ADJUSTING PERSONAL GOALS AND SEARCHING FOR NEW PURPOSE: BENEFICIAL TO ADAPT TO ARTHRITIS

Background: Patients have a significant responsibility in the treatment of and coping with their disease. Clarity about (threatened) personal goals and goal management competencies can help to find the adequate way to strive for successful adaptation to arthritis. Objectives: To find out which goal management strategies are beneficial for patients with arthritis. The study focused on four strategies: goal maintenance, goal adjustment, goal disengagement and goal re-engagement. Studies in patients with other chronic diseases showed that goal management is important for the adaptation to a chronic condition but the precise orchestration of strategies is still unclear. Therefore two research questions were examined in this study: 1. Which goal management strategies are beneficial for subjective wellbeing and the absence of depressive symptoms in patients with arthritis? 2. Are there specific combinations of strategies which are associated with successful adaptation to the disease? Methods: At the rheumatology outpatient clinic of the Medisch Spectrum Enschede, patients were asked to participate in a questionnaire study on personal goals. Goal management was measured with two instruments with each two subscales: The Goal Pursuit and Flexible Goal Adjustment Scale (30 items, α for goal pursuit = 0.72, α for Flexible Goal Adjustment = 0.76) and the Goal Adjustment Scale (10 items, α for Goal disengagement = 0.63, α for Goal re-engagement = 0.82). Subjective wellbeing was measured with the subscale mental health of the SF 36v2, α = 0.87. Depressive symptoms were measured with the Geriatric Depression Scale, α was 0.84. Results: 34 men (mean age = 56, min=32, max=86) and 44 women (mean age = 55, min=21, max=83) participated in the study. Mean disease duration was 9.5 years (min=1, max=50). Patients reported RA (26%), OA (13%) or other forms of arthritis (36%). 23% was not able to indicate which form of arthritis they were diagnosed with. Pearson correlations revealed significant relationships of two goal management strategies with subjective wellbeing: r=0.51 for flexible goal adjustment and r=0.25 for goal re-engagement. Depressive symptoms were substantially negatively associated with flexible goal adjustment (r=-0.46). To find out whether specific combinations of strategies were more beneficial than others, we tested the interaction effects of median split goal management variables with analyses of variances. We found slightly significant interactions for the combination of goal disengagement and goal re-engagement (p=0.056 for depressive feelings and p=0.067 for subjective wellbeing). Patients who scored high on goal disengagement and low on goal re-engagement reported clearly lower levels of subjective wellbeing and higher levels of depressive symptoms in comparison with al other combinations. Conclusions: Mainly the tendency to adjust personal goals when facing difficulties (flexible goal adjustment) was associated with psychological adaptation to arthritis. The use of this strategy seems to work the best in combination with searching for new personal goals. References: 1. Garnefski N et al. Cognitive coping and goal adjustment in people with PAD: Relationships with depressive symptoms. Pat Educ Couns 2009 76,132-37 Disclosure of Interest: None DeclaredCitation: Annals of the Rheumatic Diseases, volume 70, supplement 3, year 2011, page 759Session: Psychology / Social sciences (Poster Presentations )