Living a good life with arthritis: managing personal goals to improve psychological health

This thesis focused on the role that goal-based coping plays for the psychological adaptation of people with arthritis. People with polyarthritis experience elevated levels of distress and lower levels of wellbeing compared with the general population [1-3]. These results have a negative effect on disease symptoms and treatment adherence which influences people’s quality of life [4-6]. Effective use of goal-based coping is considered to increase adaptation to a chronic disease and lead to a higher level of psychological health [7-10]. In this thesis, goal-based coping was studied in its role as a facilitator of adjustment and as a starting point for the support of persons with arthritis. This thesis was divided into two parts to address the following research questions: Part I: What is the relationship between goal management and psychological adaptation to arthritis? Part II: What is the effect of a goal management programme on the psychological health of people with arthritis and mild depressive symptoms? In Part I, the relationship between four goal management strategies and five outcomes of psychological health were explored and a domain-specific measurement instrument for goal management was presented. In Part II, the development and effect of a goal management programme for persons with arthritis and mild depressive symptoms was discussed. Also, key components of the programme from the participants’ perspective and its fidelity were evaluated. In this general discussion, the main findings with regard to the research questions are summarized. Subsequently, the theoretical and methodological considerations of this thesis are explored and finally, recommendations for research and practice are given.