Tenacious goal pursuit and flexible goal adjustment in older people over 5 years: a latent profile transition analysis

Bailly, Nathalie; Martinent, Guillaume; Ferrand, Claude; Gana, Kamel; Joulain, Michèle; Maintier, Christine

doi:10.1093/ageing/afv203

Cited by 21 publications

(36 citation statements)

References 26 publications

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“…Subsequently, in our findings, hope, tenacity, and QoL positively influence each other. Therefore, the opportunity of trial participation can be considered as a factor that supports personal well‐being in motivated patients …”

Section: Discussionmentioning

confidence: 99%

Understanding how coping strategies and quality of life maintain hope in patients deliberating phase I trial participation

et al. 2017

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Objective: This study aimed to understand how hope and motivation of patients considering phase I trial participation are affected by psychological factors such as coping strategies and locus of control (LoC) and general well-being as measured by the quality of life (QoL).Methods: An exploratory cross-sectional study was performed in patients with incurable cancer (N = 135) referred to our phase I unit for the first time. Patients were potentially eligible for phase I trial participation and participated in our study while deliberating phase I trial participation. We used questionnaires on hope, motivation to participate, coping, LoC, and QoL. To investigate the nature and magnitude of the relationships between the scales, a structural equation modeling (SEM) was fitted to the data.Results: Hope significantly predicted the motivation to participate in phase I trials. Predictors of hope were a combination of flexible and tenacious goal pursuit (both P < .01), internal LoC (P < .01), and QoL (P < .01). The SEM showed an exact fit to the data, using a null hypothesis significance test: chi-square (8) = 9.30, P = .32. Conclusions:Patients considering phase I trial participation seem to use a pact of tenacious and flexible coping and control to stay hopeful. Furthermore, hope and QoL positively affected each other. The psychological pact may promote an adaptation enabling them to adjust to difficult circumstances by unconsciously ignoring information, called dissonance reduction. This mechanism may impair their ability to provide a valid informed consent. We suggest including a systematic exploration of patients' social context and values before proposing a phase I trial. Patients may struggle to decide whether to engage in a treatment with unknown efficacy, benefit, and side effects, or to opt solely for symptom-oriented palliative care.2 During this deliberation, their mindset may help them deal with this choice by setting goals. 3Mindset represents people's personal attitudes that influence their goals and behavior. 4 Equally, physicians face the difficult decision whether to offer a phase I trial to their patients and how to answer patients' questions, not knowing whether the experiment is worthwhile. Additionally, when treatment options are sparse or not available, considering phase I trial participation may represent a health crisis. 21This crisis, facing a life-threatening situation, can trigger 2 modes of coping: tenacious goal pursuit (tenacity) and flexible goal adjustment (flexibility). 21 Patients who use tenacity try to modify their circumstances to fulfill their personal preferences. In contrast, patients who use flexibility adapt their personal preferences to the new situation.In both coping strategies, another psychological factor, the sense of control, can play a role.Locus of control (LoC) refers to the extent to which people believe their lives can be controlled by external factors (such as doctors) or internal factors (themselves). 22 One may assume that palliative patients with cancer, wh...

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Section: Discussionmentioning

confidence: 99%

Understanding how coping strategies and quality of life maintain hope in patients deliberating phase I trial participation

et al. 2017

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“…See Table 1 for details of positive, negative and neutral associations. Three prospective cohort studies with the longest follow-up periods (≥ 5 years) reported positive associations between goal adjustment and depression (Bailly et al, 2016); goal adjustment and improved wellbeing (Hall et al, 2010), (Martinent et al, 2017) and goal disengagement and improved physical health, in populations with mixed long-terms conditions.…”

Section: Synthesis Of the Goal Adjustment Literaturementioning

confidence: 99%

Goal adjustment by people living with long-term conditions: A scoping review of literature published from January 2007 to June 2018.

Scobbie

Thomson

Pollock

et al. 2020

Neuropsychological Rehabilitation

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Long-term health conditions can limit achievement of personal goals. We aimed to map and synthesize definitions of goal adjustment, theoretical underpinnings, associations with recovery and supportive interventions for adults with long-term conditions. We searched multiple databases (January 2007-June 2018) and identified peer-reviewed research relating to goal adjustment. Data were charted, mapped and synthesized using content analysis and descriptive summaries. Two stakeholder consultations informed the review. Ninety-one articles were included. A range of long-term conditions were represented including cancer (22%), stroke (12%) and mixed neurological conditions (8%). Goal adjustment was one available option when faced with unattainable goals; other options were goal disengagement and goal re-engagement. Most studies were quantitative (58%), reporting mainly positive associations between goal adjustment, disengagement, reengagement and recovery. The Dual Process Model, Goal Adjustment Model and Self-Regulation Theory were most cited underpinning models/theory. Five interventions were identified; only one (self-system therapy) was evaluated in a randomized controlled trial. Our review provides original and significant insights into goal adjustment definitions, theoretical underpinnings and association with recovery. Effective interventions to support goal adjustment, disengagement and reengagement are lacking. This research-practice gap warrants attention to ensure people with long-term conditions are optimally supported when facing unattainable goals.

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“…Older people who are high in both tenacity and flexibility are less likely to suffer from depression [20–22], a correlate of restricted life-space mobility [23]. Further, older people who actively use both strategies seem to report higher life-satisfaction, and better self-rated health [21, 22].…”

Section: Introductionmentioning

confidence: 99%

Association of tenacious goal pursuit and flexible goal adjustment with out-of-home mobility among community-dwelling older people

et al. 2018

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Background As people age, functional losses may limit the potential to get outside the home and participate in desired activities and community life. Coping with age-related losses has been reported to be important for psychological well-being. Hitherto is not known whether active use of coping strategies also helps maintain out-of-home mobility. Aims We investigated how two coping strategies, tenacious goal pursuit (TGP; persistency in reaching one’s goals) and flexible goal adjustment (FGA; adjusting one’s goals to changed circumstances), are associated with life-space mobility and perceived autonomy in participation outdoors among community-dwelling older people. Methods Participants ( n = 186) were aged 79–93 years. TGP and FGA were self-reported using separate scales. Perceived autonomy in participation was assessed with the Impact on Participation and Autonomy Outdoors-subscale, and life-space mobility with the Life-Space Assessment. Two-step cluster analysis was used to create data-driven coping profiles of TGP and FGA. Results General linear model analyses showed that the profile including highly tenacious and flexible older people had the highest life-space mobility and perceived autonomy outdoors, whereas the profile including people with low TGP and low FGA showed the lowest scores. Depressive symptoms attenuated the associations. Conclusions Active use of both TGP and FGA is favorable for out-of-home mobility and enables more active participation in society in later life. Electronic supplementary material The online version of this article (10.1007/s40520-018-1074-y) contains supplementary material, which is available to authorized users.

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Tenacious goal pursuit and flexible goal adjustment in older people over 5 years: a latent profile transition analysis

Abstract: high flexibility and tenacity in older people is a stable coping profile that is associated with successful ageing.

Cited by 21 publications

References 26 publications

Understanding how coping strategies and quality of life maintain hope in patients deliberating phase I trial participation

Understanding how coping strategies and quality of life maintain hope in patients deliberating phase I trial participation

Goal adjustment by people living with long-term conditions: A scoping review of literature published from January 2007 to June 2018.

Association of tenacious goal pursuit and flexible goal adjustment with out-of-home mobility among community-dwelling older people

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