Higher Goal Attainment Research Articles

Once a job crafter, always a job crafter? Investigating job crafting in organizations as a reciprocal self-concordant process across time

Research depicts job crafting as a desirable, ongoing employee behavior rather than a one-off event. However, insights are lacking into how employees’ active engagement in job crafting may be sustained across time. In this study, we advance a dynamic framework of how changes that follow employees’ periods of job crafting may, in turn, motivate versus impede continued crafting of one’s job role over time. Drawing from self-concordance theorizing, we propose and test a framework on how job crafting and employees’ attainment of self-concordant and organizational work goals are reciprocally related over time. Longitudinal data from a large, three-wave study collected over four years among church ministers support a positive reciprocal relationship between job crafting and self-concordant goal attainment, as well as an indirect positive relationship between job crafting and organizational goal attainment via self-concordant goal attainment. However, in line with our theorizing, organizational goal attainment did not predict subsequent job crafting. Instead, high organizational goal attainment weakened the extent to which job crafting at one time point positively related to job crafting at the next time point. We discuss the theoretical and practical implications of our findings for employees’ continued engagement in job crafting in organizations.

Process evaluation of the New Interventions for independence in Dementia Study (NIDUS) Family stream randomised controlled trial: protocol

IntroductionNew Interventions for independence in Dementia Study (NIDUS)-Family is an Alzheimer’s Society funded new manualised, multimodal psychosocial intervention to support people living with dementia (PLWD) to achieve goals that they...

Optimal medical therapy in patients with stable coronary artery disease in Poland: the ISCHEMIA trial experience.

Introduction: Optimal medical therapy (OMT) is the cornerstone of treatment for stable coronary disease with the ISCHEMIA trial showing similar outcomes using OMT with or without an initial invasive approach. Objectives: To describe OMT goal attainment in Polish ISCHEMIA participants compared with other countries. Patients and methods: Among 5179 trial participants, 333 were randomized in Poland. The median follow-up was 3.2 years. OMT targets were: not smoking, high-intensity statin therapy, low-density lipoprotein cholesterol (LDL-C) of less than 70 mg/dl, systolic blood pressure of less than 140 mm Hg, aspirin therapy, and ACEI / ARB, and β-blocker therapy if indicated. Results: Compared with 36 other countries, at randomization, patients in Poland were older (67 [62–75] y vs 65 [58–71] y); P <⁠0.001), more often female (30% vs 22%; P = 0.002), with a longer history of angina (3 [1–9] y vs 1 [0–3] y; P <⁠0.001), and there were more cases of prior myocardial infarction (32% vs 18%; P <⁠0.01) and revascularization (PCI, 40% vs 19%; CABG, 11% vs 3%; P <⁠0.001 for both). The number of OMT goals attained increased from baseline to follow-up visits (5 [4–5] vs 6 [5–6]; P <⁠0.001) in Poland and other countries alike (P = 0.89 vs P = 0.14). In Poland, significant improvements were achieved regarding high-intensity statin therapy (27% vs 50%), LDL-C <⁠70 mg/dl (29% vs 65%), and systolic blood pressure of less than 140 mm Hg (63% vs 81%) (P <⁠0.001 for all), whereas not-smoking (89% vs 89%), aspirin (90% vs 88%), ACEI / ARB (93% vs 95%), and β-blocker therapy (94% vs 90%) remained high. Conclusions: With regular surveillance and contemporary medical therapy, high OMT goal attainment was achievable among the participants of the ISCHEMIA trial in Poland relative to other countries. There is still room for improvement in LDL-C and blood pressure management.

136. Influence of goal attainment scaling on cognitive behavioral based physical therapy outcomes after lumbar spine surgery

<h3>BACKGROUND CONTEXT</h3> Patient-centered goal setting is an important component of behavioral interventions for chronic pain. Limited data exist on the relationship between goal attainment during cognitive-behavioral based physical therapy (CBPT) and pain-related outcomes. <h3>PURPOSE</h3> The purpose of this study was to examine the relationship between CBPT goal attainment and pain-related outcomes in a cohort of patients who completed a 6-week telephone-based CBPT intervention after lumbar spine surgery. <h3>STUDY DESIGN/SETTING</h3> Secondary analysis from a randomized trial comparing postoperative CBPT and an education program. The primary results of the trial showed superiority of CBPT in an intervention completers only analysis. <h3>PATIENT SAMPLE</h3> This study included 108 participants (mean ± SD age = 63.5 ± 11.3 years, 54 [50%] female, 92 [85%] White) who completed the CBPT intervention were included. <h3>OUTCOME MEASURES</h3> Six and 12-month outcomes included physical function (PROMIS), pain interference (PROMIS), and back and leg pain intensity (Brief Pain Inventory). <h3>Methods</h3> At each session, CBPT participants used goal attainment scaling (GAS) to set goals and report goal attainment from the previous session. The number and type of goals and percentage of goals met were recorded. A GAS t-score for achievement of goals across all sessions was computed for each patient. Patients were grouped as high or low goal attainment based on a GAS t-score of 50, which indicates goals were met as expected. Outcome differences between groups at each follow-up time point were examined using linear regression analyses controlling for baseline outcome score. Alpha was set at the 0.05 level for statistical significance. <h3>Results</h3> Participants set a median of 3 goals (range: 1 to 6) at each CBPT session. The most common goals were related to participating in a physical/recreational activity (36%), adopting a cognitive or behavioral strategy (28%), exercising (11%), or performing activities of daily living (11%). The least common goals related to social activities (2%). Forty-six (43%) participants met criteria for high goal attainment (mean % goals met = 87% compared to 64% in the low goal attainment group, p<0.001). Greater improvements in the high goal attainment group were observed in physical function at 6 (unstandardized beta = 4.2, p < 0.05) and 12 months (unstandardized beta = 3.5, p < 0.05) and back pain intensity at 12 months (unstandardized beta = -0.9 p < 0.05). <h3>Conclusions</h3> The attainment of personalized goals within a CBPT intervention was an important factor related to improvements in physical functioning after spine surgery. Implementing a structured process for setting personalized goals and tracking goal attainment may be an essential aspect of a biopsychosocial approach for addressing functional impairment following surgery. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Goal Setting and Achievement in Individualized Rehabilitation of Younger Total and Unicondylar Knee Arthroplasty Patients: A Cohort Study

ObjectiveTo investigate activity goals, intensity and achievement of these activity goals in younger knee arthroplasty (KA) patients, and to identify the differences between total knee arthroplasty (TKA) and unicondylar knee arthroplasty (UKA) patients. DesignProspective cohort study. SettingDepartment of orthopedic surgery and physical therapy practices. ParticipantsPatients (N=48) aged 65 years or younger who underwent KA. InterventionRehabilitation with goal attainment scaling (GAS). Main Outcome MeasuresGAS goals for daily life activity, work and leisure time, corresponding metabolic equivalent of task (MET) values, corrected MET values, and GAS scores at 3 and 6 months. ResultsThe intensity levels of all 144 formulated activity goals were light in 16% of cases, moderate in 63%, and vigorous in 21%. Intensity levels did not differ between TKA and UKA patients. Following rehabilitation using GAS, 54% of daily life activity goals, 65% of work activity goals, and 46% of leisure time activity goals were attained after 3 months. After 6 months, 91% of daily life activity goals, 93% of work activity goals, and 89% of leisure time activity goals were attained. Goal attainment did not differ between MET intensity levels. Higher goal attainment was achieved in the UKA group (100%) compared with the TKA patients (82%) after 6 months (P<.001). ConclusionsYounger patients aim to perform many different activities of varying metabolic intensity levels following KA. After 6 months of rehabilitation using GAS, in these patients attain 91% of their preoperatively formulated activity goals, independent of the MET intensity level. After 6 months, UKA patients attain significantly more activity goals than TKA patients. GAS might be a useful objective outcome measure in evaluating clinical outcomes of individual KA patients.

Emotional Intelligence and Its Direct and Indirect Effects on Personal and Organisational Effectiveness

This literature review examined the relationship between emotional intelligence and organisational and personal effectiveness. And, various factors which intermediate the relation between the two i.e. factors like improved organisational culture, high goal attainment, high client satisfaction, high performance, job satisfaction and employee creativity. This study revealed that there is a strong positive relation between EI and above mentioned factors, hence, EI should be considered as an important element in any organisational or personal effectiveness in any given situation.

From the top-down: Transformational leadership considerations for health care organizations

Nurse leaders can positively influence critical issues in healthcare by engaging in transformational leadership (TL) practices. High in humility, extraversion, self-efficacy, and emotional intelligence, transformational leaders focus on followers as individuals and inspire high goal attainment. Organizations can increase TL behaviors through top-down training strategies. This paper evaluates salient TL characteristics and considerations for organizations wishing to create positive organization-wide change.

Comparing the Effectiveness of Individual Coaching, Self-Coaching, and Group Training: How Leadership Makes the Difference

Few empirical studies have used a randomized controlled design to evaluate the impact of coaching, and there are even fewer that have compared coaching with other interventions. In the current field study, we investigated the relative effectiveness of coaching as an intervention to reduce procrastination. In a randomized controlled study, participants (N = 84) were assigned to an individual coaching, a self-coaching, a group training, or a control group condition. Results indicate that individual coaching and group training were effective in reducing procrastination and facilitating goal attainment. Individual coaching created a high degree of satisfaction and was superior in helping participants attaining their goals, whereas group training successfully promoted the acquisition of relevant knowledge. The results for the self-coaching condition show that independently performing exercises without being supported by a coach is not sufficient for high goal attainment. Moreover, mediation analysis show that a coach’s transformational and transactional leadership behavior influenced participants’ perceived autonomy support and intrinsic motivation, resulting in beneficial coaching outcomes. The results may guide the selection of appropriate human resource development methods: If there is a general need to systematically prepare employees to perform on specific tasks, group training seems appropriate due to lower costs. However, when certain aspects of working conditions or individual development goals are paramount, coaching might be indicated. However, further research is needed to compare the relative effectiveness of coaching with other interventions in different contexts.

Relational coordination among home healthcare professions and goal attainment in nursing care

To examine whether interprofessional coordination is related to goal attainment in home visit nursing care. Self-administered questionnaire surveys were administered to home visit nursing agencies in Chiba Prefecture, Japan, from July to December 2014. Nurses evaluated their interprofessional coordination with professional groups (nursing colleague and managers, home doctors, care managers, home care workers, visiting therapists, day service and day care professionals, visiting bath professionals, and short stay professionals) using the Japanese version of the Relational Coordination Scale (RCS-J). Goal attainment across all clients during the most recent 3 months was measured with a rating scale ranging from incompletely attained (0) to completely attained (10). Data were analyzed with multivariate logistic regression analysis. A total of 83 nurses in 14 agencies responded, and data from 74 nurses were analyzed. The mean RCS-J and goal attainment scores were 3.59 (standard deviation = 0.47) and 6.51 (1.40), respectively. The RCS-J scores of the low and high goal attainment groups were 3.41 (0.46) and 3.73 (0.42), respectively. Multivariate logistic regression analysis revealed that RCS-J scores were positively associated with goal attainment (odds ratio, 5.71; 95% confidence interval, 1.65-19.79). The finding of this study suggest that well-coordinated professionals may fulfill client needs better than poorly coordinated professionals do. Future research is needed to determine whether similar results are obtained in individual clients using a well-validated goal attainment scale.

The effects of treatment adherence and treatment-specific therapeutic competencies on outcome and goal attainment in telephone-based therapy with caregivers of people with dementia

Objectives: Contradictory results have been found for the impact of therapist's adherence and competence on intervention outcomes. Most studies focus on generic aspects of competence and adherence, rather than taking into account treatment-specific aspects or specific challenges of the clientele. Appropriate analyses are lacking for cognitive behavioral therapy (CBT) with caregivers of people with dementia.Method: In a sample of 43 caregivers, we examined adherence and different competence ratings of 80 complete sessions, as predictors of symptom change and goal attainment. Therapist's competence was evaluated by four raters, using an adapted version of the cognitive therapy scale (CTS) on three subscales of competence: General therapeutic (GT), session-structuring (SS), and treatment-specific CBT technique (CT). Therapist's adherence to the manual was also assessed.Results: The results show that GT competencies were associated with lower post-test depression scores and that CT competencies predicted a decrease in caregiver burden and higher goal attainment, while SS competencies predicted higher post-test burden. Therapist's adherence had no relationship to outcome, but the higher application of modifying dysfunctional thoughts was associated with higher goal attainment.Conclusion: The results suggest the importance of treatment-specific competencies for outcome. Future research should identify empirically what kind of therapeutic behavior is appropriate to the challenges of a specific clientele such as caregivers of people with dementia.

Efficacy and tolerability of a single-pill combination of telmisartan/ hydrochlorothiazide 80/25 mg in Chinese and Korean patients with moderate to severe hypertension: a subgroup analysis of a randomized, double-blind, active-controlled trial

Background Hypertension is an important issue in Asia, responsible for up to 66% of cardiovascular disease cases. This randomized controlled trial subgroup analysis compared telmisartan 80 mg (T80)/hydrochlorothiazide 25 mg (H25) single-pill combination with T80 monotherapy, specifically in Chinese and Korean patients. Methods Patients with grade 2/3 hypertension were randomized to receive telmisartan 40 mg (T40)/hydrochlorothiazide 12.5 mg (H12.5) combination or T40 monotherapy for one week, before uptitrating the dose to T80/H25 or T80, respectively, for the remaining 6 weeks. The primary endpoint was systolic blood pressure (SBP) mean change from baseline. Secondary endpoints included mean diastolic blood pressure (DBP) change from baseline, and blood pressure (BP) goal achievement. Adverse events were recorded. Results Of a total 888 patients who were treated, efficacy analyses for Chinese and Korean patients included 127 patients treated with T80/H25 and 54 patients treated with T80. At week 7, mean SBP reductions from baseline were −37.5 mmHg (1 mmHg=0.133 kPa) and −26.9 mmHg in the T80/H25 and T80 groups (adjusted mean difference, −10.6 mmHg; 95% confidence interval (CI), −15.6 to −5.7). Mean DBP reductions were −19.0 and −14.1 mmHg in the T80/H25 and T80 groups (adjusted mean difference, −4.9 mmHg; 95% CI, −8.0 to −1.8). In total, 56.7% of patients receiving T80/ H25 achieved BP goal (&lt;140/90 mmHg) compared with 35.2% receiving T80. SBP goal attainment (&lt;140 mmHg) and DBP goal attainment (&lt;90 mmHg) were also higher in the T80/H25 group compared with the T80 group (SBP: 69.3% vs. 48.1%; DBP: 62.2% vs. 46.3%). A small number of treatment-related adverse events were observed in both T80/H25 (nine patients, 6.9%) and T80 monotherapy (two patients, 3.6%) groups. Conclusions In Chinese and Korean patients with moderate-to-severe hypertension, treatment with T80/H25 provided large reductions in mean SBP and DBP, and high BP goal attainment rates. This once-daily combination is effective and well tolerated in this patient group. (ClinicalTrials.gov identifier NCT00926289)

Nurse’s perceptions of their group goal attainment capability and professional autonomy: a pilot study

A pilot study to examine staff nurses' perceptions of, and relationships between, group goal attainment capability and professional autonomy. A nursing group's capability to employ appropriate nursing interventions leads to improvement in patient outcomes. Nurses' goal attainment capability plays a role in achieving high-quality patient outcomes and may be related to professional autonomy. Staff nurses (N = 90) in one community hospital completed the Sieloff-King Assessment of Group Goal Attainment Capability within Organizations and the Nursing Activity Scale instrument. Staff nurses reported high goal attainment capability and high professional autonomy, and a positive significant but weak correlation (r = 0.24, P < 0.05) was found between nurses' perceptions of group goal attainment capability and perceptions of professional autonomy. Three of the eight group goal attainment subscales were positively correlated with professional autonomy including: group leaders' goal attainment capability competency, goals/outcomes competency and goal attainment capability perspective. While three subscales of goal attainment capability were significant, the correlations were weak between professional autonomy and group leader's goal attainment competency, goals/outcome competency and goal attainment perspective. Nurse managers can play a key role in nurses' group goal attainment capability and perceived professional autonomy.

Provider cultural competency, client satisfaction, and engagement in home-based programs to treat child abuse and neglect.

Home-based programs to treat child abuse and neglect suffer from high rates of attrition, limiting their impact. Thus, research is needed to identify factors related to client engagement. Using data (N = 1,305) from a statewide family preservation program, this study investigated the role of program type (i.e., SafeCare(®) [SC] vs. Services as Usual [SAU]) and client perceived provider cultural competence on client satisfaction and engagement with services. Families in SC completed more treatment goals than those in SAU. In addition, provider cultural competence and client satisfaction were higher in SC than in SAU. Higher provider cultural competence was associated with higher goal attainment and satisfaction, and these effects partially mediated the service program differences. The effects of service type and cultural competence on goal attainment and satisfaction varied somewhat by client ethnicity. Findings suggest that clients receiving manualized programs for child maltreatment may be more likely to meet their goals and may perceive such programs to be culturally appropriate and satisfactory.

Begin with the Real-world Patients of Non-goal-achieved Hypercholesterolemia in Taiwan through the Ezetimibe/Simvastatin Tablet – The BRAVO Study

Objective:To assess the efficacy, safety, and tolerability of a combination of 10 mg ezetimibe and 20 mg simvastatin in Taiwanese patients with hypercholesterolemia.Research design and methods:A prospective, open-label, multi-center, hospital-based cohort study was conducted to evaluate the efficacy, safety, and tolerability of a single tablet combination of ezetimibe/simvastatin for the treatment of hypercholesterolemia. Taiwanese adults without low-density lipoprotein cholesterol (LDL-C) goal achievement, based on the National Cholesterol Education Program Adult Treatment Panel III guidelines, were treated with ezetimibe/simvastatin once daily for 6 weeks. The primary endpoint was the percentage of patients achieving LDL-C treatment goals after 6 weeks of treatment. Secondary endpoints included percentage change from baseline of LDL-C, total cholesterol, high-density lipoprotein cholesterol, and triglyceride. Safety and tolerability were assessed via clinical and laboratory examinations. The clinicaltrial.gov identifier of this study was NCT00654628.Results:In total, 173 patients with a mean age of 57.9 ± 10.4 years were included. Of these, 57.8% were female and the average body mass index was 25.5 ± 3.4 kg/m2. After 6 weeks of treatment, the great majority of the patients had reached their treatment goals (90.4% for LDL-C; 87% for TC; and 59% for TG). LDL-C levels were significantly reduced from 156.8 ± 30.8 mg/dL at baseline to 75.9 ± 25.4 mg/dL (51.4%, P < 0.0001) after only 6 weeks of therapy. Forty-nine adverse events (AEs), including one non-drug related serious AE, were reported. For non-serious AEs, the most common reported AEs during the entire study period were myalgia and upper respiratory infection (both n = 7). Nine patients dropped out of the study, reportedly due to AEs.Conclusions:A single tablet combination of 10 mg ezetimibe and 20 mg simvastatin in Taiwanese patients with hypercholesterolemia provided high LDL-C goal attainment rates and resulted in significant reductions in LDL-C.

Identifying challenges, goals and strategies for success for people with diabetes through life coaching

Many working adults with diabetes face barriers to effective disease self-management and consequently are at risk for deteriorating health, job loss, and dependence on public assistance. The Hawaii Live Healthy Work Well project examined how individuals with diabetes (a potentially disabling condition) perceived life coaching and person-centered planning as an intervention to maintain employment and manage chronic health issues. For one year, 108 participants received life coaching, using goal setting as a central activity. Based on administrative and survey data, participants' perceived usefulness and value of life coaching in relation to their diabetes, health status, and employment was coded and analyzed. Participant and coach perceptions of the challenges people with diabetes face in managing their health and work are discussed. Participants reported high satisfaction with the intervention and demonstrated high goal attainment. Although more research is needed, life coaching may be a viable tool to assist people with diabetes to maintain their employment and health. Employers and other providers may want to explore life coaching as an early intervention for employees with diabetes and other chronic conditions such as obesity.

Using Business Theory to Motivate Undergraduate Students in Goal Attainment: An Empirical Assessment and Model for High Level Motivation and Goal Attainment

Students at a private university in southern California took part in a study focusing on high level motivation and goal commitment. Using path analysis, this study mapped out two-paths. The first path to motivation and, therefore, goal commitment was through self-efficacy. The second path to goal commitment required a more supportive course. Spiritual, peer, family and leadership support combined to create a more encouraging sequence of action toward motivation and goal dedication. There are many motivators that lead to goal completion. These motivators are generated from various influences—from peers, from family, from leaders, from faith, and from oneself. The purpose of this research is to look at motivation and goal achievement through the lens of personal motivators. The objective is to take a primarily business theory and apply it to college student marathon training.

Safety and Efficacy of Ezetimibe/Simvastatin Combination Versus Atorvastatin in Patients 65 Years of Age and Older

Synopsis: More than 80% of coronary heart disease (CHD)-related mortality occurs in patients 65 years of age or older. The use of statins to mitigate CHD risk has been suboptimal, in part because of concerns of increased side effects in older patients. Few clinical studies have focused on the efficacy and safety of lipid-lowering strategies in this population. Purpose: This study assessed the efficacy and safety of ezetimibe/simvastatin and atorvastatin in hypercholesterolemic patients 65 years or older with or without cardiovascular disease. Methods: Multicenter, 12-week, randomized, double-blind, parallel group trial. A total of 1289 patients randomized to the usual starting dose of ezetimibe 10 mg/simvastatin 20 mg versus atorvastatin 10 mg or 20 mg, and the next greater dose of ezetimibe/simvastatin (10 mg/40 mg) versus atorvastatin 40 mg. The primary end point was percent change from baseline low-density lipoprotein cholesterol (LDL-C). Secondary endpoints were attainment of LDL-C <70 and <100 mg/dL, safety/tolerability, and percent change from baseline lipids and lipoprotein ratios. Results: Patients randomized to ezetimibe/simvastatin had greater percent reductions in LDL-C and significantly greater attainment of LDL-C <70 and <100 mg/dL compared with those randomized to atorvastatin for all dose comparisons (P values from <.05 to <.001). Analysis of risk groups showed a significantly greater percent of high-risk patients with cardiovascular disease (CVD) achieving LDL-C <70 mg/dL on ezetimibe 10 mg/simvastatin 20 mg versus atorvastatin 10 mg (P < .001) and ezetimibe 10 mg/simvastatin 40 mg versus atorvastatin 40 mg (P < .05), and a significantly greater percent of moderately high/high-risk patients without CVD achieving LDL-C <100 mg/dL on ezetimibe 10 mg/simvastatin 20 mg versus atorvastatin 10 mg (P < .05). Improvements in non-high-density lipoprotein cholesterol, total C, apolipoprotein B, and lipoprotein ratios were significantly greater with ezetimibe/simvastatin than atorvastatin for all comparisons (P values from <.01 to <.001). High-density lipoprotein cholesterol and triglyceride results were more variable. Adverse experiences were low for ezetimibe/simvastatin and atorvastatin, and generally similar to previous findings. Conclusions: In this large randomized trial of older patients with or at risk for CVD, ezetimibe/simvastatin provided significantly greater improvements in key lipid parameters and higher goal attainment than atorvastatin with comparable tolerability. Ezetimibe/simvastatin may be a useful treatment option for dyslipidemia in elderly patients, particularly where statin side effects may limit use or titration. Clinical outcome trials with ezetimibe/simvastatin are ongoing.

Sense of hyper-positive self, goal-attainment beliefs and coping strategies in bipolar I disorder

There is some evidence that cognitive therapy (CT) is beneficial in reducing relapses in bipolar disorder. However, not all bipolar patients benefit from it. A previous study found that a group of non-responders to CT shared common characteristics: they value some of the high goal-attainment beliefs and characteristics associated with being in a state of mild hypomania - a high 'sense of hyper-positive self' (SHPS). To promote of our understanding of this group of patients, the present study investigated the relationship between SHPS, preferred internal state, dysfunctional attitudes and coping with hypothetical manic prodromal scenarios. Fifty-four bipolar I patients filled in self-report questionnaires that assess preferred mood state, coping with scenarios, dysfunctional attitudes and SHPS. The Sense of Hyper-positive Self Scale Ideal score (SHPSS-Ideal) predicted patients' preferred internal state of mania. Coping with hypothetical scenarios was predicted by Dysfunctional Attitude Scale (DAS) goal-attainment scores: the higher the goal-attainment score, the higher the participant's tendency to identify with self-descriptors linked to hypomania and to engage in stimulating behaviours that may escalate the prodromal stage to mania. Clinicians should check and modify goal-attainment beliefs, particularly of those who exhibit features of SHPS. These patients' tendency to identify with hypomanic traits as self-descriptors should be dealt with by psychological techniques such as cognitive restructuring.