goal attainment
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Stroke ◽  
2022 ◽  
Vol 53 (Suppl_1) ◽  
Author(s):  
Jane Anderson ◽  
Barbara Kimmel ◽  
Shubhada Sansgiry ◽  
Gina Evans-Hudnall ◽  
Anette Ovalle ◽  
...  

Background and Purpose: Self-management Support (SMS) helps stroke survivors control risk factors to prevent second stroke. Little is known about feasibility and effectiveness of using mobile health technology (MHT) for SMS among underserved stroke survivors. The investigators studied feasibility and effectiveness of using a video teleconference mobile application to deliver a SMS program to underserved, hard to reach stroke survivors. Methods: The Video teleconference Self-management TO Prevent stroke (V-STOP) program was evaluated using longitudinal design with measurements at baseline, immediately post intervention (6 weeks), intermediate (12 weeks), and at study end (18 weeks). Medically underserved stroke survivors with uncontrolled stroke risk factors were included. Feasibility was assessed as time in intervention, telehealth satisfaction, stroke knowledge and SMS effectiveness were measured as psychological (depression, PHQ-8; anxiety, GAD-7), social (community integration questionnaire), and stroke self-management (goal attainment) outcomes. Generalized estimating equations were used with site and time in intervention as covariates. Results: V-STOP was successfully delivered to 106 participants using MHT over 2 years. Mean age was 59.3 (±10.9), majority were white (82.1%), males (54.3%), not living alone (85.9%), married (52.8%), with low annual income (<$25,000) ( 58.5%), and health insurance (59.4%). Program feasibility indicated mean number of V-STOP sessions were 4.6 (±1.8), with 4.4 (±2.0) hours of total time for the intervention. Overall satisfaction at 6 weeks with V-STOP (4.8(±0.5)) and telehealth (4.7(±0.5)) was high. Stroke knowledge was high at 12 weeks (9.6(±0.7)). SMS effectiveness indicated improvement in psychological outcomes at 6, 12, and 18 weeks from baseline; depression (18 weeks - β = 0.64 (CI 0.49-0.84)) and anxiety (18 weeks - β = 0.66 (CI 0.51-0.85)). Community integration improved by 18 weeks - β = 1.08 (CI 1.01-1.16) and stroke self-management also improved long term at 12 and 18 weeks (β = 0.92 (CI 0.84-0.99). Conclusion: MHT is feasible to deliver SMS to underserved stroke survivors. It improves psycho-social and self-management goal setting and goal attainment outcomes.


2022 ◽  
Author(s):  
Thiago Falcão Hora ◽  
Agostinho de Alencar Guerra ◽  
Gerson Otmar Kuhne ◽  
Vinícius de Sousa Alvarenga ◽  
Sabrina Fonseca Oliveira ◽  
...  

Abstract Purpose: Botulinum toxin (BTX) is a neurotoxin produced by the bacterium Clostridium botulinum, in recent decades, BTX has become an important adjunct treatment to neurological or rehabilitative strategies.We aimed to describe the clinical aspects of patients admitted to a rehabilitation hospital who were treated with BTX for spasticity and dystonia. Methods: This was a historical cohort; data was collected from the electronic charts of all outpatients treated with BTX between 2014 and 2016 in the spasticity and movement disorders service of a quaternary, open access, rehabilitation hospital. The inclusion criteria were limb spasticity due to traumatic brain injury (TBI), and stroke; limb tremor; cervical dystonia; and generalized limb dystonia from any cause in addition to pain that limits rehabilitation. We used relatively lower doses than those generally published in the literature. Therapeutic response was determined by the Goal attainment scale (GAS), pain (graded by visual analogue scale ), independence for daily living activities, target joint range of motion (pre- and post-application), and gait analysis (only for walkers patients). Results: A total of 63 patients were enrolled in this study with a mean follow-up of 2 years. There was significant improvement in joint restriction ) with 66.7% of patients reporting improvement in the GAS scale, best improvement occurred with ortheses and limb adjustments. Conclusions: Most patients have improved functionality on the GAS scale after treatment with BTX, which is used as an adjunct therapy in subjects already in rehabilitation programs. The main rehabilitation objectives with the GAS scale were achieved in most patients.


Toxins ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 43
Author(s):  
Christian Wong ◽  
Ian Westphall ◽  
Josephine Sandahl Michelsen

Sixty-seven percent of children with cerebral palsy (CCP) experience pain. Pain is closely interrelated to diminished quality of life. Despite this, pain is an overlooked and undertreated clinical problem. The objective of this study was to examine the analgesic effect of a single lower extremity intramuscular injection of Abobotulinum toxin A/Dysport in CCP. Twenty-five CCP with at least moderate pain (r-FLACC ≥ 4) during passive range of motion were included. Localized pain and pain in everyday living were measured by r-FLACC and the Paediatric Pain Profile (PPP), respectively. Functional improvements were evaluated by the goal attainment scale (SMART GAS). Quality of life was evaluated by either the CPCHILD or the CP-QOL. The subjects were evaluated at baseline before injection, then after 4, 12, and 28 weeks. Twenty-two subjects had a significant mean and maximum localized pain reduction (p < 0.001) at four weeks post-treatment in 96% (21/22). The reduction was maintained at 12 (19/19) and 28 weeks (12/15). Daily pain evaluated by the PPP was significantly reduced and functional SMART GAS goals were significantly achieved from 4 to 28 weeks. Quality of life improved significantly at four weeks (CPCHILD). Significant functional gains and localized and daily pain reduction were seen from 4 to 28 weeks.


2022 ◽  
Author(s):  
Maik Bieleke ◽  
Eve Legrand ◽  
Astrid Mignon ◽  
Peter M Gollwitzer

Forming implementation intentions (i.e., if-then planning) is a powerful self-regulation strategy that enhances goal attainment by facilitating the automatic initiation of goal-directed responses upon encountering critical situations. Yet, little is known about the consequences of forming implementation intentions for goal attainment in situations that were not specified in the if-then plan. In three experiments, we assessed goal attainment in terms of speed and accuracy in an object classification task, focusing on situations that were similar or dissimilar to critical situations and required planned or different responses. The results of Experiments 1 and 3 provide evidence for a facilitation of planned responses in critical and in sufficiently similar situations, enhancing goal attainment when the planned response was required and impairing it otherwise. In Experiment 3, additional unfavorable effects however emerged in situations that were dissimilar to the critical one but required the planned response as well. We discuss theoretical implications as well as potential benefits and pitfalls emerging from these non-planned effects of forming implementation intentions.


2022 ◽  
Vol 15 ◽  
pp. 117863292110664
Author(s):  
Tadesse Jobira ◽  
Habtamu Abuye ◽  
Awol Jemal ◽  
Tadesse Gudeta

Background: Good pharmaceutical inventory control enables health facilities (HFs) to provide complete health care by ensuring the availability of safe, effective, and affordable pharmaceuticals and related supplies of the required quality, inadequate quantity, at the required place and at all times. It boosts patients’ trust in the HFs and motivates working staff. However, it needs well-trained and skilled professionals. The aim of the current study was, therefore, assessing knowledge, practice, and challenges of pharmacy professionals conducting inventory control in selected public health facilities of West Arsi Zone, Oromia regional state for the year 2016 to 2018. Method: A mixed-methods study design was used to assess pharmacy professionals’ knowledge, skills, and challenges in applying inventory management methods. A semi-structured questionnaire was implemented for quantitative, whereas an open-ended question was employed for key informants (KIs) to explore qualitative data. Result: Ninety percent of pharmacy professionals knew about VEN analysis concepts and 70% about ABC analysis. However, none of them had a concept of FSN and XYZ analysis. Among the respondents who knew the concept, 75% had gained knowledge through formal training and 10% of them learned from on-job training. When they asked about the methods of inventory control, 60% responded as they did not hear about it. Of those who said “Yes” on being asked to mention at least 1 method of it, 80% could not able to correctly mention the methods used in inventory control. However, 44%, 62.5%, and 75% of respondents had practiced ABC, VED, and ABC-VED matrix analysis respectively. The challenges that prevented these professionals from practicing pharmaceutical inventory control in their HFs were grouped into price-related, training-related, human resource-related, and managerial-related factors. Conclusion: Inventory control is the heart of the pharmaceutical supply system. Without its healthy action, HFs’ goal attainment will not be viable. Problems of sick pharmaceutical inventory control are directly related to a lack of knowledge and appreciation of it by the concerned bodies. The current finding revealed almost all pharmacy professionals included in the study had little knowledge about how to manage their inventories. Managers’ unwillingness to cooperate and facilitate necessary resources prevented the professionals from doing inventory control.


2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Ai Sumirah Setiawati ◽  
Wagiran Wagiran ◽  
Subyantoro Subyantoro

The objective of the study is to evaluate the learning implementation of the Nihongo Noryoku Shiken N5 course as a new course offered in the 2020 curriculum at the Japanese Language Education Study Program in UNNES. A goal-oriented evaluation model by Tyler was employed in the evaluation process to measure how far the learning goals that have been determined at the beginning of the lecture are achieved. This evaluative research relied on a quantitative descriptive approach; its steps comprised (1) data collection, (2) data processing and analysis, and (3) recommendation formulation. According to the evaluation results, the learning goals of Nihongo Noryoku Shiken N5 had been met, although it was not that significant. Several conditions cause such issues. (1) In the class, some students had good Japanese language skills; they claimed that the lesson was too easy, so their progress was not significant. (2) The evaluation instruments were not valid. (3) Other conditions, e.g., the implementation of online learning and tests, hindered classroom activities and monitoring. Improving the teaching and learning materials and evaluation instruments is recommended. Furthermore, some additions to the curriculum need to be considered, such as adding the credits for the grammar or Bunpo course.


2021 ◽  
Vol 15 (12) ◽  
pp. 3481-3484
Author(s):  
Smitha Sunny Joseph ◽  
Reshmy Ann George ◽  
Reny Jose ◽  
Bindhu Sebastian

Objective: Peripheral Intravenous catheterization is a common clinical procedure that demands a high level of nursing competency. This study intends to assess the effect of nursing care protocol for peripheral intravenous therapy on knowledge and practice of registered nurses and the association between pretest knowledge scores and selected socio-demographic variables using King’s conceptual framework and Goal Attainment Theory. Methodology: One group- pretest-posttest design, was used with self - reports and observation methods to collect knowledge and practice data from 30 registered nurses selected by simple random sampling (lottery method). Structured questionnaire and checklist based on personal, interpersonal, and social system of king’s conceptual system was used to assess the knowledge and practice of registered nurses, respectively. Results: Even though 30% of the nurses had attended previous continuing education on peripheral intravenous therapy, only 3.3% had very good knowledge. There was a significant difference in the knowledge and practice after implementation of the nursing care protocol. The pre-test knowledge scores have association with attendance in previous continuing nursing education. Conclusion: Study findings reveals the advantages of protocol development and improved knowledge and practice of nurses, which in turn obviously increase the health status of the patients and quality index of the hospital. Recommendation: The novice nurses can be educated on the protocol as a hospital policy enhancing the effectiveness of nursing care. Its implication can be evaluated using nursing audit at periodic intervals. Keywords: King’s conceptual framework, Goal Attainment Theory, nursing care protocol, peripheral intravenous therapy, knowledge, and practice.


2021 ◽  
pp. 216770262110566
Author(s):  
Iris Ka-Yi Chat ◽  
Erin E. Dunning ◽  
Corinne P. Bart ◽  
Ann L. Carroll ◽  
Mora M. Grehl ◽  
...  

The reward-hypersensitivity model posits that trait reward hypersensitivity should elicit hyper/hypo-approach motivation following exposure to recent life events that activate (goal striving and goal attainment) or deactivate (goal failure) the reward system, respectively. To test these hypotheses, we had 87 young adults with high trait reward (HRew) sensitivity or moderate trait reward (MRew) sensitivity report frequency of life events via the Life Event Interview. Brain activation was assessed during the functional MRI monetary-incentive-delay task. Greater exposure to goal-striving events was associated with higher nucleus accumbens (NAc) reward anticipation among HRew participants and lower orbitofrontal cortex (OFC) reward anticipation among MRew participants. Greater exposure to goal-failure events was associated with higher NAc and OFC reward anticipation only among HRew participants. This study demonstrated different neural reward anticipation (but not outcome) following reward-relevant events for HRew individuals compared with MRew individuals. Trait reward sensitivity and reward-relevant life events may jointly modulate reward-related brain function, which has implications for understanding psychopathology.


2021 ◽  
Vol 4 (4) ◽  
pp. 940
Author(s):  
Muklis Muklis ◽  
Nora Susilawati

Penelitian ini bertujuan untuk menjelaskan strategi yang dilakukan oleh BPAB untuk mempertahankan eksistensi. Terlihat bahwasanya sumber air bersih BPAB ini telah berdiri dari tahun 2003 yang dibangun secara swadaya dalam bentuk kerjasama oleh mayarakat Nagari Sungai Sariak Lumpo. BPAB telah menjadi aset Nagari Sungai Sarik Lumpo, singga BPAB harus bisa eksis dan berkembang di tengah-tengah masyarakat. Untuk menganalisis permasalahan penelitian ini, penulis menggunakan teori structural fungsional Talcott Parsons. Dalam teori terdapat empat unsur penting untuk melaksanakan sistem agar tetap bertahan, keempat sistem itu iyalah Adaptation (Adaptasi), Goal Attainment (Pencapaian Tujuan), Integration (Penyatuan), Latency (Pemeliharaan Pola). Metode yang digunakan ialah pendekatan kualitatif dengan tipe studi kasus serta teknik pemilihan informan adalah Teknik purposive sampling. Pengumpulan data dilakukan dengan cara observasi, wawancara, dokumentasi denga teknik analisis data interaktif dari Miles dan Huberman. Hasil penelitian mengenai strategi yang digunakan BPAB dalam mempertahankan eksistensi, secara internal: (1). Kekompakan antara pengurus (2). Pengurus menjalankan peranya untuk menjaga kualitas air (3). Pengurus merespon dengan cepat masalah atau keluhan pelanggan. Secara eksternal: (1). Menganggap pelanggan sebagai keluarga.


2021 ◽  
Vol 35 (1) ◽  
pp. 89-91
Author(s):  
Ann E. Fronczek

The COVID-19 pandemic has ushered in a new era for nurses and healthcare. King’s conceptual framework continues to provide a practical theoretical underpinning for nurse-client interactions in virtual care spaces that are now a pervasive part of the interacting systems framework. The author in this article discusses the current applications and future opportunities for applications of King’s work in practice, education, and research.


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