title: People with cancer use goal adjustment strategies in the first 6 months after diagnosis and tell us how.
abstract: OBJECTIVE
  Theory has offered suggestions on how people may adjust their personal goals after goal disturbance or altered life situations. However, the actual use of these goal adjustment strategies has rarely been studied. This study aimed to investigate whether the goal adjustment strategies identified in the literature are used in the first 6 months following a diagnosis of cancer and whether alternative strategies can be identified.
  
  
  METHODS
  Exploratory design with a qualitative method of data collection.
  
  
  METHODS
  Patients were asked to list their current personal goals within a month after being diagnosed with colorectal cancer. Six months later, they were asked what had happened to each of these goals. For each goal, raters scored whether (1) it was achieved or being pursued as planned, (2) a known strategy was used, or (3) an alternative strategy was used.
  
  
  RESULTS
  Patients with colorectal cancer (n = 130) reported that more than half of their goals had been achieved or were being pursued as planned. The remaining goals (n = 210) required goal adjustment strategies. Patients used five of six known strategies that involved mostly limited adjustment. Additionally, they used combinations of goal adjustment strategies, and two alternative strategies were identified.
  
  
  CONCLUSIONS
  This study found that patients with cancer use goal adjustment strategies, and it provides illustrations on how these strategies are used, thus deepening and extending existing knowledge of and theory on goal adjustment. Future studies should take the newly identified strategies into account as well as the possible use of combinations of strategies.
  What is already known on this subject? The successful pursuit of personal goals is important for maintaining well-being. However, an unexpected and serious illness such as cancer can lead to the need to adjust goals, either because they have become difficult or impossible to attain due to physical hindrance of the illness and/or its treatment, or because other goals have become important due to the confrontation with the fragility of life. Theories have proposed options of how people may deal with their personal goals, but whether these so-called goal adjustment strategies are actually used by cancer patients, and whether there are alternative strategies we need to take into account, is still unclear. What does this study add? This study employs a qualitative method of data collection to study what actually happens to cancer patients' goals during the first 6 months after diagnosis. This study found that almost all goal adjustment strategies from theory are indeed used by cancer patients and that they mostly use strategies which involve only limited adjustment and a continued focus on the original goal. We found that patients with cancer use combinations of strategies and two alternative strategies, thereby complementing and expanding theories on goal adjustment.
authors.affiliation: Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Moniek
authors.initials: M
authors.lastname: Janse
authors.affiliation: Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Adelita V
authors.initials: AV
authors.lastname: Ranchor
authors.affiliation: Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Ans
authors.initials: A
authors.lastname: Smink
authors.affiliation: Department of Medical Psychology, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: Mirjam A G
authors.initials: MA
authors.lastname: Sprangers
authors.affiliation: Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Joke
authors.initials: J
authors.lastname: Fleer
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000523:psychology*; D005260:Female; D006040:Goals; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011795:Surveys and Questionnaires
keywords: adjustment; cancer; goals; oncology; qualitative; strategies