Cancer Control Research5R01CA085464-03
Peterman, Amy H.
GOAL INTERFERENCE AS A CLINICAL OUTCOME MEASURE
APPLICANT?S DESCRIPTION: Despite the proliferation of hundreds of health-related quality of life (HRQL) questionnaires, most do not provide information about individually meaningful problems that are amenable to intervention. Perhaps one reason for this difficulty is that the vast majority of the available assessments do not focus upon personally relevant goals which vary across people and which are differentially affected by illness and treatment. Given significant theoretical and empirical support for the centrality of goal pursuit to well-being, we propose to test a theoretically-derived, patient-rated assessment of illness-and treatment-related interference with progress toward personal goals as a clinical outcome measure. The psychometric properties of the Goal Interference Scale will be rigorously evaluated using both Rasch item response theory and classical test theory methods. Goal interference may be an important mechanism by which physical symptoms affect global perception of HRQL. Demonstration of such a mechanism would provide guidance for interventions that aim to decrease the impact of symptoms on HRQL, even when it is not possible to significantly relieve the symptoms themselves. Therefore, we will also evaluate whether goal interference mediates the relationship between illness- and treatment-related symptoms and global quality of life perceptions. Furthermore, both theory and empirical evidence suggest that people will attempt to respond to goal interference in a variety of ways: goal perseverance, goal shifting, goal disengagement. The psychosocial outcomes of these major goal pursuit categories may be modified by factors such as rate of progress, expectations regarding rate of progress, and goal importance. An understanding of these processes has significant implications for clinical interventions with cancer patients. However, to date, there is little data on even the most basic questions regarding responses to goal interference. Therefore, we will explore both the prevalence and the psychosocial consequences of these goal pursuit categories among cancer patients. These three specific aims will be examined in a longitudinal study of 300 oncology patients (150 early stage and 150 late stage patients). The results from this investigation could facilitate the assessment and treatment of cancer patients whose symptoms are interfering with their ability to make progress toward important goals.