SEARCH · PubMed Health

Results for “Goals”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources

PubMed1992

Factors related to successful goal attainment in case management.

Goal planning is fundamental to the case management process. Manager and client identify specific long-term goals and then systematically break them down into the incremental behaviors needed to be accomplished to achieve each goal. The goal-setting process may fail as a result of four types of factors: (1) behavioral, (2) cognitive, (3) affective, and (4) environmental. To decrease the likelihood of failure, case managers must be knowledgeable about goal planning. They must help the client set goals that are expressed positively, that are client focused, realistic and achievable, measurable, and easily understood, with one observable outcome per goal. For both case manager and client, setting and attaining goals must be viewed as part of a continuing learning process, rather than a success-failure dichotomy.

Goals↗

PubMed1993

There is more to emotion than goal attainment.

The current conflict theory of emotion states that emotions arise at junctures of plans in which circumstances show the likely attainment or nonattainment of a goal and in which those circumstances include other plans and other goals. But emotions often arise from side goals rather than from the goal being aimed at. This article raises the question of what a goal is and suggests that any goal statement should include goals about a person's identity, self-definition, and cognitive development. This approach questions the sharp distinction usually drawn between goal and cognitive structure and puts forward a broader view of emotion as the awareness of important cognitive change that results from the validation or invalidation of one's cognitive system or a part of it. This view emphasizes the role of having a model of the self and shows how emotions can be defined as beliefs about changes in belief. This approach suggests that, just as pain monitors changes in physical states, so emotions monitor changes in mental states, providing high-level information for the management of cognitions. Another function of emotion is to identify the type and magnitude of inconsistencies between two mental states in a timely manner; such identification avoids the need for logical proof or numerical calculation.

Awareness↗

PubMed1999

Achievement Goals and Student Well-Being.

This study is concerned with the role that achievement goals may play in facilitating the psychological well-being of students. Specifically, we build on "goal theory" analysis of adaptive behavior in examining the relationship between task and ego goals, perceptions of school emphases on task and ego goals, and indices of well-being and disruptive behavior. Generally, task goals and perception of the school as emphasizing task goals were related to positive psychological well-being, and ego goals and perceiving the school as emphasizing ego goals were related to negative psychological well-being. This pattern was found for both African American and Euro-American students. However, path analyses pointed to possible different processes as operating for the African Americans and the Euro-Americans in the sample. Copyright 1999 Academic Press.

Journal Article↗

PubMed1997

Opportunistic Planning: Being Reminded of Pending Goals

Pending goals are intentions that are postponed by a planner because they do not fit into the current, ongoing activity. Recognizing later opportunities to achieve pending goals is an important cognitive ability because it allows one to defer work on a goal until one is in a better position to achieve it. This research focuses on when and how pending goals are recognized in everyday planning situations and offers a predictive encoding model of goal representation. Experiment 1 provides evidence that pending goals are stored as long-term memory elements that become associated, at the time of encoding, with features of the environment representing opportunities to achieve the goals, consistent with the predictive encoding model. Experiment 2 shows that these predictive inferences tend to be concrete (e.g., "use Vaseline to remove a stuck ring"), rather than more abstract (e.g., "use any lubricant"), which is nonoptimal for recognizing novel opportunities. However, as shown in Experiment 3, instructions to encode a potential plan with only abstract constraints can lead to recognition of a wider range of opportunities. These findings provide evidence for the predictive encoding model and suggest ways to facilitate the later recognition of opportunities for satisfying pending goals. Copyright 1997Academic Press

Journal Article↗

PubMed2001

The Assessment of Goal Commitment: A Measurement Model Meta-Analysis.

Goals are central to current treatments of work motivation, and goal commitment is a critical construct in understanding the relationship between goals and performance. Inconsistency in the measurement of goal commitment hindered early research in this area but the nine-item, self-report scale developed by Hollenbeck, Williams, and Klein (1989b), and derivatives of that scale, have become the most commonly used measures of goal commitment. Despite this convergence, a few authors, based on small sample studies, have raised questions about the dimensionality of this measure. To address the conflicting recommendations in the literature regarding what items to use in assessing goal commitment, the current study combines the results of 17 independent samples and 2918 subjects to provide a more conclusive assessment by combining meta-analytic and multisample confirmatory factor analytic techniques. This effort reflects the first combined use of these techniques to test a measurement model and allowed for the creation of a database substantially larger than that of previously factor analyzed samples containing these scale items. By mitigating sampling error, the results clarified a number of debated issues that have arisen out of previous small sample factor analyses and revealed a five-item scale that is unidimensional and equivalent across measurement timing, goal origin, and task complexity. It is recommended that this five-item scale be used in future research assessing goal commitment. Copyright 2001 Academic Press.

Journal Article↗

PubMed2005

Role of angiotensin receptor blockers as monotherapy in reaching blood pressure goals.

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure emphasizes the urgent need to lower blood pressure (BP) to a goal of <140/90 mm Hg in patients with uncomplicated hypertension and to <130/80 mm Hg in high-risk patients, such as those with diabetes mellitus or chronic kidney disease, to prevent cardiovascular disease morbidity and mortality. Consequently, a meaningful measure of the efficacy of an antihypertensive therapy is its ability to achieve BP reduction to below the recommended BP goals. Angiotensin II receptor blockers (ARB) are highly effective antihypertensive agents with excellent tolerability profiles similar to those of placebo. A literature search using MEDLINE, EMBASE, and BIOSIS to identify studies reporting data on the percentage of patients attaining BP goals found that monotherapy with an ARB can generally result in the attainment of the diastolic BP (DBP) goal of <90 mm Hg in approximately 50% of hypertensive patients. However, to our knowledge, the attainment of the systolic BP (SBP) and combined SBP/DBP goals with ARB monotherapy has not been reported. Therefore, a secondary analysis of BP efficacy data from a published study that directly compared recommended starting doses of four currently marketed ARB was performed to assess combined SBP and DBP goal attainment. This analysis showed that the percentage of patients achieving the combined SBP/DBP goal rate of <140/90 mm Hg was highest with olmesartan medoxomil (32.4%) compared with recommended starting doses of losartan potassium (16.1%), valsartan (14.5%), or irbesartan (25.9%). Optimal ARB monotherapy can achieve recommended BP goals in a significant proportion of hypertensive patients. However, the majority of hypertensive patients will require combination therapy with two or more antihypertensive agents.

Angiotensin II Type 1 Receptor Blockers↗

PubMed2006

When Goals Conflict But People Prosper: The Case of Dispositional Optimism.

Optimistic persistence in pursuing goals may have beneficial consequences such as protection against negative affect and greater likelihood of goal attainment, but persistence can also result in greater likelihood of goal conflict, which can have negative consequences. Two studies, one cross-sectional (N = 100) and one longitudinal (N = 77), found that optimism associated with higher goal conflict. However, objectively rated goal conflict did not significantly undermine adjustment, and when balance among goal value, expectancy, and conflict was considered, optimism associated with better balance. In turn, balance accounted for part of optimists' better goal progress over the course of a semester. Although goal conflict may have costs, these costs appear to be offset by accompanying benefits, particularly for optimists.

Journal Article↗

PubMed2003

Guidelines for lowering lipids to reduce coronary artery disease risk: a comparison of rosuvastatin with atorvastatin, pravastatin, and simvastatin for achieving lipid-lowering goals.

Both the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III and the Second Joint Task Force of European Societies guidelines have established low-density lipoprotein (LDL) cholesterol goals for lipid-lowering treatment to reduce the risk of coronary artery disease. Data from 3 trials that compared rosuvastatin 10 mg (n = 389) with atorvastatin 10 mg (n = 393) and 2 trials that compared rosuvastatin 10 mg (n = 226) with pravastatin 20 mg (n = 252) and simvastatin 20 mg (n = 249) were pooled separately to compare the achievement of LDL cholesterol goals over 12 weeks of treatment in hypercholesterolemic patients. Noncomparative pooling of rosuvastatin 10 mg results from all 5 trials (n = 615) showed that 80% achieved NCEP ATP III goals and 81% achieved the European goal of <3.0 mmol/L. Compared with atorvastatin 10 mg, significantly more patients treated with rosuvastatin 10 mg achieved their ATP III (76% vs 53%) and European (82% vs 51%) goals (p <0.001). Also, in comparisons with simvastatin 20 mg and pravastatin 20 mg, 86% of patients treated with rosuvastatin 10 mg achieved ATP III goals, compared with 64% of simvastatin-treated patients and 49% of pravastatin-treated patients (p <0.001). The proportions of patients who achieved the European goal were 80%, 48%, and 16% for rosuvastatin 10 mg, simvastatin 20 mg, and pravastatin 20 mg, respectively, in this comparison (all p <0.001). A total of 71% of patients treated with rosuvastatin 10 mg who had triglyceride levels > or =200 mg/dL met both their LDL cholesterol and their non-high-density lipoprotein cholesterol goals.

Adult↗

PubMed2001

Goals of genetic counseling.

The goals of genetic counseling have differed over the past three decades. Two schools of thought are prominent in reviewing past literature. One upholds the goal of preventing birth defects and genetic disorders while the other promotes a goal of improved psychological well-being in client adaptation to a genetic condition or risk. Both types of goals emphasize that clients should make their own reproductive decisions; however, the former relies on clients making decisions that will reduce the impact of genetic disorders. The differences in the types of goals may be due to the training and orientation of genetics health care providers, socio-cultural views, or priorities of health care settings. Regardless, there are ample reasons to dismiss the prevention of birth defects as a goal. This mini-review recommends use of genetic counseling sub-specialties as a framework for considering different client needs and thus different counseling goals and specific aims in the reproductive, pediatric/adult, and common disease settings. Given the extent of new genetic information, technologies, and the need to evaluate genetic counseling practice, genetics health care providers should work toward arriving at consensus on the goals of genetic counseling, and in doing so, the needs of clients should be considered.

Congenital Abnormalities↗

PubMed1998

Narrative comprehension and aging: the fate of completed goal information.

Previous research has shown that older adults are able to use situation models in a manner similar to younger adults. However, other areas of cognition have shown that older adults are less able to remove irrelevant information from the current stream of processing. Accordingly, the authors tested whether older and younger adults would differ in reducing the availability of information about a completed goal in a situation model during narrative comprehension. In 2 experiments, memory probes tested for the availability of protagonist goal information during reading when it was either failed goal, completed goal, or neutral information. The results for both age groups showed that goal information was most available in the failed goal condition, less available in the completed goal condition, and least available in the neutral condition. No reliable differences between younger and older adults in the pattern of response times were observed. Reading time data were also examined to explore the possibility that older adults engage in a longer wrap-up period after a goal is completed, but no such difference was found.

Adolescent↗

PubMed2005

Association between achieving treatment goals for lipid-lowering and cardiovascular events in real clinical practice.

BACKGROUND: There is substantial evidence that treatment with lipid-lowering agents can decrease cardiovascular morbidity and total mortality in patients with elevated serum lipid values and/or prior ischaemic heart disease. However, only a minority of these high-risk patients are believed to receive treatment, and among those who do receive pharmaceutical treatment the majority do not reach the therapeutic goal. Our goal was to investigate if this translates to a higher risk of cardiovascular events in real clinical practice. DESIGN: A retrospective cohort study using linkage of electronic medical records, the Swedish national inpatient registry and cause of death registry was performed, enrolling a total of 4976 patients who received treatment with a lipid-lowering agent at any time between 1 January 1993 and 1 December 2001. METHODS: Cox proportional hazards regression was used to evaluate the impact of goal attainment along with potential confounding factors. RESULTS: Patients who reached treatment goals were 24% less likely to suffer a cardiovascular event (relative risk: 0.76, 95% confidence interval: 0.60-0.96) than patients who did not reach treatment goals. A substantial proportion of patients treated with lipid-lowering agents do not achieve the treatment goals. CONCLUSIONS: Failure to reach treatment goals translates into a higher risk of cardiovascular events, and it is thus of importance to ensure that patients reach goals.

Cardiovascular Diseases↗

PubMed2006

A modified goal-directed protocol improves clinical outcomes in intensive care unit patients with septic shock: a randomized controlled trial.

We evaluated whether a goal-directed protocol, without measurement of central venous oxygen saturation, would improve survival in medical intensive care unit (ICU) patients with septic shock. This is a prospective, controlled study in a 24-bed medical ICU at a tertiary care hospital. From a total of 241 consecutive patients with septic shock, 224 were randomly assigned to receive therapy with or without a written protocol using central venous pressure, mean arterial pressure, and urine output as therapeutic goals. Baseline characteristics were similar between groups. Implementation of goal-directed therapy caused a more rapid reversal of persistent shock (47 +/- 22.8 vs. 65.4 +/- 32.1 h, P = 0.006) and decreases of ICU (50% vs. 67.2%, P = 0.009) and in-hospital (53.7% vs. 71.6%, P = 0.006) mortality rates compared with non-goal-directed therapy. Patients receiving goal-directed therapy also had less risk for developing central nervous system or renal failure than patients without. Patients with goal-directed therapy received more fluid during the period of persistent shock (136.2 +/- 119 vs. 88.6 +/- 57.7 mL h, P = 0.034) and less delay in vasopressor administration (78 +/- 22.2 vs. 104.4 +/- 29 min, P = 0.001) than patients with non-goal therapy. Implementation of a goal-directed protocol improves survival and clinical outcomes in ICU patients with septic shock. These benefits may arise from adequate fluid resuscitation, earlier vasopressor administration, rapid shock reversal, and protection of major organ function. With central venous oxygen saturation measurement to detect tissue perfusion, the clinical outcomes may be further improved.

Aged↗

PubMed1999

Prevalence and socio-demographic predictors of dietary goal attainment in an older population.

OBJECTIVE: To describe the measured dietary intakes and anthropometry of a large, free-living population of middle-aged and older Australians who participated in the Australian Blue Mountains Eye Study (BMES), and to identify the socio-demographic characteristics associated with attainment or non-attainment of dietary goals. METHOD: Anthropometry and dietary intakes were compared with current population dietary goals and Recommended Dietary Intakes for 2,873 people (79% of eligible residents) aged > or = 49 years who participated in the BMES. Nutrient intakes were measured by a validated food frequency questionnaire. RESULTS: Nutrients for which mean intakes deviated most from nutrition goals included: percentages of energy from total and saturated fat, carbohydrate and alcohol (men), as well as absolute intakes of calcium, zinc and fibre. More than half the men (60%) and women (54%) were overweight or obese. Several micro-nutrient goals were more likely to be met in households where the respondents and/or their spouses were independent. Married men were more likely to meet goals for fibre and iron, but less likely to meet the goal for cholesterol. Several goals were more likely to be met by men and women who had qualifications after leaving school, those with higher job status and non-pensioners, suggesting an socio-economic status dimension. CONCLUSIONS AND IMPLICATIONS: These results indicate that over- rather than under-nutrition is more prevalent among community-dwelling older people, although under-nutrition should not be overlooked. Particular sub-groups that are less likely to meet some dietary goals may require targeting in community nutrition interventions.

Age Distribution↗

PubMed2005

Implications of changing national cholesterol education program goals for the treatment and control of hypercholesterolemia.

BACKGROUND: Modifications to the National Cholesterol Education Program (NCEP) guidelines lowered optional low-density lipoprotein cholesterol (LDL-C) treatment goals. OBJECTIVE: We evaluated the implications of widely adopting these optional goals in clinical practice. DESIGN AND PARTICIPANTS: We performed a cross-sectional study using 1999 to 2002 data from 3,281 U.S. adults aged 20 to 79 years participating the National Health and Nutrition Examination Survey. MEASUREMENTS: The primary outcomes were the proportions of adults whose fasting LDL-C levels exceeded NCEP recommended and optional targets from 2001 and 2004. We used survey weights to estimate the size of the U.S. population exceeding targets. We examined outcomes for 4 coronary disease risk subgroups described by the NCEP. RESULTS: Low-density lipoprotein cholesterol values exceeded 2001 NCEP goals for 30.0% of adults, and 35.8% had levels above optional 2004 goals. An estimated 24,900,000 individuals (14.2%) exceeded 2001 thresholds for drug therapy, 46,200,000 (26.3%) exceeded optional 2001 thresholds for drug therapy, and 56,500,000 (32.2%) were above the optional 2004 thresholds for drug therapy. For lower, moderate, moderately high, and high-risk groups, 13.4%, 44.2%, 58.8%, and 71.8%, respectively, exceeded 2001 NCEP goals; 13.4%, 15.7%, 87.4%, and 96.0% of these groups exceeded optional 2004 thresholds for drug therapy. CONCLUSIONS: In 1999 to 2002, LDL-C levels commonly exceeded 2001 NCEP goals, especially for moderately high and high-risk individuals, and cholesterol-lowering medications were underused. Optional goals promulgated by the NCEP in 2001 and 2004 moderately increased the number of adults with LDL-C above their goal, and greatly increased the number of low, moderately high, and high-risk adults who exceeded LDL-C thresholds, for cholesterol-lowering medication.

Adult↗

PubMed2006

Sexual Assault Nurse Examiner (SANE) program goals and patient care practices.

PURPOSE: To examine Sexual Assault Nurse Examiners (SANE) programs' goals and guiding philosophies and how they influence patient care practices for sexual assault victims. DESIGN: Data were collected from a national random sample of SANE to examine whether programs differed significantly in their goals and patient care practices. METHODS: Iterative cluster analysis was used to identify types of programs distinct in their stated goals. FINDINGS: Three types of emphasis in SANE programs were identified: (a) prosecution of cases as a primary goal; (b) attending to patients' emotional needs, supporting feminist values, empowering patients, and changing the community response to rape; and (c) least importance on prosecution of cases and average importance on the other goals. Programs that were more focused on prosecution goals provided less comprehensive patient services. CONCLUSIONS: Programs focused on prosecution as a primary goal were less likely to provide comprehensive services, especially those involving patient education. Such information is important for patients because their health concerns (e.g., pregnancy, STIs) have long-term implications for their well-being. Historical and structural differences among SANE programs might explain these different patient care practices. Researchers should examine the underlying processes in SANE programs that shape both their goals and patient care approaches.

Adult↗

PubMed2004

Rehabilitation outcomes after brain injury: disability measures or goal achievement?

BACKGROUND: The outcome of rehabilitation interventions following brain injury is commonly rated by disability scales. Goal-setting and achievement are important in inpatient rehabilitation, but seldom assessed as outcomes. OBJECTIVE: To compare the information acquired from using disability ratings and goal attainment/variances as outcome measures in brain injury rehabilitation. SETTING: An inpatient regional neurological rehabilitation unit. SUBJECTS: One hundred and seventy-seven patients admitted after single incident brain injury over a three-year period. MAIN MEASURES: (1) Disability outcomes by the Barthel Index and the Functional Independence Measure, (2) goal achievement and variance distribution, and (3) the influence of diagnosis and demographics on these measures. RESULTS: Patients improved significantly on all disability scales employed (p < 0.0001), with the baseline admission scores being inversely correlated with changes in dependency by discharge (rho approximately -0.4). The median attainment rate of long-term goals was 75% per patient. Nonachievement was most frequently due to cognitive problems (38%), followed by behavioural difficulties and physical limitations (18% each). Goal achievement correlated poorly with disability outcome at discharge (rho < 0.3). Patients who accomplished all their goals tended to be less disabled at admission. Diagnostic groups and demographic factors had little influence on either disability or goal achievement outcomes. CONCLUSIONS: The use of a simple goal achievement and variance coding scheme has been relatively straightforward to incorporate into the daily practice of the unit. It provides useful information on rehabilitation process and outcome after brain injury that is complementary to the utilization of disability measures.

Achievement↗

PubMed2005

Use of an overhead goal alters vertical jump performance and biomechanics.

This study examined whether an extrinsic motivator, such as an overhead goal, during a plyometric jump may alter movement biomechanics. Our purpose was to examine the effects of an overhead goal on vertical jump height and lower-extremity biomechanics during a drop vertical jump and to compare the effects on female (N = 18) versus male (N = 17) athletes. Drop vertical jump was performed both with and without the use of an overhead goal. Greater vertical jump height (p = 0.002) and maximum takeoff external knee flexion (quadriceps) moment (p = 0.04) were attained with the overhead goal condition versus no overhead goal. Men had significantly greater vertical jump height (p < 0.001), maximum takeoff vertical force (p = 0.009), and maximum takeoff hip extensor moment (p = 0.02) compared with women. A significant gender x overhead goal interaction was found for stance time (p = 0.02) and maximum ankle (p = 0.04) and knee flexion angles (p = 0.04), with shorter stance times and lower angles in men during overhead goal time. These results indicate that overhead goals may be incorporated during training and testing protocols to alter lower-extremity biomechanics and can increase performance.

Adult↗

PubMed1998

The cost of reaching National Cholesterol Education Program (NCEP) goals in hypercholesterolaemic patients. A comparison of atorvastatin, simvastatin, lovastatin and fluvastatin.

OBJECTIVE: Recognising the importance of treating hyperlipidaemia, the National Cholesterol Education Program (NCEP) has established widely accepted treatment goals for low density lipoprotein cholesterol (LDL-C). Medications used most commonly to achieve these LDL-C goals are HMG-CoA reductase inhibitors. The relative resource utilisation and cost associated with the use of reductase inhibitors of different LDL-C lowering efficacy are unknown, but are major health and economic concerns. The objective of this study was to determine the mean total cost of care to reach NCEP goals with various reductase inhibitors. DESIGN: In a randomised, 54-week, 30-centre controlled trial we compared resources used and costs associated with treating patients to achieve NCEP goals using 4 reductase inhibitors: atorvastatin, simvastatin, lovastatin and fluvastatin. PATIENTS AND PARTICIPANTS: The trial studied 662 patients; 318 had known atherosclerotic disease. INTERVENTIONS: Reductase inhibitor therapy was initiated at recommended starting doses and increased according to NCEP guidelines and package insert information. For patients who did not reach the goal at the highest recommended dose of each reductase inhibitor, the resin colestipol was added. MAIN OUTCOME MEASURES AND RESULTS: Patients treated with atorvastatin, compared-with other reductase inhibitors, were more likely to reach NCEP goals during treatment (p < 0.05), required fewer office visits (p < 0.001) and less adjuvant colestipol therapy (p = 0.001). Consequently, the mean total cost of care (1996 values) to reach NCEP goals was lower with atorvastatin [$US1064; 95% confidence interval (CI): $US953 to $US1176] compared with simvastatin ($US1471, 95% CI: $US1304 to $US1648), lovastatin ($US1972; 95% CI: $US1758 to $US2186) and fluvastatin ($US1542; 95% CI: $US1384 to $US1710). Results were similar for patients with or without known atherosclerotic disease. CONCLUSIONS: In patients requiring drug therapy for hypercholesterolaemia, NCEP LDL-C goals are achieved significantly more often using fewer resources with atorvastatin compared with simvastatin, lovastatin or fluvastatin.

Aged↗