title: Goal management tendencies predict trajectories of adjustment to lower limb amputation up to 15 months post rehabilitation discharge.
abstract: OBJECTIVE
  To explore patterns of change in positive affect, general adjustment to lower-limb amputation, and self-reported disability from rehabilitation admission to 15 months postdischarge, and to examine whether goal pursuit and goal adjustment tendencies predict either initial status or rates of change in these outcomes, controlling for sociodemographic and clinical covariates.
  
  
  METHODS
  Prospective cohort study with 4 time points (t1: on admission; t2: 6wk postdischarge; t3: 6mo postdischarge; t4: 15mo postdischarge).
  
  
  METHODS
  Inpatient rehabilitation.
  
  
  METHODS
  Consecutive sample (N=98) of persons aged ≥18 years with major lower-limb amputation.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Positive affect subscale of the Positive and Negative Affect Schedule; general adjustment subscale of the Trinity Amputation and Prosthesis Experience Scales-Revised; and World Health Organization Disability Assessment Schedule 2.0.
  
  
  RESULTS
  Positive affect decreased from t1 to t4 for the overall sample, whereas general adjustment increased. Self-reported disability scores remained stable over this period. Stronger goal pursuit tendencies were associated with greater positive affect at t1, and stronger goal adjustment tendencies were associated with more favorable initial scores on each outcome examined. With regard to rates of change, stronger goal pursuit tendencies buffered against decreases in positive affect and promoted decreases in self-reported disability over time, whereas stronger goal adjustment tendencies enhanced increases in general adjustment to lower-limb amputation.
  
  
  CONCLUSIONS
  Greater use of goal pursuit and goal adjustment strategies appears to promote more favorable adjustment to lower-limb amputation over time across a range of important rehabilitation outcomes.
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland; Dublin Psychoprosthetics Group, Dublin, Ireland.
authors.forename: Laura
authors.initials: L
authors.lastname: Coffey
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland; Dublin Psychoprosthetics Group, Dublin, Ireland. Electronic address: pamela.gallagher@dcu.ie.
authors.forename: Pamela
authors.initials: P
authors.lastname: Gallagher
authors.affiliation: Dublin Psychoprosthetics Group, Dublin, Ireland; Department of Psychology, National University of Ireland Maynooth, Maynooth, Co. Kildare, Ireland.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Desmond
authors.affiliation: Department of Rehabilitation Medicine, National Rehabilitation Hospital, Dun Laoghaire, County Dublin, Ireland.
authors.forename: Nicola
authors.initials: N
authors.lastname: Ryall
authors.affiliation: Department of Physical Medicine and Rehabilitation, The Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Wegener
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000523:psychology* / Q000534:rehabilitation; D004185:Disability Evaluation; D005260:Female; D006040:Goals; D006801:Humans; D008137:Longitudinal Studies; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Adaptation, psychological; Amputation; Goals; Longitudinal studies; Rehabilitation