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

Figures & data

Figure 1. Staged and strategy.

Figure 2. PRISMA diagram: articles included at each stage of the review process.

Figure 3. Study populations.

Figure 4. Defining goal response options.

Table 1. Summary of positive, negative and neutral associations.

Direction of association (with recovery/wellbeing variable)	Goal Adjustment associations (n)	Goal Disengagement associations (n)	Goal Reengagement associations (n)	Total Associations (Number; %)
Positive	21	10	18	49 (79%)
Negative	0	2	1	3 (5%)
Neutral	0	7	3	10 (16%)
Key: n = number; % = percentage				62 (100%)

Table 2. Strategies used by people with long-term conditions to support goal adjustment.

Long-term condition	Strategies used to support goal adjustment
Colorectal cancer (Janse et al., 2016a, 2016b)	Goal strategies: 1. Shifting priorities across life goal domains; 2. Scaling goals back in the same life domain 3. Scaling goals up in the same life domain 4. Form shorter-term goal, 5. Form longer-term goal, 6. Put goal on hold, 7. Continue to pursue disturbed goals and 8. Give up goal commitment without adopting a new goal
Lower limb amputation (Dunne et al., 2014)	1. Interpersonal strategies – accepting help from others, seeking support/assurance from fellow patients & emotional support from friends/family. 2. Strategies to manage limitations – adjusting goals to constraints, maintaining a positive outlook, sense of humour, de-emphasizing the impact of amputation, realising there are others worse off and accepting limitations. 3. Meaning-making strategies – involved higher-order cognitive strategies used to accommodate goal disruption into the broader context of life as a whole; benefit finding and re-orientation
Visual impairment (Boerner & Wang, 2012).	Psychological strategies: 1. Concentrate on the positive, 2. Accept what cannot be changed, 3. Motivational self-talk, 4. Acknowledge I cannot do it, 5. Acknowledge other people are worse off, 6. Try not to think about it, 7. Rationalize to self why some activities are no longer do-able, 8. Seek distraction, 9. Positive attitude toward using help, 10. Use sense of humour, 11. Trust in support from others, 12. Get encouragement from how others cope

Janse, M. , Fleer, J. , Smink, A. , Sprangers, M. A. G. , & Ranchor, A. V. (2016a). Which goal adjustment strategies do cancer patients use? A longitudinal study. Psycho-Oncology , 25 (3), 332–338. https://doi.org/10.1002/pon.3924

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Janse, M. , Ranchor, A. V. , Smink, A. , Sprangers, M. A. G. , & Fleer, J. (2016b). People with cancer use goal adjustment strategies in the first 6 months after diagnosis and tell us how. British Journal of Health Psychology , 21 (2), 268–284. https://doi.org/10.1111/bjhp.12167

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Dunne, S. , Coffey, L. , Gallagher, P. , & Desmond, D. (2014). “If I can do it I will do it, if I can’t, I can’t”: A study of adaptive self-regulatory strategies following lower limb amputation. Disability and Rehabilitation , 36 (23), 1990–1997. https://doi.org/10.3109/09638288.2014.885993

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Boerner, K. , & Wang, S. (2012). Goals with limited vision: A qualitative study of coping with vision related goal interference in midlife. Clinical Rehabilitation , 26 (1), 81–93. https://doi.org/10.1177/0269215511407219

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