Goal management intervention for polyarthritis patients with mild depressive symptoms: results from a quasi-experimental study

Abstract

Background: People have to manage a chronic disease most of the time outside of the health-care system; therefore interventions that provide skills to live with the disease in daily life are essential. Purpose of this study was to establish whether an intervention based on goal management is effective in decreasing depressive symptoms and increasing adaptation in patients with polyarthritis. Methods: Eighty-five persons with polyarthritis and mild depressive symptoms participated in the group-based ‘Right on Target’ with measurements at baseline and 6 months follow-up. Participants practice the flexible use of goal management competencies (goal maintenance, goal adjustment, goal disengagement and goal re-engagement). A quasi-experimental design was applied in which the reference group consisted of 151 participants of an observational study. Primary outcome was depression; secondary outcomes anxiety, purpose in life, positive affect and satisfaction with participation. Mediating variables were goal management strategies and arthritis self-efficacy. Linear mixed model procedure was applied to evaluate changes in outcomes. Findings: No improvement was found for depressive symptoms. Positive affect improved in the intervention group mediated by an increase in goal adjustment. No changes were found for the other secondary outcomes, while goal maintenance decreased and self-efficacy for other symptoms increased in the intervention group. Discussion: This study indicates the value of improving the management of personal threatened goals of people with polyarthritis and showed that especially facilitating goal adjustment and downgrading goal tenacity are potentially helpful. The present study provides a small but promising direction towards greater wellbeing for patients with polyarthritis.