ABSTRACT

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.

摘要

长期的健康状况会限制个人目标的实现。我们的目的是绘制和综合目标调整的定义、理论基础、与康复的关联以及对患有长期疾病的成年人的支持性干预。我们搜索了多个数据库（2007 年 1 月至 2018 年 6 月）并确定了与目标调整相关的同行评审研究。使用内容分析和描述性摘要对数据进行图表绘制、映射和综合。两次利益相关者磋商为审查提供了信息。包括 91 篇文章。代表了一系列长期疾病，包括癌症 (22%)、中风 (12%) 和混合神经系统疾病 (8%)。面对无法实现的目标时，目标调整是一种可行的选择；其他选择是目标脱离和目标重新参与。大多数研究是定量的 (58%)，主要报告目标调整、脱离、重新参与和恢复之间的正相关。双过程模型、目标调整模型和自我调节理论是被引用最多的支撑模型/理论。确定了五项干预措施；只有一种（自我系统疗法）在随机对照试验中得到评估。我们的评论对目标调整定义、理论基础以及与恢复的关联提供了原创和重要的见解。缺乏支持目标调整、脱离和重新参与的有效干预措施。这种研究与实践之间的差距值得关注，以确保长期状况不佳的人在面临无法实现的目标时得到最佳支持。目标调整模型和自我调节理论是被引用最多的支撑模型/理论。确定了五项干预措施；只有一种（自我系统疗法）在随机对照试验中得到评估。我们的评论对目标调整定义、理论基础以及与恢复的关联提供了原创和重要的见解。缺乏支持目标调整、脱离和重新参与的有效干预措施。这种研究与实践之间的差距值得关注，以确保长期状况不佳的人在面临无法实现的目标时得到最佳支持。目标调整模型和自我调节理论是被引用最多的支撑模型/理论。确定了五项干预措施；只有一种（自我系统疗法）在随机对照试验中得到评估。我们的评论对目标调整定义、理论基础以及与恢复的关联提供了原创和重要的见解。缺乏支持目标调整、脱离和重新参与的有效干预措施。这种研究与实践之间的差距值得关注，以确保长期状况不佳的人在面临无法实现的目标时得到最佳支持。我们的评论对目标调整定义、理论基础以及与恢复的关联提供了原创和重要的见解。缺乏支持目标调整、脱离和重新参与的有效干预措施。这种研究与实践之间的差距值得关注，以确保长期状况不佳的人在面临无法实现的目标时得到最佳支持。我们的评论对目标调整定义、理论基础以及与恢复的关联提供了原创和重要的见解。缺乏支持目标调整、脱离和重新参与的有效干预措施。这种研究与实践之间的差距值得关注，以确保长期状况不佳的人在面临无法实现的目标时得到最佳支持。