Effectiveness of Tailored Rehabilitation Education in Improving the Health Literacy and Health Status of Postoperative Patients With Breast Cancer: A Randomized Controlled Trial.

BACKGROUND: The improvement of breast cancer treatment and the extension of survivorship have led to the development of postoperative complications among cancer survivors. Health literacy (HL), defined as patients' capability of using health information to maintain their health status, can enable breast cancer patients to manage postoperative complications. OBJECTIVE: The aims of this study were to develop a tailored rehabilitation education (TRE) program and examine the effectiveness of this program in improving the HL and health status with breast cancer. METHODS: This randomized controlled trial recruited 99 breast cancer patients (49 and 50 in the intervention and control groups, respectively) within 1 week after surgery. Four-week individualized TRE programs were implemented to improve their HL and health status. RESULTS: Our results showed that the TRE program produced significant improvements in HL and health status in the components of the International Classification of Functioning, Disability and Health. However, no significant difference was observed in the activity scores obtained using the Barthel Index between the 2 groups. CONCLUSION: Our finding supports the effectiveness of 1-month TRE in improving HL and all components of the International Classification of Functioning, Disability and Health status, except the activity component among breast cancer in Taiwan. IMPLICATIONS FOR PRACTICE: Clinicians could incorporate the TRE techniques in the rehabilitation sessions according to the healthcare, disease prevention, and health promotion domains to improve the clinical outcomes as well as change their health behaviors and attitudes of patients with breast cancer.

Does a Mobile app improve patients' knowledge of stroke risk factors and health-related quality of life in patients with stroke? A randomized controlled trial.

BACKGROUND: Developing a stroke health-education mobile app (SHEMA) and examining its effectiveness on improvement of knowledge of stroke risk factors and health-related quality of life (HRQOL) in patients with stroke. METHODS: We recruited 76 stroke patients and randomly assigned them to either the SHEMA intervention (n = 38) or usual care where a stroke health-education booklet was provided (n = 38). Knowledge of stroke risk factors and HRQOL were assessed using the stroke-knowledge questionnaire and European Quality of Life-Five Dimensions (EQ-5D) questionnaire, respectively. RESULTS: Sixty-three patients completed a post-test survey (the SHEMA intervention, n = 30; traditional stroke health-education, n = 33). Our trial found that patients' mean knowledge score of stroke risk factors was improved after the SHEMA intervention (Mean difference = 2.83; t = 3.44; p = .002), and patients' knowledge was also improved in the after traditional stroke health-education (Mean difference = 2.79; t = 3.68; p = .001). However, patients after the SHEMA intervention did not have significantly higher changes of the stroke knowledge or HRQOL than those after traditional stroke health-education. CONCLUSIONS: Both the SHEMA intervention and traditional stroke health-education can improve patients' knowledge of stroke risk factors, but the SHEMA was not superior to traditional stroke health-education. TRIAL REGISTRATION: NCT02591511 Verification Date 2015-10-01.

It's the journey, not the destination: How metaphor drives growth after goal attainment.

People pursue goals throughout their lives, and many of these attempts end happily-a goal is achieved. However, what facilitates the continuation of behaviors that are aligned with the completed goal, such as continuing to monitor food intake after completing a diet program? The results of 6 studies involving over 1,600 people across cultures and samples (executives in Africa, dieters in a 7-day food diary program, exercisers in a 14-day walking program, and college students) demonstrated that construing an achieved goal as a journey one has completed (compared with an alternative metaphor of having reached a destination, or a no-metaphor control) led to a greater likelihood of people continuing behaviors aligned with this attained goal. These findings demonstrated how shifting people's focus of a metaphor (i.e., focusing on the journey vs. the destination part of a completed path) can lead to consequentially different perceptions and behaviors. We isolated a mechanism for why people would continue goal-aligned behaviors after attaining their specific goals-enhanced perceptions of personal growth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

And the winner is . . . ? Forecasting the outcome of others' competitive efforts.

People frequently forecast the outcomes of competitive events. Some forecasts are about oneself (e.g., forecasting how one will perform in an athletic competition, school or job application, or professional contest), while many other forecasts are about others (e.g., predicting the outcome of another individual's athletic competition, school or job application, or professional contest). In this research, we examine people's forecasts about others' competitive outcomes, illuminate a systematic bias in these forecasts, and document the source of this bias as well as its downstream consequences. Eight experiments with a total of 3,219 participants in a variety of competitive contexts demonstrate that when observers forecast the outcome that another individual will experience, observers systematically overestimate the probability that this individual will win. This misprediction stems from a previously undocumented lay belief-the belief that other people generally achieve their intentions-that skews observers' hypothesis testing. We find that this lay belief biases observers' forecasts even in contexts in which the other person's intent is unlikely to generate the person's intended outcome, and even when observers are directly incentivized to formulate an accurate forecast. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

When individual goal pursuit turns competitive: How we sabotage and coast.

People working toward individual goals often find themselves surrounded by others who are pursuing similar goals, such as at school, in fitness classes, and through goal-oriented network devices like Fitbit. This research explores when these individual goal pursuits can turn into competitions, why it happens, and the downstream consequences of this pseudocompetition on goal pursuers. We found that people were more likely to treat their goal pursuit as a competition when they were near the end (vs. at the beginning) of their individual goal and, thus, prioritized relative positional gain (i.e., performing better than others sharing similar pursuits) over making objective progress on their own goal, sabotaging others when they had the opportunity to do so (Studies 1-3B). Further, we provided evidence that certainty of goal attainment at a high (vs. low) level of progress drove this shift in focus, leading to such sabotage behaviors (Studies 3A and 3B). Ironically, success in gaining an upper hand against others in these pseudocompetitions led individuals to subsequently reduce their effort in their own pursuits (Studies 1-5). Six experiments captured a variety of competitive behaviors across different goal domains (e.g., selecting games that diminished others' prospects, selecting difficult questions for fellow students). (PsycINFO Database Record (c) 2019 APA, all rights reserved).

How winning changes motivation in multiphase competitions.

What drives motivation in multiphase competitions? Adopting a dynamic approach, this research examines how temporary standing-being ahead of (vs. behind) one's opponent-in a multiphase competition shapes subsequent motivation. Six competitions conducted in the lab and in the field demonstrate that the impact of being ahead on contestants' motivation depends on when (i.e., in which phase of the competition) contestants learn they are in the lead. In the early phase, contestants are concerned about whether they can win; being ahead increases motivation by making winning seem more attainable. In the later phase, however, contestants are instead driven by how much additional effort they believe they need to invest; being ahead decreases motivation by reducing contestants' estimate of the remaining effort needed to win. Temporary standing thus has divergent effects on motivation in multiphase competitions, driven by a shift in contestants' main concern from the early to the later phase and thus the meaning they derive from being ahead of their opponent. By leveraging insights gained from approaching individuals' self-regulation as a dynamic process, this research advances understanding of how motivation evolves in a unique interdependent self-regulatory context. (PsycINFO Database Record

All roads lead to Rome: the impact of multiple attainment means on motivation.

Individuals have different concerns before and after they become relatively certain about a goal's attainability; hence, we propose that the presence of alternative means of goal attainment will have a distinctive impact on motivation, depending on their stage of goal pursuit. In the initial stage of goal pursuit, people are concerned about whether the goal is attainable. The presence of multiple attainment means (vs. a single means) makes the goal seem more easily attainable and thus leads to greater motivation. Conversely, when people have made substantial progress on the goal and its attainment is relatively secured, they focus more on how they can race to the end and complete the pursuit. At these times, a single means (vs. multiple means) provides a more straightforward action plan and in turn leads to greater motivation. Two field studies and 3 lab experiments support this theorizing.

So near and yet so far: the mental representation of goal progress.

In the present article, we explore whether people's mental representation of progress level can function as a self-regulation mechanism that helps motivate continued effort in the pursuit. We propose that when individuals have just started pursuing a goal and have accumulated only limited progress, they exaggerate the achieved progress level in their mental representation to signal a higher chance of eventual goal attainment and thus elicit greater effort. In contrast, when people have made substantial progress and are approaching the goal attainment, they downplay the achieved progress in their mental representation to create greater perceived discrepancy, hence eliciting greater effort. Empirical evidence from 4 studies supported the hypothesis.