Goal management tendencies predict trajectories of adjustment to lower limb amputation up to 15 months post rehabilitation discharge

Objective: To explore patterns of change in positive affect, general adjustment to lower limb amputation, and self-reported disability from rehabilitation admission to 15 months post-discharge; to examine whether goal pursuit and goal adjustment tendencies predict either initial status or rates of change in these outcomes, controlling for sociodemographic and clinical covariates. Design: Prospective cohort study with four time points (T1 = on admission; T2 = 6 weeks post-discharge; T3 = 6 months post-discharge; T4 = 15 months post-discharge). Setting: Inpatient rehabilitation. Participants: Consecutive sample of 98 persons aged 18 years and over with major lower limb amputation. Interventions: Not applicable. Main Outcome Measures: Positive affect subscale of the Positive and Negative Affect Scales (PANAS); general adjustment subscale of Trinity Amputation and Prosthesis Experience Scales-Revised (TAPES-R); World Health Organisation Disability Assessment Schedule Version 2.0 (WHODAS 2.0). Results: Positive affect decreased from T1 to T4 for the overall sample, while general adjustment increased; self-reported disability scores remained stable over this period. Stronger goal pursuit tendencies were associated with greater positive affect at T1, stronger goal adjustment tendencies were associated with more favourable initial scores on each outcome examined. With regard to rates of change, stronger goal pursuit tendencies buffered against decreases in positive affect and promoted decreases in self-reported disability over time, while stronger goal adjustment tendencies enhanced increases in general adjustment to lower limb amputation. Conclusions: Greater use of goal pursuit and goal adjustment strategies appears to promote more favourable adjustment to lower limb amputation over time across a range of important rehabilitation outcomes