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 127 records · Page 7Linked to original sources

PubMed1999

Goal-setting in clinical medicine.

The process of setting goals for medical care in the context of chronic disease has received little attention in the medical literature, despite the importance of goal-setting in the achievement of desired outcomes. Using qualitative research methods, this paper develops a theory of goal-setting in the care of patients with dementia. The theory posits several propositions. First, goals are generated from embedded values but are distinct from values. Goals vary based on specific circumstances and alternatives whereas values are person-specific and relatively stable in the face of changing circumstances. Second, goals are hierarchical in nature, with complex mappings between general and specific goals. Third, there are a number of factors that modify the goal-setting process, by affecting the generation of goals from values or the translation of general goals to specific goals. Modifying factors related to individuals include their degree of risk-taking, perceived self-efficacy, and acceptance of the disease. Disease factors that modify the goal-setting process include the urgency and irreversibility of the medical condition. Pertinent characteristics of the patient-family-clinician interaction include the level of participation, control, and trust among patients, family members, and clinicians. The research suggests that the goal-setting process in clinical medicine is complex, and the potential for disagreements regarding goals substantial. The nature of the goal-setting process suggests that explicit discussion of goals for care may be necessary to promote effective patient-family-clinician communication and adequate care planning.

Aged↗

PubMed2006

Abstinence and moderate use goals in the treatment of marijuana dependence.

AIMS: The purpose of this study was to examine the influence of personal goals (abstinence or moderation) on treatment outcomes for marijuana use. Hypotheses regarding self-efficacy for goal attainment were tested. DESIGN: Adult marijuana users seeking treatment were assigned randomly to three treatment conditions: (1) cognitive-behavioral relapse prevention support group; (2) individualized brief motivational enhancement; and (3) delayed treatment control group. Follow-up assessments were conducted at 4, 7, 13 and 16 months. SETTING: University research offices. PARTICIPANTS: Participants were 291 adult marijuana users. Measurements Marijuana use, personal treatment goals and self-efficacy for achieving one's goal were assessed across the 16-month follow-up. FINDINGS: Greater marijuana related problems and dependence symptoms were associated with an initial goal of abstinence. Participants were more likely to achieve outcomes consistent with their personal goals. Participants with abstinence goals reported greater self-efficacy for goal achievement than those with moderation goals after participating in the abstinence oriented treatment; self-efficacy for goal success predicted goal achievement for both moderate use and abstinence goals. CONCLUSIONS: Marijuana users approaching an abstinence-oriented treatment varied in the extent to which they were actively seeking abstinence as the outcome. Differences in goals were predictable from severity of problems related to use. Goal preference and self-efficacy for achieving goals predicted outcomes. Future research should incorporate personal goals into treatment and assess their effects on outcomes.

Adult↗

PubMedDate not supplied

Goal setting as a strategy for dietary and physical activity behavior change: a review of the literature.

OBJECTIVE: Estimate effectiveness of goal setting for nutrition and physical activity behavior change, review the effect of goal-setting characteristics on behavior change, and investigate effectiveness of interventions containing goal setting. DATA SOURCE: For this review, a literature search was conducted for the period January 1977 through December 2003 that included a Current Contents, Biosis Previews, Medline, PubMed, PsycINFO, and ERIC search of databases and a reference list search. Key words were goal, goal setting, nutrition, diet, dietary, physical activity, exercise, behavior change, interventions, and fitness. STUDY INCLUSION AND EXCLUSION CRITERIA: The search identified 144 studies, of which 28 met inclusion criteria for being published in a peer reviewed journal and using goal setting in an intervention to modify dietary or physical activity behaviors. Excluded from this review were those studies that (1) evaluated goal setting cross-sectionally without an intervention; (2) used goal setting for behavioral disorders, to improve academic achievement, or in sports performance; (3) were reviews. DATA EXTRACTION AND SYNTHESIS: The articles were categorized by target audience and secondarily by research focus. Data extracted included outcome measure, research rating, purpose, sample, sample description, assignment, findings, and goal-setting support. RESULTS: Thirteen of the 23 adult studies used a goal-setting effectiveness study design and eight produced positive results supporting goal setting. No adolescent or child studies used this design. The results were inconclusive for the studies investigating goal-setting characteristics (n = 7). Four adult and four child intervention evaluation studies showed positive outcomes. No studies reported power calculations, and only 32% of the studies were rated as fully supporting goal setting. CONCLUSIONS: Goal setting has shown some promise in promoting dietary and physical activity behavior change among adults, but methodological issues still need to be resolved. The literature with adolescents and children is limited, and the authors are not aware of any published studies with this audience investigating the independent effect of goal setting on dietary or physical activity behavior. Although, goal setting is widely used with children and adolescents in nutrition interventions, its effectiveness has yet to be reported.

Diet↗

PubMed1985

Goal attainment scaling with hospitalized sexual offenders.

Forty-six hospitalized sex offenders participated in a 6-month evaluation of treatment outcome. This study used the concept of goal attainment scaling, an individualized, scaled description of personal goals, for measuring therapeutic outcome. Conjoint therapist and patient goal setting resulted in 180 treatment goals being set. At follow-up, 38 patients exceeded the "expected" success level on a total of 159 treatment goals, whereas eight patients only made minimal progress on 21 of their 40 selected goals. Despite the benign clinical improvement shown by most patients, few patients actually achieved the best anticipated level of attainment on all of their personal goals (usually three to six goals). Retrospective review of all goal attainment scaling protocols indicated that four major content dimensions account for nearly all of the goals devised: sexual deviation, 30 goals; anger and emotional expression, 64 goals; self concept, 31 goals; and poor interpersonal relations, 51 goals. These goal-oriented profiles may have important ramifications for the future assessment, program planning, and rehabilitation of convicted sex offenders.

Adolescent↗

PubMed2007

A first-line nurse manager's goal-profile.

AIM: The aim of this case study was to acquire understanding concerning the first-line nurse manager's goal-profile, i.e. prioritization of goals in her work as a first-line nurse manager, through use of an action-theoretic and confirmatory theory. BACKGROUND: The first-line nurse manager's pivotal role regarding quality of care and development in relation to on-going changes in the health care sector is stressed by many researchers and the transition from nurse to manager is described as a demanding challenge for the first-line nurse manager. METHODS: The case study described in this paper concerns a first-line nurse manager in an actual working environment in care of older people. Data collection comprised interviews, observations, a job description and policy documents. A hermeneutic interpretation was used for data analysis. RESULTS: The results showed that the first-line nurse manager had three goals in her goal-profile, in the following order of priority: (i) a nurse goal that she had strongly accepted and in which she had excellent control, (ii) an administrator goal that she had accepted and in which she had control, (iii) a leadership goal that she had not accepted and in which she did not have control. Both the administrator and leadership goals were based on her job description, but the nurse goal was a personally chosen goal based on her own self-relation/goal-fulfillment. CONCLUSION: The first-line nurse manager's prioritized self-identity, based on successful realization of goals in her goal-profile, was decisive in the manifestation of her work. RELEVANCE TO CLINICAL PRACTICE: This study contributes to a new understanding of the first-line nurse manager's self-identity related to work in terms of goal acceptance and goal control of prioritized goals. This action-theoretic approach could be a valuable 'key' for understanding leadership (or lack of leadership) in clinical practice.

Female↗

PubMed2003

Multiple goals, motivation and academic learning.

BACKGROUND: The type of academic goals pursued by students is one of the most important variables in motivational research in educational contexts. Although motivational theory and research have emphasised the somewhat exclusive nature of two types of goal orientation (learning goals versus performance goals), some studies (Meece, 1994; Seifert, 1995, 1996) have shown that the two kinds of goals are relatively complementary and that it is possible for students to have multiple goals simultaneously, which guarantees some flexibility to adapt more efficaciously to various contexts and learning situations. AIM: The principal aim of this study is to determine the academic goals pursued by university students and to analyse the differences in several very significant variables related to motivation and academic learning. SAMPLE: Participants were 609 university students (74% women and 26% men) who filled in several questionnaires about the variables under study. METHOD: We used cluster analysis ('quick cluster analysis' method) to establish the different groups or clusters of individuals as a function of the three types of goals (learning goals, performance goals, and social reinforcement goals). By means of MANOVA, we determined whether the groups or clusters identified were significantly different in the variables that are relevant to motivation and academic learning. Lastly, we performed ANOVA on the variables that revealed significant effects in the previous analysis. RESULTS: Using cluster analysis, three groups of students with different motivational orientations were identified: a group with predominance of performance goals (Group PG: n = 230), a group with predominance of multiple goals (Group MG: n = 238), and a group with predominance of learning goals (Group LG: n = 141). CONCLUSIONS: Groups MG and LG attributed their success more to ability, they had higher perceived ability, they took task characteristics into account when planning which strategies to use in the learning process, they showed higher persistence, and used more deep learning strategies than did the students with predominance of performance goals (Group PG). On the other hand, Groups MG and PG took the evaluation criteria more into account when deciding which strategies to use in order to learn, and they attributed their failures more to luck than did Group LG. Students from Group MG attributed their success more to effort than did the other two groups and they attained higher achievement than Group PG. Group LG tended to attribute their failures more to lack of effort than did the other two groups.

Achievement↗

PubMed2003

Weight goals in a college-age population.

OBJECTIVE: Although a growing body of literature has found unrealistic weight loss goals to be common among older, primarily female, subjects, little is known about weight loss goals of younger adults. RESEARCH METHODS AND PROCEDURES: Three hundred seventy-nine college students had their height and weight taken and reported their "goal," "dream," "happy," "acceptable," and "disappointed" weights. A series of 2 (gender) x 2 (nonoverweight vs. overweight) ANOVAs were conducted with both absolute weight goals and percentage of weight loss needed to obtain those goals as dependent variables. RESULTS: When examined in terms of absolute weight goals, women generally had lower body mass index (BMI) goals than men, and nonoverweight participants had lower BMI goals than overweight participants. Surprisingly, most overweight participants would accept a weight loss that would still place them in the overweight BMI range. When examined in terms of percentage loss needed to reach those goals, only overweight women chose goal and dream weights that would require a loss greater than can be expected from nonsurgical weight-loss treatments, and all overweight participants chose happy and acceptable weights within 15% of current weight. DISCUSSION: Participants in this study had generally reasonable weight-loss goals, and even the most extreme weight loss goals were much more moderate than those found in previous studies. These results are surprising given the extreme social pressures for thinness facing young adults. Future studies should examine the variables that influence selection of goal weights and how goal weights affect actual dieting behavior.

Adolescent↗

PubMed2005

An organizational perspective on goal setting in community-based brain injury rehabilitation.

PURPOSE: To use a taxonomy of goal content, developed in community-based brain injury rehabilitation to examine and compare the content of goals set within two different service settings; and to further examine the potential of the taxonomy to be a reliable and comprehensive framework for classifying goals. METHOD: Qualitative analysis and categorization of 1492 goal statements extracted from a community-based brain injury rehabilitation service over two time periods (1996--97, 1998--99), and cross-organizational comparison of ratings of goal classifications using a random sample of 100 goal statements drawn from this data set and the original 1765 goal statements used in developing the taxonomy. RESULTS: Application of the taxonomy beyond the original service setting in which it was developed indicated a strong inter-rater reliability, with a high test-retest agreement reported over time. For both services, a small number of categories accounted for a substantial proportion of goals set within the two time periods, while considerable change was evident in goals between the two periods for one service. Further, both placed emphasis on individually focused goals rather than relationship or family-related goals. CONCLUSION: The taxonomy provides a reliable means for classifying goals and is a useful tool for exploration of the multiple influences on goal setting. Further application of the taxonomy to examine the relative influence on goal setting of client factors versus a range of organizational factors would be beneficial.

Activities of Daily Living↗

PubMed2006

Concordance in goal setting between patients with multiple sclerosis and their rehabilitation team.

OBJECTIVE: To determine the concordance between patients with multiple sclerosis and their clinical team members on the identification of goals for an inpatient rehabilitation stay. DESIGN: Prospective cohort study of patients admitted for rehabilitation in an adult inpatient neurospinal unit at a Rehabilitation Centre in Ottawa, Canada. Twenty-seven patients (11 men and 16 women, mean age of 45.3 yrs) with either a laboratory or a clinically supported diagnosis of multiple sclerosis. Patients rated 55 goals from a preexisting list, indicating the importance of each goal to be addressed during the inpatient stay. The goals fell into five broad domains of health/medical issues, daily activities, mobility, community life, and personal well-being. Patients also identified their five most important individual goals. In a separate session, the clinical team also rated the 55 goals in relation to each patient and identified an independent list of the five most important rehabilitation goals. Main outcome measures included concordance between patient and team ratings in the identification of goals, ratings of the likelihood of success of achieving each goal, and ratings of the amount of change required to realize a minimal clinically important difference. RESULTS: The patients and the team agreed on an average of 1.7 of the patient's five top-rated goals. Compared with the team, patients gave higher importance ratings to goals within the health/medical, mobility, and daily activities domains. They also considered that a greater average improvement would be required to achieve a meaningful benefit, and they gave higher ratings of the likelihood of success in achieving their selected goals. CONCLUSION: Patients with multiple sclerosis and clinical team members do not necessarily agree on specific goals for a rehabilitation stay. Patients may also have greater expectations than clinicians with respect to the amount of improvement and the likelihood of achieving their goals.

Activities of Daily Living↗

PubMed2005

Optimizing rehabilitation for adults with visual impairment: attention to life goals and their links to well-being.

OBJECTIVE: To examine the importance of different life goals among working-age adults with vision impairment, the extent to which vision impairment interfered with goals, and how rehabilitation addressed these life goals. DESIGN: Cross-sectional descriptive study. SETTING: Vision rehabilitation agency. SUBJECTS: Working-age adults with visual impairment. METHOD: Telephone interviews using structured and open-ended assessments of life goal importance, goal interference due to vision loss, the role of goals in rehabilitation, and indicators of well-being. RESULTS: Eighty-six people participated. The life domains most frequently rated as extremely important were finances (60), residential and domestic arrangements (55), family (51), partner (48), and personal care (48). The extent to which vision loss interferes with these life goals was extreme for finances (46), residential and domestic arrangements (36), partner (27), family (25), and personal care (14). A life goal was addressed in rehabilitation: residential/domestic arrangements (41), work (39), finances (31), leisure/hobbies (28), personal care (24), family (17), partner (16), friends (10), and religion/life philosophy (8). Reports of a life goal being addressed in ineffective ways emerged for functional life goals, but not for relationship and religion/life philosophy goals. Goal interference was significantly correlated with well-being indicators across life domains. In contrast only partner and family relationship importance were significantly linked with well-being indicators. CONCLUSIONS: Relationship-related goals were a top priority for this study population, but functional compared to relationship goals were more commonly addressed in vision rehabilitation services.

Activities of Daily Living↗

PubMed2006

Representation of future and previous spatial goals by separate neural populations in prefrontal cortex.

The primate prefrontal cortex plays a central role in choosing goals, along with a wide variety of additional functions, including short-term memory. In the present study, we examined neuronal activity in the prefrontal cortex as monkeys used abstract response strategies to select one of three spatial goals, a selection that depended on their memory of the most recent previous goal. During each trial, the monkeys selected a future goal on the basis of events from the previous trial, including both the symbolic visual cue that had appeared on that trial and the previous goal that the monkeys had selected. When a symbolic visual cue repeated from the previous trial, the monkeys stayed with their previous goal as the next (future) goal; when the cue changed, the monkeys shifted from their previous goal to one of the two remaining locations as their future goal. We found that prefrontal neurons had activity that reflected either previous goals or future goals, but only rarely did individual cells reflect both. This finding suggests that essentially separate neural networks encode these two aspects of spatial information processing. A failure to distinguish previous and future goals could lead to two kinds of maladaptive behavior. First, wrongly representing an accomplished goal as still pending could cause perseveration or compulsive checking, two disorders commonly attributed to dysfunction of the prefrontal cortex. Second, mistaking a pending goal as already accomplished could cause the failures of omission that occur commonly in dementia.

Animals↗

PubMed2006

Exploring the relation of independent and interdependent self-construals to why and how people pursue personal goals.

The authors examined whether independent or interdependent self-construals were associated with the way in which individuals pursued personal goals. Individuals with an independent self-construal orient toward personal-goal pursuit, whereas individuals with interdependent self-construal prioritize in-group goals above personal ones. The authors used a 1-week, prospective goal-setting paradigm. The present results revealed that interdependent self-construals were significantly associated with introjected reasons for pursuing goals, experiencing conflict among goals, and achieving less goal progress. Independent self-construals were significantly associated with intrinsic and identified reasons for goal pursuit and greater goal progress. There was some evidence that the relation of interdependent and independent self-construals to goal progress was mediated by goal conflict and goal intrinsic motivation, respectively. The present results also replicated previous research indicating the goal-setting benefits of intrinsic motivation, implementation intentions, and goal harmony.

Achievement↗

PubMed2005

The effect of botulinum toxin type A treatment of the lower extremity on the level of functional abilities in children with cerebral palsy: evaluation with goal attainment scaling.

OBJECTIVE: To measure the effect of botulinum toxin type A (BTX-A) treatment in children with cerebral palsy with regard to individual goals concerning functional abilities, using goal attainment scaling. DESIGN: A single-blind randomized multiple baseline/treatment phase design across subjects. SETTING: The paediatric department of a rehabilitation centre. SUBJECTS: Eleven children with cerebral palsy participated. INTERVENTION: BTX-A treatment of the lower extremity. MAIN MEASURES: A six-point goal attainment scaling of three individual treatment goals at the level of functional abilities. Standardized video-tapes of each goal were recorded weekly for a period of 14 weeks. Rating on the predetermined goal attainment scaling was blinded. RESULTS: Nine of the 11 subjects showed significant improvement in 18 out of 33 goals. Seven subjects showed clinically relevant improvement (at least 2 points on the goal attainment scaling) in 11 goals. Testing the difference between all medians of baseline measurements (after correction for improvement during baseline) and the medians of the treatment phase measurements for all goal attainment scaling scores (n = 33) resulted in significant improvement (p < 0.001). Tested at subject level (medians of the three goal attainment scaling scores per assessment, n = 11), a significant improvement was also found (p = 0.005). The change in goal attainment scaling score was related to the moment of treatment with BTX-A. CONCLUSION: Clinically relevant improvement in individual rehabilitation goals at ability level, achieved with the treatment of BTX-A in children with cerebral palsy, were demonstrated using the goal attainment scaling method.

Activities of Daily Living↗

PubMed2006

Goal setting as a shared decision making strategy among clinicians and their older patients.

OBJECTIVE: Older adults are less likely than other age groups to participate in clinical decision-making. To enhance participation, we sought to understand how older adults consider and discuss their life and health goals during the clinical encounter. METHODS: We conducted six focus groups: four with community-dwelling older persons (n=42), one with geriatricians and internists (n=6), and one with rehabilitation nurses (n=5). Participants were asked to discuss: patients' life and health goals; communication about goals, and perception of agreement about health goals. Group interactions were tape-recorded, transcribed, and analyzed using content analysis. RESULTS: All participants were willing to discuss goals, but varied in the degree to which they did so. Reasons for non-discussion included that goal setting was not a priority given limited time, visits focused on symptoms, mutual perception of disinterest, and the presumption that all patients' goals were the same. CONCLUSION: Interventions to enhance goal setting need to address key barriers to promoting goals discussions. Participants recognized the benefits of goal setting, however, training and instruments are needed to integrate goal setting into medicine. PRACTICE IMPLICATIONS: Setting goals initially and reviewing them periodically may be a comprehensive, time-efficient way of integrating patients' goals into their care plans.

Adult↗

PubMed2004

Goal contagion: perceiving is for pursuing.

Six studies examined the goal contagion hypothesis, which claims that individuals may automatically adopt and pursue a goal that is implied by another person's behavior. Participants were briefly exposed to behavioral information implying a specific goal and were then given the opportunity to act on the goal in a different way and context. Studies 1-3 established the goal contagion phenomenon by showing that the behavioral consequences of goal contagion possess features of goal directedness: (a) They are affected by goal strength, (b) they have the quality of goal appropriateness, and (c) they are characterized by persistence. Studies 4-6 show that people do not automatically adopt goals when the observed goal pursuit is conducted in an unacceptable manner, because the goal will then be perceived as unattractive. The results are discussed in the context of recent research on automatic goal pursuits.

Adult↗

PubMed2004

Goal planning: a retrospective audit of rehabilitation process and outcome.

OBJECTIVE: To consider the effectiveness of a goal planning programme for people with spinal cord injury (SCI) and address some of the current evidence gaps in goal setting. DESIGN: Retrospective audit. SUBJECTS: Consecutive series of 65 newly injured SCI patients. MAIN OUTCOME MEASURES: The Needs Assessment Checklist (NAC) has been specifically developed for the SCI population, and is used to assess patient attainment in core rehabilitation areas. A 'Goal Planning Progress' form was also used to specifically detail the goal planning process. RESULTS: Across the 65 patients, 396 goal planning meetings were held with 6176 goals set in total. Seventy-two per cent of the goals set at the first goal planning meeting were achieved by the second meeting. The rate of achievement at subsequent meetings was 68%. Significant differences in the number of planned rehabilitation days, number of goal planning meetings, and goals set were identified between injury categories. Significant positive correlations were found between the number of goals set and achievement, as measured by the NAC, in certain rehabilitation domains. CONCLUSIONS: The findings of this study demonstrate that the Needs Assessment and Goal Planning framework is effective in planning SCI rehabilitation. The capacity of this goal planning system to reflect individual need has also been established. Further systematic analyses of this process could potentially lead to more efficient rehabilitation and the identification of care pathways within clinical areas.

Adolescent↗

PubMed1977

Uses of individualized client goals in the evaluation of drug and alcohol programs.

The issue of accountability increasingly places demands on administrators to evaluate program results. This paper attempts to show that individualized goal setting by clients can provide information which can be used (1) to compare stated program goals to actual client goals, and (2) as a realistic, individualized set of outcomes for follow-up evaluation. Evaluation of many drugs and alcohol programs is often based on the premise that abstinence is the goal of all treatment programs for all clients. While this may be a proper ultimate goal, it may not be sufficiently precise for more specific or short-term evaluations. A technique recently developed in the mental health field is Goal Attainment Scaling (GAS). In this approach, individual goals are usually developed through negotiations between client and counselor and provide individualized measurement of client success in treatment. GAS was tested on a sample of clients entering public and private drug and alcohol treatment facilities: (1) nearly all clients in the sample chose to set goals, although they were not required to do so; (2) a content analysis aggregated individual goals into a group profile of percent of clients writing goals in each of 17 goal areas; (3) goal content changed over successive interviews; and (4) there were differences in goal content between age and facility subgroups.

Achievement↗

PubMed1998

FORUM: Defining Goals and Criteria for Ecosystem-Based Management

/ Identifying goals or targets for landscape and ecosystem management is now a widely recognized need that has received little systematic attention. At a micro-level most planners and managers of both ecosystems and economies continue to pursue traditional goals and targets that miss many desirable characteristics of ecosystem-based management goals. Desirable characteristics of ecosystem and landscape management goals and targets include: addressing complexity, transdisciplinarity, and the dynamic nature of natural systems; reflecting the wide range of interests and goals that exist; recognizing goals and values and limits; involving people and being explainable and implementable in a consistent way to different people and groups; and evolving adaptively as conditions and knowledge change. Substantive and procedural goals can be distinguished; the latter supporting the former. Substantive goals can be grouped according to their relationship to system structure, organization, and process/dynamics, and their disciplinary or subsystemic breadth. These discussions are illustrated by a review of the goals of biodiversity, sustainability, ecological health, and integrity. An example of a hierarchical framework of procedural goals and objectives that supports achievement of substantive goals is also provided. The conclusion is that a parallel, linked system of substantive and procedural goals at different levels of complexity and disciplinarity is needed to facilitate ecosystem-based management.KEY WORDS: Ecosystem management; Goals and objectives; Assessment criteria

Journal Article↗