Predictors and influence of goal orientation on self-management and health-related quality of life after lung transplant

Abstract

Context-Lung transplant recipients are encouraged to perform self-management behaviors to maximize health outcomes; however, performance is often less than ideal. Goal orientation is known to influence achievement of academic goals, but the influence of goal orientation on performance of self-management is unknown. Objectives-To identify characteristics at transplant that are predictive of higher goal orientation and examine relationships between Goal Orientation Index (GOI) subscores (Acting, Planning, Reflecting), self-management behaviors (adhering, self-monitoring, and communicating critical changes), and health-related quality of life (HRQOL) at 1 year after transplant. Design-A descriptive, secondary analysis of data from 33 lung transplant recipients who were assessed at transplant and followed for 1 year as part of a clinical trial. GOI subscores were dichotomized at the median to categorize recipients with high and low goal orientation. Logistic regression was used to identify predictors of higher GOI subscores. Correlations between higher GOI subscores, self-management, and HRQOL were examined. Results-Lung transplant recipients reported relatively high mean GOI subscores (Acting, Planning, and Reflecting) and the 3 subscores were correlated (r=0.31-0.86). Self-care agency was the only significant predictor (P=.04) of higher GOI (Reflecting). Lung transplant recipients with higher Planning and Reflecting subscores were more likely to adhere (r = 0.36 and 0.46, respectively). Recipients with higher GOI subscores reported significantly better mental HRQOL (r = 0.42-0.36). Recipients with higher GOI Planning or Acting subscores reported significantly less anxiety (r = -0.39-0.46) and fewer depressive symptoms (r = -0.40-0.43). Conclusion-Assessing goal orientation may offer a novel approach for promoting adherence and HRQOL after lung transplant.