Abstract
Patient-generated treatment goals describe what patients value, yet the content of these goals, and the relationship among goal types, goal accomplishment, and treatment outcomes has received little examination. We used inductive sorting to categorize patient-generated goals made by 147 adults receiving cognitive-behavioral therapy for chronic pain. The resulting goal categories were: Physical Activity (29.0%), Functional Status (24.6%), Wellness (16.3%), Recreational Activities (11.3%), House/Yard Work (9.7%), Socializing (7.1%), and Work/School (2.0%). Next, we examined associations between number of goals by category, goal accomplishment, and clinically meaningful improvements in pain-related interference, pain intensity and depressive symptoms. Improvement in all outcome domains was related to goal accomplishment. Additionally, depressive symptoms were related to number of Physical Activity, House/Yard Work, Recreational Activities, and Wellness goals, whereas improved pain-intensity was significantly related to House/Yard Work. Classifying patient-generated goals facilitates investigation of the relationships among goal type, goal accomplishment and treatment outcomes.
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Acknowledgements
This material is based upon work supported by Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development Center of Innovation (CIN-13-407) and Clinical Science Research and Development Service Merit Grant. Dr. Piette is a VA Senior Career Research Scientist.
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Alicia A. Heapy, Laura Wandner, Mary A. Driscoll, Kathryn LaChappelle, Rebecca Czlapinski, Brenda T. Fenton, John D. Piette, James E. Aikens, Mary R. Janevic, and Robert D. Kerns declare that they have no conflicts of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all patients for being included in the study.
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Heapy, A.A., Wandner, L., Driscoll, M.A. et al. Developing a typology of patient-generated behavioral goals for cognitive behavioral therapy for chronic pain (CBT-CP): classification and predicting outcomes. J Behav Med 41, 174–185 (2018). https://doi.org/10.1007/s10865-017-9885-4
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DOI: https://doi.org/10.1007/s10865-017-9885-4