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At least 235 records · Page 13Linked to original sources

PubMed2006

Quantifying the role of factors that limit attainment of K/DOQI urea reduction ratio dialytic goal.

BACKGROUND: For many ESRD patients who are prescribed a certain level of hemodialysis (HD), delivered dose often does not achieve prescription. While various causes have been well-documented in the literature, there are no available data that may be used in predicting the likelihood of achieving a particular urea reduction ratios (URR) goal based on the number of these factors present. This study evaluated URRs of all patients in an outpatient HD unit for a 6-month period to identify factors significant in attaining goal in order to predict likelihood of goal attainment based on number of factors present. METHODS: The inclusion criterion in this study was any HD patient during the study period with > or = 3 monthly URR measurements. Of 203 patients, 169 qualified for 900 treatments. A database was created for each patient that included demographics, factors affecting K(urea), time and access. After grouping percentages of patients with URR > or = 70%, 65 - < 70%, and < 65%, we studied a subset of 107 patients (568 treatments) that had at least 1 URR < 70% to identify factors associated with a URR of > or = 65% vs. < 65%. To determine factors predictive of URR > or = 65%, a sum percentage across all treatments was created for each patient. Mean percentages were compared between groups created by constant characteristics (e.g. gender, DM). Variables, e.g. catheters, were summarized as a percentage for each patient, and these percentages were correlated with rate of URR > or = 65%. Time was assigned a value of 0 (prescribed), positive (longer), negative (shorter), summarized as per-patient mean. After these factors were identified, each treatment was reviewed to determine the percentage of treatments > or = 65% with the number of statistically significant factors present. RESULTS: The average, across all patients, of percentage of treatments meeting URR > or = 65% was 87.95% while a mean of 66.65% met URR > or = 70%. Factors associated with percentage of treatments per patient not meeting K/DOQI goal included catheter use (Spearman's correlation = -0.31, p = 0.001), blood flow < 90% of prescription (Spearman's correlation = -0.17, p = 0.041), younger age (> or = 61 years vs. < 61 years, p = 0.001: patients > or = 61 years had a higher percentage of URR > or = 65%), inadequate access for prescribed blood flow (Spearman's correlation = -0.32, p = 0.001), actual time vs. prescribed time (Spearman's correlation = 0.25, p = 0.009), and HD w/o heparin (Spearman's correlation = -0.21, p = 0.031). In 178 treatments, all having "good" values (no catheter, blood flow > or = 90% prescribed, age < or = 61 years, etc.), the percentage of treatments meeting URR of < or = 65 was 96.1%. With 1 bad value factor: 83.8% of 216 treatments met goal, 2 bad value factors: 71.7% of 106 met goal, 3 bad value factors: 60.5% of 43 met goal. With 4 or 5 bad value factors: only 36.1% of 25 treatments met goal. CONCLUSIONS: Significant factors in meeting adequacy defined by K/DOQI in rank order (excluding age) include inadequate access for prescribed blood flow, catheter use, time, lack of heparin and inability to achieve blood flow > or = 90% prescribed. A direct correlation exists between number of these factors present and K/DOQI goal attainment in a given treatment.

Aged↗

PubMed2026

How is goal setting used in interventions for chronic disease prevention and management in sub-Saharan Africa? A systematic review and narrative synthesis.

Non-communicable diseases are increasingly prevalent in sub-Saharan Africa, and goal setting is often used to promote healthy self-management behaviours. In this review, we aimed to synthesise literature around how goal setting is used, for application in future interventions in the region. A systematic search was conducted in six databases and results screened for eligibility. Study characteristics, intervention details, goal setting components, feedback from participants and facilitators were extracted. Data were analysed using narrative synthesis and thematic analysis. The Mixed Methods Appraisal Tool was used to assess study quality. We included 24 publications describing 18 unique interventions. Included studies were of high to moderate methodological quality. Goal setting intervention components were informed by a variety of frameworks and involved a range of tasks. Interventions were often facilitator-led; many were conducted in group settings. Participants reported goal setting as useful for putting self-management into practice but encountered challenges related to language and literacy levels. Adequate detail on goal setting intervention components was not always present. Through this review, we provide a comprehensive picture of the variability of goal setting approaches in chronic disease prevention and management in sub-Saharan Africa and recommend more standardised use and reporting of goal setting intervention components.

Humans↗

PubMed1987

Goals of treatment in diabetes: a comparison of doctors and parents of children with diabetes.

Treatment failure is usually understood as a problem of patient compliance. This paper suggests another approach: to see this problem as resulting from a difference in the goals of the two parties involved, the doctor and the patient. Comparison was made between the goals of doctors and those of parents in treating children with diabetes. Significant differences emerged between the goals. Parents' goals of treatment were governed more by avoidance of the short-term threat of diabetes (hypoglycemia); doctors' goals more by the long-term threat of diabetes (diabetic complications). The outcome of treatment (diabetic control) was more closely related to parents' than doctors' goals of control. These results indicate that doctors and patients do not always share the same goals in treatment. It is suggested that a more effective clinical alliance would result if the goals of the clinical team were at least made explicit, even if they were not always shared.

Adolescent↗

PubMed1993

Social goals: relationship to adolescent adjustment and to social problem solving.

Examined the relations between adolescent boys' social goals of dominance, revenge, avoidance, and affiliation and (1) self-reported negative adolescent outcomes; (2) subjective sense of self-esteem; and (3) externalizing, internalizing, and prosocial behaviors, as rated by peers and teachers. Results indicated that social goal values were related to diverse aspects of self-, teacher-, and peer-reported social and behavioral functioning, with a consistent association found between a range of delinquent, substance-using, and behavioral difficulties, and endorsement of high goal values for dominance and revenge and low goal values for affiliation. Results also indicated that teacher-identified aggressive boys differed from nonaggressive boys in the value they placed on social goals, with aggressive boys placing a higher value on goals of dominance and revenge, and lower value on goals for affiliation. Finally social goal choice had a clear relation to the social problem-solving differences of aggressive and nonaggressive boys.

Adolescent↗

PubMed2006

Fluctuating awareness of treatment goals among patients and their caregivers: a longitudinal study of a dynamic process.

BACKGROUND: Because increasing numbers of people now survive for months or years with advanced cancer, communication between patients, service providers, and family caregivers often continues over long periods. Hence, understanding of the goals of medical treatment may develop and change as time elapses and disease progresses. This understanding is closely related to the "awareness of dying," which has been studied in both qualitative and quantitative research. However, when both a patient and family caregiver are involved, the question of "awareness" becomes more complex. A recent longitudinal study reported on patient and caregiver knowledge of treatment goals, but no comparison of such knowledge using matched interview schedules and paired data analysis has been provided. This report examines patterns of awareness and factors associated with these patterns. MATERIALS AND METHODS: One hundred sixty-three patients with incurable cancer and their nominated principal family caregivers (136) were recruited from The Canberra Hospital Oncology Services. Participants' understanding of the treatment goals were measured by interview questions at weeks 1 and 12. RESULTS: One-third of both patients and caregivers understood that the treatment goal was not curative; however, not all patient and caregiver pairs had the same understanding. In 15% of pairs, both patient and caregiver believed that the goal of treatment was curative, while another 13% said that they did not know the aim of the treatment. Thirty-nine percent of pairs registered incongruent responses in which only one member of the pair understood that the treatment was not intended to cure the disease. Over time, a few respondents changed their perception of the treatment goals toward accurate clarification. Bivariate analysis using an awareness variable, constructed for the purpose, showed that in 6 months before death, at least one person in 89% of pairs understood that the treatment was noncurative. Time-to-death, gender, and place of residence were also important predictors of knowledge. CONCLUSIONS: Discrepancies between patients and their caregivers may complicate the delivery of effective care when patients are seriously ill. Misunderstanding or uncertainty about treatment goals will obstruct proper informed consent. Health professionals providing care for families dealing with advanced cancer must recognize that the discussion of treatment goals is a dynamic process, which may require them to extend their communication skills.

Adult↗

PubMed2005

Goal disturbance in relation to anxiety, depression, and health-related quality of life after Myocardial Infarction.

Aim of this cross-sectional study, was to examine whether the sudden event of hospitalization for Myocardial Infarction (MI) would lead to a disturbance in the attainment of important higher order or life goals, and secondly, whether goal importance as well as goal disturbance would be related to emotional distress and health-related quality of life (HRQL) shortly (two to five weeks) after the MI. Respondents were 160 patients who were hospitalized for MI. Results indicate that patients experience goal disturbance as a result of their cardiac event. Hierarchical regression analyses showed that independently from demographics, medical characteristics and prior lifestyle, disturbance of important higher order goals was a powerful correlate of anxiety, depression as well as HRQL. Furthermore, the extent to which patients valued higher order goals in their life (goal importance) was an independent correlate of depression. Based on self-regulation theory, we suggest that emotional distress and lower levels of HRQL can be explained in terms of threat to goal attainment. Recommendations for further research and practical implications for rehabilitation programs were formulated.

Adult↗

PubMed2006

Goals and means in action observation: a computational approach.

Many of our daily activities are supported by behavioural goals that guide the selection of actions, which allow us to reach these goals effectively. Goals are considered to be important for action observation since they allow the observer to copy the goal of the action without the need to use the exact same means. The importance of being able to use different action means becomes evident when the observer and observed actor have different bodies (robots and humans) or bodily measurements (parents and children), or when the environments of actor and observer differ substantially (when an obstacle is present or absent in either environment). A selective focus on the action goals instead of the action means furthermore circumvents the need to consider the vantage point of the actor, which is consistent with recent findings that people prefer to represent the actions of others from their own individual perspective. In this paper, we use a computational approach to investigate how knowledge about action goals and means are used in action observation. We hypothesise that in action observation human agents are primarily interested in identifying the goals of the observed actor's behaviour. Behavioural cues (e.g. the way an object is grasped) may help to disambiguate the goal of the actor (e.g. whether a cup is grasped for drinking or handing it over). Recent advances in cognitive neuroscience are cited in support of the model's architecture.

Attention↗

PubMedDate not supplied

The significance of graduate admission written goal statements.

Written goal statements are often required of applicants to nursing graduate programs. There is a lack of data describing the significance of written goal statements, the topics addressed by applicants in their written goal statements, and the relationship between goal statement quality of writing (QOW) and graduate-level coursework. Using content analysis, the written goal statements of 157 graduate students from one Midwestern school of nursing were analyzed for their QOW and for the identification of content categories. Analysis of the goal statements' content categories revealed that applicants tended to focus their writing on the immediate goal of getting admitted to graduate school and on clinical practice issues they felt were important to their desired program major. Data were analyzed to determine the relationship between goal statement content and graduate program major as well as that between QOW and the final grade in a writing-intensive nursing theory course. The results indicated that QOW did not differ by program major and that it was significantly related to the nursing theory final course grade. Implications for graduate nursing education and advanced nursing practice are addressed.

Analysis of Variance↗

PubMed2001

Using goal setting as a strategy for dietary behavior change.

Recent reviews have noted that behavioral theory-based nutrition education programs are more successful at achieving food behavior change than knowledge-based programs and that a clear understanding of the mechanisms of behavior change procedures enable dietetics professionals to more effectively promote change. Successful dietary behavior change programs target 1 or more of the personal, behavioral, or environmental factors that influence the behavior of interest and apply theory-based strategies to influence or change those factors. Goal setting is a strategy that is frequently used to help people change. A 4-step goal-setting process has been identified: recognizing a need for change; establishing a goal; adopting a goal-directed activity and self-monitoring it; and self-rewarding goal attainment. The applications of goal setting in dietary interventions for adults and children are reviewed here. Because interventions using goal setting appear to promote dietary change, dietitians should consider incorporating the goal-setting strategies to enhance the behavior change process in nutrition education programs.

Adult↗

PubMed1997

Physicians prefer goal-oriented note format more than three to one over other outcome-focused documentation.

To assess preference for outcome-focused nutrition notes, two note formats were selected from the literature and tested against a modified, goal-oriented format. Focus charting and intervention, evaluation, and revision (IER) formats were compared with a charting-by-exception style that was modified to include goals and reassessment of risk. Notes were handwritten in each format and contained the same information. Physicians were asked to choose their preference and explain why that format was selected. Initially, focus charting was tested against the goal-oriented format. The more popular of the two was then tested against the IER format. Nineteen physicians were surveyed by a registered dietitian for each comparison. Physicians preferred the goal-oriented format over focus charting and IER formats 9:1 and 3:1, respectively. In the first survey, physicians preferred the goal-oriented format because the plan was clearly stated, thereby rendering the note easier to understand. The goal-oriented format was preferred in the second survey because the note was considered to be concise and easy to read and contained expected outcomes. Physicians want short communication that includes easily identifiable goals and plans. We recommend that experienced dietitians use the goal-oriented format developed for this study, and preferred by physicians, for follow-up nutrition notes.

Attitude of Health Personnel↗

PubMed1999

Cognitive and affective improvement in brain dysfunctional patients who achieve inpatient rehabilitation goals.

OBJECTIVE: To evaluate whether improvements in specific cognitive and affective functions are associated with achieving inpatient rehabilitation goals after the acute onset of brain dysfunction. DESIGN: Retrospective analysis of data obtained in a prospective inception cohort study. STUDY SETTING: Medical center and neurological institute. SUBJECTS: Ninety-five heterogeneous brain dysfunctional patients who participated in an interdisciplinary inpatient neurorehabilitation program. Subjects were classified as having achieved their rehabilitation goals (Group 1) or not (Group 2) at time of discharge. MAIN OUTCOME MEASURE: Number of treatment goals attained. RESULTS: Although overall level of performance on the BNI Screen (BNIS) for Higher Cerebral Functions distinguished patients who later achieved their inpatient rehabilitation goals, on admission only performance on the visual spatial subtest was associated with later goal attainment. In contrast, at discharge, patients who showed greater improvement in awareness, affect, visual spatial skills, memory, and attention/concentration were likely to obtain their rehabilitation goals. This was true when the initial level of performance was taken into account. CONCLUSIONS: Measurement of overall neuropsychological status and specific visual spatial abilities at time of admission may help determine which brain dysfunctional patients will obtain inpatient rehabilitation goals. Improvement in a variety of cognitive and affective functions was associated with goal attainment. Early cognitive rehabilitation should focus on both cognitive and affective disturbances to facilitate recovery and rehabilitation outcome.

Analysis of Variance↗

PubMed2001

The goals of medicine. Towards a unified theory.

The purpose of this article is to present a normative theory of the goals of medicine (a theory that tells us in what respects medicine should benefit the patient) that is both comprehensive and unified. A review of the relevant literature suggests that there are at least seven plausible goals that are irreducible to each other, namely to promote functioning, to maintain or restore normal structure and function, to promote quality of life, to save and prolong life, to help the patient to cope well with her condition, to improve the external conditions under which people live, and to promote the growth and development of children. However, it seems that all these goals need to be qualified in different ways, e.g. it does not seem reasonable to improve physiological function or functional ability unless this is expected to have positive effects on quality of life and/or length of life, or to improve the quality of life in any respect, or by any means. These qualifications all suggest that the proposed goals are, as goals, conceptually, and not just causally, related to one another, and that they should therefore not be regarded in isolation. Instead, we should think of the medical enterprise as having a multidimensional goal structure rather than a single goal. In order to depict clearly how the different goals are related to one another, a multidimensional model is constructed.

Activities of Daily Living↗

PubMed2003

Punishment goals of crime victims.

Research on subjective punishment goals has focused on the perspective of third-party observers of criminal offenses and neglected the perspective of victims. This study investigates punishment goals among 174 adult crime victims (rape and nonsexual assault) for each participant's real criminal case. Scales measuring support for punishment goals are constructed by factor analysis of an 18-item list. Results show that 5 highly supported goals can be distinguished: retaliation, recognition of victim status, confirmation of societal values, victim security, and societal security. Analysis of relations between punishment goal scales and personal variables, situational variables, and demanded punishment severity corroborates the view that the punishment goals revealed can be classified according to the two independent dichotomies of moral versus instrumental goals, and micro versus macro goals.

Adolescent↗

PubMed2002

Building a practically useful theory of goal setting and task motivation. A 35-year odyssey.

The authors summarize 35 years of empirical research on goal-setting theory. They describe the core findings of the theory, the mechanisms by which goals operate, moderators of goal effects, the relation of goals and satisfaction, and the role of goals as mediators of incentives. The external validity and practical significance of goal-setting theory are explained, and new directions in goal-setting research are discussed. The relationships of goal setting to other theories are described as are the theory's limitations.

Goals↗

PubMed1995

Social dating goals in late adolescence: implications for safer sexual activity.

This research examined 2 age-typical goals that adolescents may pursue in social dating (intimacy goals related to open communication and mutual dependence and identity goals related to self-reliance and self-exploration) and the implications of these different goal sets for responsiveness to educational and daily life situations. Education about safer sexual activity that emphasized interpersonal communication skills was more effective in increasing intentions regarding safer sex for adolescents with predominant intimacy goals in dating, whereas education that focused on technical skills was more effective for those with predominant identity goals. Adolescents were also less likely to engage in risky sexual behavior when they were in dating situations that encouraged goal-relevant activities for ensuring safer sex. Discussion focuses on the dynamics within the broader bidirectional fit between personal goals and situational affordances.

Adolescent↗

PubMed1992

Framing the construct of life satisfaction in terms of older adults' personal goals.

Older adults' life satisfaction can be better understood in light of their personal goals. This study of 179 elders examined (a) how goals correlate with satisfaction, (b) whether elders maintain satisfaction by accommodating goals to past losses, and (c) how correlations between satisfaction and key predictors differ among groups with different goals. Satisfaction was related positively to social maintenance and energetic life-style goals and negatively to concerns for improvement, disengagement, stability, and reduced activity. Past losses were correlated with current goals but not with satisfaction, consistent with the notion of accommodation. A cluster analysis identified 5 patterns of goals: high demand, age prescribed, self-focused, socially engaged, and low demand. Correlations between satisfaction and other predictors differed by cluster, suggesting that the determinants of elders' satisfaction depend on personal goals.

Achievement↗

PubMed2004

Growth goals, maturity, and well-being.

In 2 studies (125 college students and 51 adults), 2 forms of growth goals (exploratory and intrinsic) were compared with 2 forms of personality development (social-cognitive maturity and social-emotional well-being). Participants whose narratives of major life goals emphasized conceptual exploration were especially likely to have high levels of maturity (measured as ego development; J. Loevinger, 1976), whereas those whose goals emphasized intrinsic interests (K. M. Sheldon & T. Kasser, 1995) were especially likely to have high levels of well-being. Participants who had coherent hierarchies of growth goals on the levels of major life goals and everyday goals were especially likely to have high levels of personality development. Finally, growth goals accounted for some relationships between age and personality development. Growth goals are discussed in terms of intentional self-development and specific developmental paths.

Adolescent↗

PubMed2005

An interpersonal circumplex model of children's social goals: links with peer-reported behavior and sociometric status.

The objective of the present research was to develop an assessment model for children's social goals. The aims were (a) to fit children's social goals to a circumplex model and to examine links between goals and peer-reported social behaviors (aggression, withdrawal, and prosocial behavior) in a sample of 276 participants (134 girls, 11- to 12-year-olds) and (b) to replicate these findings and examine whether social behavior mediates the relationship between goals and sociometric status in an independent cross-validation sample of 310 participants (143 girls, 11- to 13-year-olds). Results showed a satisfactory fit to the circumplex model and adequate psychometric properties of the goal scales of the new measure, the Interpersonal Goals Inventory for Children. Other findings included significant and meaningful relations between goals and peer-reported behavior. Social behavior mediated the relations between goals and sociometric status.

Adolescent↗