OBJECTIVE\nThis study examined the mediating role of personal goal facilitation through work (PGFW), defined as perceptions of the extent to which one's job facilitates the attainment of one's... Show moreOBJECTIVE\nThis study examined the mediating role of personal goal facilitation through work (PGFW), defined as perceptions of the extent to which one's job facilitates the attainment of one's personal goals, in the association between psychosocial job characteristics and psychological distress and job-related well-being.\nMATERIAL AND METHODS\nQuestionnaire data from 217 nurses (84% female, with a mean age of 42.7 years, SD=7.2) were analyzed. Participants completed the following measures: the Leiden Quality of Work Questionnaire for Nurses, Workplace Goal Facilitation Inventory, Maslach Burnout Inventory-Human Services Survey, and Utrecht Work Engagement Scale (short version). A cross-sectional study design was applied. Hierarchical multiple regression analyses were conducted.\nRESULTS\nThe results indicated that unfavorable psychosocial job characteristics (high demands, low control, and low social support) were associated with lower PGFW. Furthermore, personal goal facilitation through work explained significant additional variance (from 2 to 11%) in psychological distress (somatic complaints and emotional exhaustion) and job-related well-being (personal accomplishment, job satisfaction, and work engagement), controlling for demographic indicators and psychosocial job characteristics. Finally, the results provided support for the mediating effects of PGFW between all psychosocial job characteristics and all outcomes, except in the case of depersonalization.\nCONCLUSIONS\nThis study suggests that hindered personal goal facilitation may be a mechanism through which psychosocial job characteristics have a negative impact on employees' well-being.(J Occup Health 2016; 58: 36-46). Show less
Pisanti, R.; Van der Doef, M.; Maes, S.; Meier, L.L.; Lazzari, D.; Violani, C. 2016
The aim of this cross-sectional study was to explore the extent to which gender, epilepsyseverity, and self-regulation concepts (illness perceptions, autonomous treatment regulation, perceived... Show moreThe aim of this cross-sectional study was to explore the extent to which gender, epilepsyseverity, and self-regulation concepts (illness perceptions, autonomous treatment regulation, perceived autonomy support by parents) predict psychological distress and quality of life (QoL) in young patients with epilepsy. Structured interviews were conducted in 100 patients (Mage = 13.9, SD = 2.21, 41% girls), and data were analyzed by means of multiple hierarchical regression analyses. Seizures of most patients (91%) were well controlled by antiepileptics, 3% of the patients had infrequent seizures, and seizures in 6% were pharmacoresistant. At a multivariate level, it appeared that youngsters with epilepsy who expect that their disease will last for a long time, who believe that they have less personal control over their illness, and who expect the illness to have a high emotional impact reported higher levels of distress. In addition, a better QoL was reported by youngsters who believed that treatment did not control their illness and who thought that their epilepsy would not affect them emotionally. Findings indicate the importance of illness perceptions, and it is suggested that they should be targeted in future interventions in youngsters with epilepsy. Show less
The purpose of this study is to evaluate the effects of targeting both the motivation and action phases of behaviour change in a 5-week intervention to increase physical activity (PA) among... Show moreThe purpose of this study is to evaluate the effects of targeting both the motivation and action phases of behaviour change in a 5-week intervention to increase physical activity (PA) among patients with rheumatoid arthritis (RA) not meeting current PA recommendations. In a randomised controlled trial, a control group—which received a group-based patient education session led by a physical therapist—was compared to a treatment group which received the education session plus a motivational interview from a physical therapist and two self-regulation coaching sessions from a rheumatology nurse. Outcomes included leisure-time PA, days per week with at least 30 min of moderate-intensity PA, self-efficacy and autonomous motivation (cognitions which predict PA initiation and maintenance), disease activity, functional status, depressive symptoms and fatigue. Effects were assessed using mixed models repeated measures. Of the 78 patients randomised, 76 and 67 completed the post-treatment and follow-up assessments, respectively. Significant treatment effects were found for leisure-time PA (p = 0.022), active days/week (p = 0.016), self-efficacy (p = 0.008) and autonomous motivation (p = 0.001). At post-treatment and 6-months follow-up, significantly more treated patients than controls met current PA recommendations. No significant effects were found for disease activity, functional status, depressive symptoms or fatigue. Combining motivation- and action-focused intervention approaches improved PA-related cognitions and led to improved uptake and maintenance of leisure-time PA. However, further research is necessary to identify ways of helping patients with RA transition to—and maintain—more intensive forms of PA which are more likely to improve disease activity and functional status. Show less
Objectives: Goal orientation is a mindset towards the achievement of work-related goals, and it has been found to be related to occupational well-being. This study explored to what extent the 4... Show moreObjectives: Goal orientation is a mindset towards the achievement of work-related goals, and it has been found to be related to occupational well-being. This study explored to what extent the 4-dimensional model of goal orientation adds additional variance to the explanation of burnout and work engagement in emergency nurses, after controlling for demographics, job characteristics and organizational variables. Methods: Self-report questionnaires including the Leiden Quality of Work Questionnaire for Nurses, Goal Orientation Questionnaire, Maslach Burnout Inventory and Utrecht Work Engagement Scale were completed by 170 out of 274 emergency nurses from 13 secondary Belgian hospitals (response rate 62%). Hierarchical multiple regression analyses were conducted. Results:Goal orientation explained 14 and 13% of the variance in burnout and work engagement respectively. Job control was predictive of both outcomes. Job demands was a predictor of burnout, and social support predicted work engagement. Reward was related to work engagement. The mastery-approach goal orientation was strongly related to an increase in work engagement and to a decrease in burnout. The performance-avoidance goal orientation was strongly related to a decrease in work engagement and to an increase in burnout. The performance-approach and mastery-avoidance goal orientations were not predictive for the two outcome variables. Conclusions: Goal orientation explains additional variance in burnout and work engagement over and above work characteristics and organizational variables. A mastery-approach goal orientation appears to be beneficial while a performance-avoidance goal orientation is not. Hospital management should therefore invest in personal involvement and growth of ER-nurses and in a rewarding organizational culture. Show less
BackgroundThis study aimed at assessing the effects of a self-regulation-based brief physical activity program for patients suffering from unexplained chronic fatigue, the “4-STEPS to control your... Show moreBackgroundThis study aimed at assessing the effects of a self-regulation-based brief physical activity program for patients suffering from unexplained chronic fatigue, the “4-STEPS to control your fatigue program”.MethodA 12-week randomized controlled trial was conducted. Adult patients meeting the CDC criteria for idiopathic chronic fatigue were randomized to either the control condition (standard care) or the intervention condition (4-STEPS). The 4-STEPS was based on self-regulation principles and consisted of motivational interviewing and self-regulation skills training. All patients were assessed at baseline and post-treatment (12 weeks) for fatigue severity (primary outcome) and impact, physical activity (leisure time physical activity, number of daily steps and personal activity goal progress), health-related quality of life, somatic distress and psychological distress (depression and anxiety).ResultsNinety-one patients (45 intervention and 46 control patients) received the allocated intervention. At post-treatment, statistical analysis revealed a significant difference for subjective experience of fatigue (4.73 points; g = 0.51) in favour of the intervention group. Mixed design ANCOVAs showed a significant effect of the 4-STEPS on fatigue severity, leisure time physical activity, personal activity goal progress and health-related quality of life. No significant effects were found for number of daily steps and somatic and psychological distress.ConclusionThe 4-STEPS program has significant beneficial effects at post-treatment. This brief self-regulation-based intervention looks promising for the management of unexplained chronic fatigue. Show less
Despite the proven health benefits, patients with rheumatoid arthritis (RA) are found to be less physically active than their healthy peers. The aim of this study was to examine to what extent and... Show moreDespite the proven health benefits, patients with rheumatoid arthritis (RA) are found to be less physically active than their healthy peers. The aim of this study was to examine to what extent and how physical activity, defined as any bodily movement resulting in energy expenditure, is currently promoted by health care providers in patients with RA and how they perceive their competencies and educational needs. For this cross-sectional study, Dutch rheumatologists, rheumatology clinical nurse specialists, and expert physical therapists were sent a postal survey including four domains: attitudes towards physical activity in RA, advices given to patients with RA, and perceived competencies and educational needs. A total of 126 rheumatologists (50%), 132 clinical nurse specialists (56%), and 112 physical therapists (53%) returned the questionnaire. More than 90% agreed that physical activity is an important health goal for RA patients and regularly advised their patients to engage in physical activity. Public health recommendations for moderate-intensity physical activity were found attainable in RA patients by 66%, 74%, and 65% and were by used by 19%, 41%, and 49% of them, respectively. On average, respondents rated their competency to promote physical activity as low to medium, and 54%, 85%, and 72% of the respondents expressed a need for additional education regarding this topic. Rheumatologists, nurses, and physical therapists considered regular physical activity to be an important health goal for RA patients. The majority of them commonly gave advice on physical activity but felt not sufficiently competent and indicated a need for additional education. Show less
Knittle, K.P.; Gucht, V. de; Hurkmans, E.J.; Vlieland, T.P.M.V.; Peeters, A.J.; Ronday, H.K.; Maes, S. 2011
OBJECTIVE To examine physical activity and achievement of physical activity goals in relation to self-reported pain and quality of life among patients with rheumatoid arthritis (RA). METHODS At... Show moreOBJECTIVE To examine physical activity and achievement of physical activity goals in relation to self-reported pain and quality of life among patients with rheumatoid arthritis (RA). METHODS At baseline, 271 patients with RA were asked to specify a physical activity goal, and filled in questionnaires assessing physical activity, motivation, and self-efficacy for physical activity, arthritis pain, and quality of life. Six months later, patients indicated to what extent they had achieved their baseline physical activity goal and completed the same set of questionnaires. These data were used to construct multiple mediation models that placed physical activity and physical activity goal achievement as mediators between self-efficacy and motivation on one hand, and arthritis pain and quality of life on the other. RESULTS A total of 106 patients with RA completed both questionnaires. Self-efficacy at baseline predicted subsequent level of physical activity and achievement of physical activity goals. Goal achievement had a direct effect upon quality of life outcomes. Bootstrapping confidence intervals revealed indirect effects of self-efficacy upon arthritis pain and quality of life through goal achievement, but not through physical activity. CONCLUSION Higher levels of self-efficacy for physical activity increase the likelihood that patients will achieve their physical activity goals. Achievement of physical activity goals seems to be related to lower self-reported arthritis pain, and higher levels of quality of life. In practice, clinicians can foster self-efficacy and goal achievement by assisting patients in setting realistic and attainable exercise goals, developing action plans, and by providing feedback on goal progress. Show less
Maes, S.; Gucht, V. de; Hurkmans, E.; Vliet-Vlieland, T. 2010
Objective. A sufficient level of physical activity is important in reducing the impact of disease in rheumatoid arthritis (RA) patients. According to self-determination theory, the achievement and... Show moreObjective. A sufficient level of physical activity is important in reducing the impact of disease in rheumatoid arthritis (RA) patients. According to self-determination theory, the achievement and maintenance of physical activity is related to goal setting and ownership, which can be supported by health professionals. Our objective was to examine the association between physical activity and the extent to which RA patients 1) believe that physical activity is a goal set by themselves (autonomous regulation) or by others (coerced regulation) and 2) feel supported by rheumatologists (autonomy supportiveness). Method. A random selection of 643 RA patients from the outpatient clinics of 3 hospitals were sent a postal survey to assess current physical activity level (Short Questionnaire to Assess Health-Enhancing Physical Activity), regulation style (Treatment Self-Regulation Questionnaire), and the autonomy supportiveness of their rheumatologists (modified Health Care Climate Questionnaire). Results. Of the 271 patients (42%) who returned the questionnaire, 178 (66%) were female, their mean +/- SD age was 62 +/- 14 years, and their mean +/- SD disease duration was 10 +/- 8 years. Younger age, female sex, higher education level, shorter disease duration, lower disease activity, and a more autonomous regulation were univariately associated with more physical activity. Hierarchical multiple regression analyses demonstrated that younger age and a more autonomous regulation were significantly associated with a higher physical activity level (P = 0.000 and 0.050, respectively). Conclusion. Regulation style was a significant determinant of physical activity in RA patients. This finding may contribute to further development of interventions to enhance physical activity in RA patients. Show less
