title: Goal adjustment influence on psychological well-being following advanced breast cancer diagnosis.
abstract: OBJECTIVE
  A diagnosis of advanced breast cancer (ABC) challenges a woman's ambitions. This longitudinal study explored (1) if goal adjustment disposition influenced psychological adjustment patterns among women with ABC and (2) if dispositional hope and optimism moderate effects of goal adjustment on psychological adjustment.
  
  
  METHODS
  One hundred ninety three out of 225 women with ABC were assessed while they were awaiting/receiving initial chemotherapy, then again at 6 weeks, 3 months, 6 months, and 12 months post-baseline. Goal disengagement, goal reengagement, optimism, hope, and psychological adjustment (anxiety, depression, and positive affect) were assessed at baseline; psychological adjustment was reassessed at each follow-up. Latent growth curve modeling was used to examine the change of psychological adjustment and test the study objectives.
  
  
  RESULTS
  High goal disengagement, low reengagement, and high optimism were associated with lower initial anxiety, while high goal disengagement and optimism predicted a slower rate of change in anxiety. High goal disengagement, reengagement, and optimism were associated with lower initial depression. High goal reengagement, optimism, and hope were associated with initial positive affect scores, while optimism predicted its rate of change. Optimism moderated the effect of goal disengagement on anxiety and depression, whereas hope moderated the effect of goal reengagement on positive affect.
  
  
  CONCLUSIONS
  Goal disengagement and reengagement are two relatively independent processes influencing psychological well-being. These findings will help clinicians to tailor specific interventions to help women coping with the diagnosis of ABC.
authors.affiliation: Centre for Psycho-Oncology Research and Training, School of Public Health, The University of Hong Kong (HKU), Pokfulam, Hong Kong.
authors.forename: Wendy W T
authors.initials: WW
authors.lastname: Lam
authors.affiliation: Department of Clinical Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Winnie
authors.initials: W
authors.lastname: Yeo
authors.affiliation: Department of Clinical Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Joyce
authors.initials: J
authors.lastname: Suen
authors.affiliation: Department of Clinical Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Wing Ming
authors.initials: WM
authors.lastname: Ho
authors.affiliation: Department of Clinical Oncology, HKU, Pokfulam, Hong Kong.
authors.forename: Janice
authors.initials: J
authors.lastname: Tsang
authors.affiliation: Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: Inda
authors.initials: I
authors.lastname: Soong
authors.affiliation: Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: Tze Kok
authors.initials: TK
authors.lastname: Yau
authors.affiliation: Department of Oncology, Princess Margaret Hospital, Toronto, Canada.
authors.forename: Ka Yan
authors.initials: KY
authors.lastname: Wong
authors.affiliation: Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong.
authors.forename: Wing Kin
authors.initials: WK
authors.lastname: Sze
authors.affiliation: Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong.
authors.forename: Alice W Y
authors.initials: AW
authors.lastname: Ng
authors.affiliation: Department of Surgery, HKU, Pokfulam, Hong Kong.
authors.forename: Ava
authors.initials: A
authors.lastname: Kwong
authors.affiliation: Department of Surgery, HKU, Pokfulam, Hong Kong.
authors.forename: Dacita
authors.initials: D
authors.lastname: Suen
authors.affiliation: School of Nursing, HKU, Pokfulam, Hong Kong.
authors.forename: Daniel
authors.initials: D
authors.lastname: Fong
authors.affiliation: Department of Applied Social Studies, City University of Hong Kong, Kowloon Tong, Hong Kong.
authors.forename: Samuel
authors.initials: S
authors.lastname: Ho
authors.affiliation: Centre for Psycho-Oncology Research and Training, School of Public Health, The University of Hong Kong (HKU), Pokfulam, Hong Kong.
authors.forename: Richard
authors.initials: R
authors.lastname: Fielding
mesh_terms: D000223:Adaptation, Psychological; D000339:Affect; D000368:Aged; D001007:Anxiety / Q000523:psychology; D001943:Breast Neoplasms / Q000473:pathology* / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D065026:Hope; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009367:Neoplasm Staging; D000067656:Optimism / Q000523:psychology; D010551:Personality