy, WA University School of Medicine, St. Louis, MO
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
| | | | | | | | | | - Teresa D Ellis
- Department of Physical Therapy, Boston University, Boston, MA
| | - Darcy S Reisman
- Department of Physical Therapy, University of DE, Newark, Delaware
| | - Gammon M Earhart
- Program in Physical Therapy, WA University School of Medicine, St. Louis, MO
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
- Department of Neuroscience, Washington University School of Medicine, St. Louis, MO
| | - Catherine E Lang
- Program in Physical Therapy, WA University School of Medicine, St. Louis, MO
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
- Department of Neurology, Washington University School of Medicine, St. Louis, MO
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26
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Ten Broeke P, Gardner B, Beckers DGJ, Geurts SAE, Bijleveld E. Why do people sit? A framework for targeted behavior change. Health Psychol Rev 2023; 17:641-654. [PMID: 36343923 DOI: 10.1080/17437199.2022.2143851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022]
Abstract
To improve health and wellbeing, it is crucial that people regularly interrupt their sitting. In this paper, we propose a framework for examining and changing sitting behavior that addresses two key steps in the process towards developing effective interventions. First, we suggest that research should move away from its current focus on sitting time, which is an outcome of behavior. Rather, researchers should focus on stand-to-sit and sit-to-stand transitions, which are discrete units of behavior. Second, drawing on goal hierarchy models, we suggest that people rarely engage in stand-to-sit and sit-to-stand transitions for the purpose of being in a sitting or standing position; rather, we suggest that these transitions are means to higher-order goals (e.g., to complete work tasks, to watch television, to eat dinner). To improve adherence to and effectiveness of sitting behavior interventions, intervention designers should aim to increase the frequency of sit-to-stand (and stand-to-sit) transitions. To achieve this aim, intervention designers should capitalize on the higher-order goals that are typically served by these transitions. We suggest four concrete intervention strategies to increase sit-to-stand transitions in congruence with people's everyday goals. We also describe the implications of our framework for theory and methods in sitting behavior research.
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Affiliation(s)
- Pam Ten Broeke
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | | | - Debby G J Beckers
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Sabine A E Geurts
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Erik Bijleveld
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
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27
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Molinaro G, Collins AGE. A goal-centric outlook on learning. Trends Cogn Sci 2023; 27:1150-1164. [PMID: 37696690 DOI: 10.1016/j.tics.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 09/13/2023]
Abstract
Goals play a central role in human cognition. However, computational theories of learning and decision-making often take goals as given. Here, we review key empirical findings showing that goals shape the representations of inputs, responses, and outcomes, such that setting a goal crucially influences the central aspects of any learning process: states, actions, and rewards. We thus argue that studying goal selection is essential to advance our understanding of learning. By following existing literature in framing goal selection within a hierarchy of decision-making problems, we synthesize important findings on the principles underlying goal value attribution and exploration strategies. Ultimately, we propose that a goal-centric perspective will help develop more complete accounts of learning in both biological and artificial agents.
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Affiliation(s)
- Gaia Molinaro
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA.
| | - Anne G E Collins
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA; Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
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28
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Nitschinsk L, Tobin SJ, Varley D, Vanman EJ. Why Do People Sometimes Wear an Anonymous Mask? Motivations for Seeking Anonymity Online. Pers Soc Psychol Bull 2023:1461672231210465. [PMID: 37997811 DOI: 10.1177/01461672231210465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
Anonymous environments are more accessible than ever. As such, it is important to understand not only how anonymity can change human behavior but also why people are motivated to seek anonymity in online spaces. In four studies, we investigated differences in motivations for seeking anonymity online and their associations with related dispositional factors and online behavior. We found that some people were motivated to seek anonymity to self-express or behave toxically. Both motivations to seek anonymity were associated with low self-concept clarity and high Machiavellianism but differed in their relation to traits such as self-consciousness and psychopathy. Further analyses suggested that people selectively engage in behaviors in anonymous online environments, in line with the specific gratifications they seek through anonymity. We conclude that people seek anonymity to pursue self- or other-related goals that are otherwise more difficult or costly to pursue when identifiable.
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Affiliation(s)
- Lewis Nitschinsk
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Stephanie J Tobin
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Deanna Varley
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Eric J Vanman
- School of Psychology, The University of Queensland, Brisbane, Australia
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Simon D, Read SJ. Toward a General Framework of Biased Reasoning: Coherence-Based Reasoning. Perspect Psychol Sci 2023:17456916231204579. [PMID: 37983541 DOI: 10.1177/17456916231204579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
A considerable amount of experimental research has been devoted to uncovering biased forms of reasoning. Notwithstanding the richness and overall empirical soundness of the bias research, the field can be described as disjointed, incomplete, and undertheorized. In this article, we seek to address this disconnect by offering "coherence-based reasoning" as a parsimonious theoretical framework that explains a sizable number of important deviations from normative forms of reasoning. Represented in connectionist networks and processed through constraint-satisfaction processing, coherence-based reasoning serves as a ubiquitous, essential, and overwhelmingly adaptive apparatus in people's mental toolbox. This adaptive process, however, can readily be overrun by bias when the network is dominated by nodes or links that are incorrect, overweighted, or otherwise nonnormative. We apply this framework to explain a variety of well-established biased forms of reasoning, including confirmation bias, the halo effect, stereotype spillovers, hindsight bias, motivated reasoning, emotion-driven reasoning, ideological reasoning, and more.
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Affiliation(s)
- Dan Simon
- Gould School of Law, University of Southern California
- Department of Psychology, University of Southern California
| | - Stephen J Read
- Department of Psychology, University of Southern California
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Orsoni M, Dubé A, Prandi C, Giovagnoli S, Benassi M, Mazzoni E, Benvenuti M. Learning Landscape in Gamification: The Need for a Methodological Protocol in Research Applications. Perspect Psychol Sci 2023:17456916231202489. [PMID: 37983480 DOI: 10.1177/17456916231202489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
In education, the term "gamification" refers to of the use of game-design elements and gaming experiences in the learning processes to enhance learners' motivation and engagement. Despite researchers' efforts to evaluate the impact of gamification in educational settings, several methodological drawbacks are still present. Indeed, the number of studies with high methodological rigor is reduced and, consequently, so are the reliability of results. In this work, we identified the key concepts explaining the methodological issues in the use of gamification in learning and education, and we exploited the controverses identified in the extant literature. Our final goal was to set up a checklist protocol that will facilitate the design of more rigorous studies in the gamified-learning framework. The checklist suggests potential moderators explaining the link between gamification, learning, and education identified by recent reviews, systematic reviews, and meta-analyses: study design, theory foundations, personalization, motivation and engagement, game elements, game design, and learning outcomes.
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Affiliation(s)
| | - Adam Dubé
- Department of Educational and Counselling Psychology, McGill University
| | - Catia Prandi
- Department of Computer Science and Engineering, University of Bologna
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Marshall EM, Gere J. Congruence and goal sharing of health-related goals among newly dating individuals explaining goal importance and commitment. Psychol Health 2023; 38:1623-1634. [PMID: 35137665 DOI: 10.1080/08870446.2022.2037849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 10/29/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The study aimed to determine whether perceived goal sharing (i.e., perceiving a partner as having the same health-related goal) and/or perceived goal congruence (i.e., being able to spend time together in health-related goal activities) with a romantic partner are associated with health-related goal commitment and importance. DESIGN AND MAIN OUTCOME MEASURES 80 participants with a health-related goal in a larger study on newly dating relationships completed two self-report questionnaires 3 months apart using validated assessments of goal commitment and importance. RESULTS Perceived goal congruence was associated with concurrent goal commitment and importance and higher goal commitment over time. However, perceived goal sharing was not associated with the health-related goal dimensions (even when interacting with goal congruence) with the exception of increased goal importance over time for those scoring lower than the average on relationship satisfaction. CONCLUSION One way to enhance health-related goal importance and commitment is to ensure goal congruence exists within romantic relationships, and partners can spend time together engaging in goal-related activities with their partner. Moreover, the results suggest that romantic partners exert an influence even among the newly dating, who are often presumed to be less impactful on health outcomes and processes.
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Affiliation(s)
| | - J Gere
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
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Favilla CG, Carter S, Atluri P, Reehal N, Genuardi MV. HeartMate 3 Left Ventricular Assist Device Improves Long-Term Cerebral Hemodynamics. Circ Heart Fail 2023; 16:e010675. [PMID: 37929601 PMCID: PMC10840602 DOI: 10.1161/circheartfailure.123.010675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
| | - Sarah Carter
- University of Pennsylvania, Department of Neurology
| | - Pavan Atluri
- University of Pennsylvania, Department of Cardiothoracic Surgery
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Jampol L, Rattan A, Wolf EB. A Bias Toward Kindness Goals in Performance Feedback to Women (vs. Men). Pers Soc Psychol Bull 2023; 49:1423-1438. [PMID: 35751137 DOI: 10.1177/01461672221088402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While research has documented positivity biases in workplace feedback to women versus men, this phenomenon is not fully understood. We take a motivational perspective, theorizing that the gender stereotype of warmth shapes feedback givers' goals, amplifying the importance placed on kindness when giving critical feedback to a woman versus a man. We found support for this hypothesis in a survey of professionals giving real developmental feedback (Study 1, N = 4,842 raters evaluating N = 423 individuals) and five experiments with MBA students, lab participants, and managers (Studies 2-5, N = 1,589). Across studies, people prioritized the goal of kindness more when they gave, or anticipated giving, critical feedback to a woman versus a man. Studies 1, 3, and 5 suggest that this kindness bias relates to gendered positivity biases, and Studies 4a and 4b tested potential mechanisms and supported an indirect effect through warmth. We discuss implications for the study of motivation and workplace gender bias.
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Whelton PK, Flack JM, Jennings G, Schutte A, Wang J, Touyz RM. Editors' Commentary on the 2023 ESH Management of Arterial Hypertension Guidelines. Hypertension 2023; 80:1795-1799. [PMID: 37354199 PMCID: PMC10527435 DOI: 10.1161/hypertensionaha.123.21592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 06/26/2023]
Abstract
Clinical practice guidelines are ideally suited to the provision of advice on the prevention, diagnosis, evaluation, and management of high blood pressure (BP). The recently published European Society of Hypertension (ESH) 2023 ESH Guidelines for the management of arterial hypertension is the latest in a long series of high BP clinical practice guidelines. It closely resembles the 2018 European Society of Cardiology/ESH guidelines, with incremental rather than major changes. Although the ESH guidelines are primarily written for European clinicians and public health workers, there is a high degree of concordance between its recommendations and those in the other major BP guidelines. Despite the large number of national and international BP guidelines around the world, general population surveys demonstrate that BP guidelines are not being well implemented in any part of the world. The level of BP, which is the basis for diagnosis and management, continues to be poorly measured in routine clinical practice and control of hypertension remains suboptimal, even to a conservative BP target such as a systolic/diastolic BP <140/90 mm Hg. BP guidelines need to focus much more on implementation of recommendations for accurate diagnosis and strategies for improved control in those being treated for hypertension. An evolving body of implementation science can assist in meeting this goal. Given the enormous health, social, and financial burden of high BP, better diagnosis and management should be an imperative for clinicians, government, and others responsible for the provision of health care services. Hopefully, the 2023 ESH will help enable this.
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Affiliation(s)
- Paul K Whelton
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (P.K.W.)
| | - John M Flack
- Hypertension Section, Division of General Medicine, Department of Medicine, Southern Illinois University, Springfield (J.M.F.)
| | - Garry Jennings
- Sydney Health Partners, University of Sydney and National Heart Foundation, New South Wales, Australia (G.J.)
| | - Alta Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, Australia (A.S.)
| | - Jiguang Wang
- Shanghai Institute of Hypertension, Shanghai Jiao Tong University School of Medicine, China (J.W.)
| | - Rhian M Touyz
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada (R.M.T.)
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Mehta T, Gonzalez N. Large Core Thrombectomies: Are We Still Conflicted or Confident. Stroke 2023; 54:2313-2315. [PMID: 37492971 DOI: 10.1161/strokeaha.123.043845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Affiliation(s)
- Tapan Mehta
- Department of Neurology and Interventional Neuroradiology, Ayer Neuroscience Institute, Hartford Healthcare, CT (T.M.)
| | - Nestor Gonzalez
- Department of Neurosurgery, Cedar-Sinai Medical Center, Los Angeles, CA (N.G.)
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Bernhardt J, Duncan PW, Lynch EA. Improving Access to, and Quality of, Stroke Rehabilitation. Stroke 2023; 54:2446-2448. [PMID: 37551590 DOI: 10.1161/strokeaha.123.042706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Affiliation(s)
- Julie Bernhardt
- The Florey Institute, University of Melbourne, Australia (J.B.)
| | - Pamela W Duncan
- Department of Neurology, Wake Forest Baptist Health, Winston-Salem, NC (P.W.D.)
| | - Elizabeth A Lynch
- Caring Futures Institute, Flinders University, Adelaide, Australia (E.A.L.)
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Gärtner HS, Shabnam J, Aagesen M, Guldin MB, Vind AB, Marsaa K, Bergenholtz HM, Graven V, Sampedro Pilegaard M, Thuesen J. Combined rehabilitation and palliative care interventions for patients with life-threatening diseases - PREGOAL. A scoping review of intervention programme goals. Disabil Rehabil 2023:1-10. [PMID: 37580981 DOI: 10.1080/09638288.2023.2246373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/14/2023] [Accepted: 07/28/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE WHO recommends integrating rehabilitation into palliative care when providing services for people with life-threatening conditions. Recently, there has been increasing interest in exploring how rehabilitation and palliative care approaches could be combined. The aim of this study was to map and discuss the goals of intervention programmes that combine rehabilitation and palliative care. METHODS A scoping review was performed. The electronic databases MEDLINE, EMBASE, and CINAHL were searched for papers published between January 2014 and September 2022. Papers were considered eligible if the participants in question had a life-threatening disease and if interventions included both rehabilitation and palliative care. All study types were included. RESULTS Ten papers describing five interventions were included. Qualitative goals were narratively described, and quantitative goals were analysed according to the International Classification of Functioning, Disability and Health, and the Total Pain framework. Findings showed an overall focus on functioning and quality of life. Further analysis indicated an emphasis on physical and psychological dimensions. Social participation, and the social and spiritual dimensions were rarely evaluated. CONCLUSION This review indicates that goals relative to social participation, the social and spiritual dimensions, and the patient's own goals may well be overlooked as points of orientation for interventions.
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Affiliation(s)
- Henriette Søby Gärtner
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Jahan Shabnam
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Maria Aagesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mai-Britt Guldin
- Research Unit for General Practice, Public Health, Aarhus University, Aarhus, Denmark
| | - Ane Bonnerup Vind
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kristoffer Marsaa
- North Zealand Hospital, University of Copenhagen, Kobenhavn, Denmark
| | - Heidi Maria Bergenholtz
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Zealand University Hospital, Research Support Unit, Koge, Denmark
| | - Vibeke Graven
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Marc Sampedro Pilegaard
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Clinical Social Medicine and Rehabilitation, Regional Hospital Gødstrup, Herning, Denmark
| | - Jette Thuesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Baker A, Cornwell P, Gustafsson L, Lannin NA. Implementing a tailored, co-designed goal-setting implementation package in rehabilitation services: a process evaluation. Disabil Rehabil 2023:1-12. [PMID: 37551867 DOI: 10.1080/09638288.2023.2243589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
PURPOSE This study aims to evaluate the process of implementing an evidence-based goal-setting package into five rehabilitation services across the continuum of rehabilitation. MATERIALS AND METHODS This study used a mixed methods approach guided by Medical Research Council (MRC) recommendations for conducting process evaluations, the RE-AIM framework, and the Theoretical Domains Framework (TDF). This study will evaluate the reach, adoption, implementation, and maintenance of the goal-setting package over six months. RESULTS Environmental context and resources, the clinician's social and professional role and identity, social influences and clinician beliefs about goal-setting consequences and individuals' capabilities were all identified as barriers or enablers throughout the implementation process. Community rehabilitation services faced challenges implementing paper-based resources, whilst inpatient rehabilitation sites faced challenges engaging nursing staff in the interdisciplinary approach to goal-setting. Social influences were an enabler in two sites that used the case conference format to facilitate setting common goals. Clinicians in all sites continued to express difficulties implementing shared decision-making with people who had cognitive impairments or were no longer progressing in their rehabilitation. CONCLUSIONS A team-based approach to implementing the goal-setting interventions centred around the case conference format appeared to be the most successful mode for implementing interdisciplinary person-centred goal-setting.
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Affiliation(s)
- Amanda Baker
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
- Statewide Rehabilitation Clinical Network, Clinical Excellence Division, Queensland Health, Brisbane, Australia
- Allied Health, Physiotherapy Department, Sunshine Coast Hospital and Health Service, Queensland Health, Nambour, Australia
| | - Petrea Cornwell
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - Louise Gustafsson
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
- Alfred Health, Melbourne, Australia
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Baker A, Cornwell P, Gustafsson L, Stewart C, Lannin NA. Implementation of best practice goal-setting in five rehabilitation services: A mixed-methods evaluation study. J Rehabil Med 2023; 55:jrm4471. [PMID: 37548542 PMCID: PMC10424097 DOI: 10.2340/jrm.v55.4471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 04/05/2023] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVE This implementation study aimed to enhance the key elements of clinical practice goal-setting across 5 rehabilitation services. DESIGN This study followed a participatory action research approach guided by the Knowledge to Action framework. METHODS Medical record audits and structured client interviews were conducted prior to and following 12 weeks of implementation, in order to evaluate the success of the goal-setting implementation package. RESULTS Medical record audits and interviews conducted pre-implementation (audits n = 132, interviews n = 64), post-implementation (audits n = 130, interviews n = 56) and at 3-month follow-up (audits n = 30) demonstrated varied success across sites. Following implementation 2 sites significantly improved their common goal focus (site 1 p ≤ 0.001, site 2 p = 0.005), these sites also demonstrated a significant increase in clients reporting that they received copies of their rehabilitation goals (site 1 p ≤ 0.001, site 2 p ≤ 0.001). Four sites improved client action planning, feedback and review, and 3 sites enhanced their specificity of goal-setting. At 3-month follow-up 4 sites had continued to improve their common goal focus; however, all sites decreased the specificity of their goal-setting. CONCLUSION Elements of the implementation package were successful at enhancing the goal-setting process; however, how the package is implemented within the team may impact outcomes.
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Affiliation(s)
- Amanda Baker
- School of Health Sciences and Social Work, Griffith University, Brisbane; Statewide Rehabilitation Clinical Network, Clinical Excellence Division, Queensland Health, Brisbane; Allied Health, Physiotherapy Department, Sunshine Coast Hospital and Health Service, Queensland Health, Sunshine Coast.
| | - Petrea Cornwell
- School of Health Sciences and Social Work, Griffith University, Brisbane; The Hopkins Centre, Menzies Health Institute Queensland, Brisbane
| | - Louise Gustafsson
- School of Health Sciences and Social Work, Griffith University, Brisbane; The Hopkins Centre, Menzies Health Institute Queensland, Brisbane
| | - Claire Stewart
- Allied Health, Physiotherapy Department, Sunshine Coast Hospital and Health Service, Queensland Health, Sunshine Coast
| | - Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia; Alfred Health, Melbourne, Australia
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Balconi M, Angioletti L, Acconito C. Self-Awareness of Goals Task (SAGT) and Planning Skills: The Neuroscience of Decision Making. Brain Sci 2023; 13:1163. [PMID: 37626519 PMCID: PMC10452128 DOI: 10.3390/brainsci13081163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
A goal's self-awareness and the planning to achieve it drive decision makers. Through a neuroscientific approach, this study explores the self-awareness of goals by analyzing the explicit and implicit processes linked to the ability to self-represent goals and sort them via an implicit dominant key. Thirty-five professionals performed a novel and ecological decision-making task, the Self-Awareness of Goals Task (SAGT), aimed at exploring the (i) self-representation of the decision-making goals of a typical working day; (ii) self-representation of how these goals were performed in order of priority; (iii) temporal sequence; and (iv) in terms of their efficacy. Electrophysiological (i.e., alpha, beta, and gamma band), autonomic, behavioral, and self-report data (General Decision Making Style and Big Five Inventory) are collected. Higher self-awareness of goals by time as well as efficacy and the greater activation of alpha, beta, and gamma bands in the temporoparietal brain area were found. Correlations reported positive associations between the self-awareness of goals via a time and dependent decision-making style and a conscientious personality, but also between the self-awareness of goals via an efficacy and rational decision-making style. The results obtained in this study suggest that the SAGT could activate recursive thinking in the examinee and grasp individual differences in self-representation and aware identification of decision-making goals.
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Affiliation(s)
- Michela Balconi
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Catholic University of the Sacred Heart, Largo Gemelli 1, 20123 Milan, Italy; (M.B.); (C.A.)
- Research Unit in Affective and Social Neuroscience, Department of Psychology, Catholic University of the Sacred Heart, Largo Gemelli 1, 20123 Milan, Italy
| | - Laura Angioletti
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Catholic University of the Sacred Heart, Largo Gemelli 1, 20123 Milan, Italy; (M.B.); (C.A.)
- Research Unit in Affective and Social Neuroscience, Department of Psychology, Catholic University of the Sacred Heart, Largo Gemelli 1, 20123 Milan, Italy
| | - Carlotta Acconito
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Catholic University of the Sacred Heart, Largo Gemelli 1, 20123 Milan, Italy; (M.B.); (C.A.)
- Research Unit in Affective and Social Neuroscience, Department of Psychology, Catholic University of the Sacred Heart, Largo Gemelli 1, 20123 Milan, Italy
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Wilkowski BM, Rivera E, Williamson LZ, DiMariano E, Meier BP, Fetterman A. Toward a Comprehensive, Data-Driven Model of American Political Goals: Recognizing the "Values" and "Vices" Within Both Liberalism and Conservativism. Pers Soc Psychol Bull 2023:1461672231185484. [PMID: 37530124 DOI: 10.1177/01461672231185484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
When a person indicates they are "liberal" or "conservative," an important part of what they are communicating is their goals for how they would like society to be structured. However, past theories have described these goals in dramatically different fashions, suggesting that either conservativism or liberalism reflects a divisive or unifying goal. To help overcome this impasse, we systematically compared a broad, representative sample of all possible higher-order goals (drawn a previous lexical investigation of more than 1,000 goals) to the political ideology of American adults (total n = 1,588). The results of five studies suggested that proposals from competing theories are all partially correct. Conservativism simultaneously reflects the unifying "value" of Tradition, as well as the divisive "vice" of Elitism; while Liberalism simultaneously reflects the unifying "value" of Inclusiveness, and the divisive "vice" of Rebellion. These results help to integrate proposals from previous competing theories into a single framework.
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Eriksson LJK, Sundin Ö, Jansson B. Exploring Response Inhibition, the Behavioral Inhibition System and Possible Sex Differences in Athletes and Non-Athletes. Int J Environ Res Public Health 2023; 20:6340. [PMID: 37510573 PMCID: PMC10379307 DOI: 10.3390/ijerph20146340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/27/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND The objective of this study was to revisit the question concerning whether athletes are better than non-athletes at fundamental cognitive abilities, such as inhibitory control, in addition to also focusing on motivational dispositions and possible sex differences. Adding the latter could be crucial since both inhibitory control and motivational dispositions, such as approach and avoidance, are central to goal-directed behavior. METHODS This study's sample was composed of 93 participants (40 males): 29 biathletes; 30 alpine skiers; and 34 non-athletes. A non-sport-specific stop-signal task was used for the assessment of inhibitory control in terms of response inhibition, and the motivational dispositions were assessed with the BIS/BAS scales. RESULTS The results showed that there were no differences between the two different sports or non-athletes with regard to response inhibition. However, females showed significantly slower response inhibition than males (p = 0.018) and scored significantly higher on the trait variable BIS (p < 0.001). CONCLUSIONS The results from this study suggest that it might be meaningful to explore the contribution of sex differences and motivational dispositions on response inhibition in conjunction with different types of sports.
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Affiliation(s)
- Lina J K Eriksson
- Department of Psychology and Social Work, Mid Sweden University, 83125 Östersund, Sweden
| | - Örjan Sundin
- Department of Psychology and Social Work, Mid Sweden University, 83125 Östersund, Sweden
- Católica Research Centre for Psychological-Family and Social Wellbeing, Universidade Católica Portugesa, 1649-023 Lisboa, Portugal
| | - Billy Jansson
- Department of Psychology and Social Work, Mid Sweden University, 83125 Östersund, Sweden
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Wren GM, Koutoukidis DA, Scragg J, Whitman M, Jebb S. The Association Between Goal Setting and Weight Loss: Prospective Analysis of a Community Weight Loss Program. J Med Internet Res 2023; 25:e43869. [PMID: 37405833 DOI: 10.2196/43869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/05/2023] [Accepted: 06/06/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Goal setting aids health-related behavior changes; however, the influence of different types of goals on weight loss remains unclear. OBJECTIVE We aimed to investigate the association of 3 aspects of goal setting with weight and program dropout over a 24-week period. METHODS This study was a prospective longitudinal analysis of participants in a 12-week digital behavioral weight loss program. Weight and engagement data for eligible participants (N=36,794) were extracted from the database. Eligible participants were adults in the United Kingdom who had enrolled in the program, had a BMI ≥25 kg/m2, and a weight reading recorded at baseline. Three aspects of goal setting were self-reported at enrollment: weight loss motivation (appearance, health, fitness, or self-efficacy), overall goal preference (low, medium, or high), and percentage weight loss goal (<5%, 5%-10%, or >10%). Weight was measured at 4, 12, and 24 weeks. Mixed models for repeated measures were used to explore the association between goals and weight across the 24-week period. To measure sustained weight change, the primary outcome was weight at 24 weeks. We explored dropout rates over the 24-week period by goal and whether engagement mediated the association between goals and weight loss. RESULTS Of the 36,794 participants (mean 46.7, SD 11.1 years; 33,902/36,794, 92.14% female) included in the cohort, 13.09% (n=4818) reported weight at 24 weeks. Most participants set goals of 5%-10% weight loss (23,629/36,794, 64.22%), but setting goals for >10% was associated with greater weight loss (mean difference 5.21 kg, 95% CI 5.01-5.41; P<.001). There was no difference between goals of 5%-10% and <5% (mean difference 0.59 kg, 95% CI 0.00-1.18; P=.05). Appearance was the most prevalent motivational factor (14,736/36,794, 40.05%), but health and fitness were associated with greater weight losses (mean difference health vs appearance 1.40 kg, 95% CI 1.15-1.65; P<.001 and mean difference fitness vs appearance 0.38 kg, 95% CI 0.05-0.70; P=.03). Goal preference had no association with weight. Engagement was an independent predictor of weight loss but not a mediator of the effect of goal setting. At 24 weeks, those who set goals of >10% were less likely to drop out compared with 5%-10% goals (odds ratio [OR] 0.40, 95% CI 0.38-0.42; P<.001); those who liked to set overall high goals were more likely to drop out compared with medium goals (OR 1.20, 95% CI 1.11-1.29; P<.001); and those motivated by fitness or health were less likely to drop out compared with appearance (OR 0.92, 95% CI 0.85-0.995; P=.04 and OR 0.84, 95% CI 0.78-0.89; P<.001, respectively). CONCLUSIONS Setting higher weight loss goals and being motivated by health or fitness were associated with greater weight loss and lower likelihood of dropout. Randomized trials for setting these types of goals are required to confirm causality.
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Affiliation(s)
- Gina M Wren
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Dimitrios A Koutoukidis
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Jadine Scragg
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | | | - Susan Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
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Zheutlin AR, Addo DK, Jacobs JA, Derington CG, Herrick JS, Greene T, Stulberg EL, Berlowitz DR, Williamson JD, Pajewski NM, Supiano MA, Bress AP. Evidence for Age Bias Contributing to Therapeutic Inertia in Blood Pressure Management: A Secondary Analysis of SPRINT. Hypertension 2023; 80:1484-1493. [PMID: 37165900 PMCID: PMC10438422 DOI: 10.1161/hypertensionaha.123.21323] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/25/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Despite evidence supporting the cardiovascular and cognitive benefits of intensive blood pressure management, older adults have the lowest rates of blood pressure control. We determined the association between age and therapeutic inertia (TI) in SPRINT (Systolic Blood Pressure Intervention Trial), and whether frailty, cognitive function, or gait speed moderate or mediate these associations. METHODS We performed a secondary analysis of SPRINT of participant visits with blood pressure above randomized treatment goal. We categorized baseline age as <60, 60 to <70, 70 to <80, and ≥80 years and TI as no antihypertensive medication intensification per participant visit. Generalized estimating equations generated odds ratios for TI associated with age, stratified by treatment group based on nested models adjusted for baseline frailty index score (fit [frailty index, ≤0.10], less fit [0.10 RESULTS Participants 60 to <70, 70 to <80, and ≥80 years of age had a higher prevalence of TI in both treatment groups versus participants <60 years of age (standard: 59.7%, 60.5%, and 60.1% versus 56.0%; 29 527 participant visits; intensive: 55.1%, 57.2%, and 57.8% versus 53.8%; 47 129 participant visits). The adjusted odds ratios for TI comparing participants ≥80 versus <60 years of age were 1.32 (95% CI, 1.14-1.53) and 1.25 (95% CI, 1.11-1.41) in the standard and intensive treatment groups, respectively. Adjustment for frailty, cognitive function, or gait speed did not attenuate the association or demonstrate effect modification (all Pinteraction, >0.10). CONCLUSIONS Older age is associated with greater TI independent of physical or cognitive function, implying age bias in hypertension management.
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Affiliation(s)
- Alexander R Zheutlin
- Department of Internal Medicine (A.R.Z.), Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
| | - Daniel K Addo
- Intermountain Healthcare Department of Population Health Sciences (D.K.A., J.A.J., C.G.D., J.S.H., T.G., A.P.B.), Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
| | - Joshua A Jacobs
- Intermountain Healthcare Department of Population Health Sciences (D.K.A., J.A.J., C.G.D., J.S.H., T.G., A.P.B.), Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
| | - Catherine G Derington
- Intermountain Healthcare Department of Population Health Sciences (D.K.A., J.A.J., C.G.D., J.S.H., T.G., A.P.B.), Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
| | - Jennifer S Herrick
- Intermountain Healthcare Department of Population Health Sciences (D.K.A., J.A.J., C.G.D., J.S.H., T.G., A.P.B.), Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
- Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs, Salt Lake City Health Care System, Utah (J.S.H., A.P.B.)
| | - Tom Greene
- Intermountain Healthcare Department of Population Health Sciences (D.K.A., J.A.J., C.G.D., J.S.H., T.G., A.P.B.), Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
| | - Eric L Stulberg
- Department of Neurology (E.L.S.), Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
| | - Dan R Berlowitz
- Department of Public Health, University of Massachusetts-Lowell (D.R.B.)
| | - Jeff D Williamson
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine (J.D.W.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - Nicholas M Pajewski
- Department of Biostatistics and Data Science, Division of Public Health Sciences (N.M.P.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - Mark A Supiano
- Geriatrics Division, Spencer Fox Eccles School of Medicine, University of Utah Center on Aging, Salt Lake City (M.A.S.)
| | - Adam P Bress
- Intermountain Healthcare Department of Population Health Sciences (D.K.A., J.A.J., C.G.D., J.S.H., T.G., A.P.B.), Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
- Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs, Salt Lake City Health Care System, Utah (J.S.H., A.P.B.)
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Kang E, Chen J, Foster ER. Implementation strategies for occupational therapists to advance goal setting and goal management. Front Health Serv 2023; 3:1042029. [PMID: 37351362 PMCID: PMC10282647 DOI: 10.3389/frhs.2023.1042029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 05/16/2023] [Indexed: 06/24/2023]
Abstract
Background There is a need for an effective evidence-based system to support high-quality goal setting and goal management implementation. We developed a new system for community-based rehabilitation, MyGoals, along with implementation strategies to support occupational therapists (OTs) in its administration. This study evaluates the acceptability, appropriateness, and feasibility of the implementation strategies, Clinician Education and Audit & Feedback. It also explores whether OTs achieve the change objectives of the MyGoals implementation strategies and MyGoals intervention fidelity. Methods This mixed-methods case series study evaluated the MyGoals implementation strategies developed using Implementation Mapping (IM), specifically IM Task 5 - Implementation Outcome Evaluation. Seven OTs and 13 adults with chronic conditions participated in this study. OTs participated in two Clinician Education sessions, delivered two MyGoals interventions, and participated in two Audit & Feedback sessions. We evaluated the implementation strategies using the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), Feasibility of Intervention Measure (FIM), and semi-structured interviews and explored the OTs' self-rated MyGoals change objectives achievement and the intervention fidelity using quantitative MyGoals intervention fidelity measures and interviews. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed by two independent coders using content analysis. Results Seven OTs participated in this study (mean years of professional experience = 9.3, SD = 5.9). Clinician Education and Audit & Feedback had high AIM (M = 17.9, SD = 2.7), IAM (M = 17.3, SD = 3.60), and FIM scores (M = 17.3, SD = 3). The OTs also had high mean scores on self-perceived achievement of change objectives and intervention fidelity. Qualitative interviews suggested that the time commitment for Clinician Education is a key barrier to its acceptability, appropriateness, and feasibility. Participants also provided suggestions on how to improve the strategies (e.g., providing recorded Clinician Education, etc.). Conclusions The MyGoals implementation strategies are acceptable, appropriate, and feasible to OTs working in community-based rehabilitation. They support OTs in achieving the change objectives necessary to deliver MyGoals completely and competently. Thus, the MyGoals implementation strategies may support clinicians in implementing a theory-based, client-engaged goal setting and goal management for adults with chronic conditions in community-based rehabilitation. This can ultimately help improve the integration of evidence-based interventions into practice.
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Affiliation(s)
- Eunyoung Kang
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States
| | - Julie Chen
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States
| | - Erin R. Foster
- Program in Occupational Therapy, Department of Neurology & Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
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46
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Kohl HW, Johnson AM, Dooley EE, Towner B, Pate RR, Heischmidt K, Elliott EM. An Assessment of State-Level Planning for Physical Activity Promotion in the United States. J Phys Act Health 2023:1-6. [PMID: 37185452 DOI: 10.1123/jpah.2022-0600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/06/2023] [Accepted: 03/01/2023] [Indexed: 05/17/2023]
Abstract
The prevalence and attributable risk of disease due to physical inactivity require it to be made a public health priority. Public health planning allows for prioritization and resource allocation, particularly at the state and local levels. The extent to which state planning efforts for physical activity exist in the United States is unknown. The purpose of this paper is to describe the scope in which physical activity is incorporated in state-level public health plans in the United States, with an emphasis on alignment with the national guidelines and the National Physical Activity Plan. A standardized internet search audit was developed and conducted for each of 50 US states and the District of Columbia between May 2017 and January 2018 to determine the prevalence and characteristics of health planning documents that include physical activity. Data abstracted for analysis used a standardized search protocol that included the components of the Physical Activity Guidelines for Americans and the US National Physical Activity Plan. Results found that most states had between 4 and 6 chronic disease prevention and control plans that mention physical activity; however, it was inconsistently aligned with recommendations from both the Guidelines and the National Plan. Only 2 states had stand-alone public health planning documents explicitly dedicated to physical activity promotion. No state planning documents addressed children and adolescents, adults, and older adults simultaneously. To be maximally effective, state public health planning for physical activity should be made a priority and these efforts should align as much as possible with current guidance from the Physical Activity Guidelines for Americans and the US National Physical Activity Plan.
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Affiliation(s)
- Harold W Kohl
- School of Public Health, University of Texas Health Science Center at Houston, Austin, TX,USA
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX,USA
| | - Ashleigh M Johnson
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA,USA
| | - Erin E Dooley
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL,USA
| | - Brooke Towner
- Department of Recreation Management and Physical Education, Appalachian State University, Boone, NC,USA
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, SC,USA
| | | | - Eloise M Elliott
- College of Applied Human Sciences, West Virginia University, Morgantown, WV,USA
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Cavallario JM, Van Lunen BL, Walker SE, Bay RC, Welch Bacon CE. Implementation of Patient-Centered Care by Athletic Training Students during Clinical Experiences: A Report from the Association of Athletic Training Education Research Network. Int J Environ Res Public Health 2023; 20:ijerph20085513. [PMID: 37107794 PMCID: PMC10138963 DOI: 10.3390/ijerph20085513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/11/2023]
Abstract
Patient-centered care (PCC) is a core competency that should be required by all healthcare education programs, but little is known about its implementation in athletic training clinical experiences. Therefore, we examined characteristics of patient encounters documented by athletic training students implementing PCC behaviors. A multisite panel design was used to recruit 363 students from twelve professional athletic training programs (five undergraduate, seven graduate). Over 1.5 years, clinical experience patient encounter data were logged in E*Value Case Logs, including student role during the encounter, length of encounter, and clinical site. Generalized estimating equations models characterized the likelihood students included PCC behaviors in 30,522 encounters. Discussing patient goals was associated with student role (χ2(2) = 40.6, p < 0.001) and length of encounter (χ2(4) = 67.6, p < 0.001). Using patient-reported outcome measures was associated with student role (χ2(2) = 21.6, p < 0.001), length of encounter (χ2(4) = 34.5, p < 0.001), and clinical site (χ2(3) = 17.3, p = 0.001). Implementing clinician-rated outcome measures was affected by length of encounter (χ2(4) = 27.9, p < 0.001) and clinical site (χ2(3) = 8.6, p = 0.04). PCC behaviors were largely associated with student role and length of encounters; clinical site had less impact. Athletic training educators should emphasize progressive autonomous supervision with preceptors and encourage students to facilitate slightly longer patient visits, when possible, to incorporate more PCC behaviors.
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Affiliation(s)
- Julie M. Cavallario
- School of Rehabilitation Sciences, College of Health Sciences, Old Dominion University, Norfolk, VA 23529, USA
- Correspondence: ; Tel.: +1-757-683-4351
| | | | - Stacy E. Walker
- School of Kinesiology, Ball State University, Muncie, IN 47306, USA
| | - R. Curtis Bay
- Department of Interdisciplinary Health Sciences, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ 85206, USA
| | - Cailee E. Welch Bacon
- Department of Athletic Training, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ 85206, USA
- Department of Basic Medical Science, School of Osteopathic Medicine in Arizona, A.T. Still University, Mesa, AZ 85206, USA
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Lendaris A, Esenwa C. Tips and Advice on Preparing a Research Manuscript for Submission and Publication in a Peer-Reviewed Stroke Journal. Stroke 2023; 54:e217-e219. [PMID: 37009744 DOI: 10.1161/strokeaha.122.037872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Affiliation(s)
- Andrea Lendaris
- Department of Neurology, Montefiore Medical Center/Albert Einstein College of Medicine, The Bronx, NY
| | - Charles Esenwa
- Department of Neurology, Montefiore Medical Center/Albert Einstein College of Medicine, The Bronx, NY
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Duncan C, Cooper M, Saxon D. Test-retest stability, convergent validity, and sensitivity to change for the Goal-Based Outcome tool for adolescents: Analysis of data from a randomized controlled trial. J Clin Psychol 2023; 79:683-696. [PMID: 35975697 PMCID: PMC10087879 DOI: 10.1002/jclp.23422] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/11/2022] [Accepted: 07/05/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE(S) To examine the psychometric properties of the idiographic Goal-Based Outcome (GBO) tool for young people: test-retest stability, convergent validity, and sensitivity to an intervention. METHODS This measure validation study used data from a randomized controlled trial of school-based humanistic counseling. We used multilevel analyses to assess test-retest stability, convergent validity of the GBO tool against nomothetic measures of mental wellbeing, and sensitivity to an intervention. RESULTS The GBO tool showed acceptable stability over a 6-24 week period; moderate convergent validity with nomothetic measures of mental well-being, self-esteem, and depression; and greater sensitivity to an intervention than a measure of psychological distress. CONCLUSIONS The GBO tool shows evidence of having acceptable psychometric properties and is suitable for monitoring change on individual goals. It may also have the capacity to function as a population-level indicator of outcomes in conjunction with the use of other measures of mental health and wellbeing.
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Affiliation(s)
- Charlie Duncan
- Department of Psychology, University of Roehampton, London, UK.,Department of Research, British Association for Counselling and Psychotherapy, Lutterworth, UK
| | - Mick Cooper
- Department of Research, British Association for Counselling and Psychotherapy, Lutterworth, UK
| | - David Saxon
- Department of Psychology, University of Sheffield, Sheffield, UK
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50
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Jacob J, Edbrooke-Childs J, Costa da Silva L, Law D. Notes from the youth mental health field: Using movement towards goals as a potential indicator of service change and quality improvement. J Clin Psychol 2023; 79:697-710. [PMID: 34114660 DOI: 10.1002/jclp.23195] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/16/2021] [Accepted: 05/30/2021] [Indexed: 11/09/2022]
Abstract
The aim of this paper is to report our notes from the field on using movement toward goals at an aggregate level as an inference of service effectiveness. Analysis of routinely collected data from UK youth mental health services was conducted (N = 8,172, age M = 13.8, 67% female, 32% male) to explore the impact of including goal-based outcome data in combined calculations of standardized measures based on the principles of reliable change ("measurable change"). Due to the broad nature of standardized measures, inferred validity becomes diluted in any team or service level aggregate analysis. To make inferences that are closer to the person's interpretation of their difficulties, we argue that Idiographic Patient Reported Outcome Measures (I-PROMs) counterbalance these limitations. This is supported by our findings. The measurable change metric is the first step towards enabling national analysis of aggregated I-PROMs. I-PROMs, supplemented by standardized measures should be used to consider service evaluation.
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Affiliation(s)
- Jenna Jacob
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK.,Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Julian Edbrooke-Childs
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK.,Department of Clinical, Educational and Health Psychology, UCL, London, UK.,Evidence Based Practice Unit, Anna Freud Centre, London, UK
| | - Luís Costa da Silva
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK.,Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Duncan Law
- Child Outcomes Research Consortium, Anna Freud Centre, London, UK.,MindMonkey Associates Ltd, London, UK
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