Gunn Hilary, Endacott Ruth, Haas Bernhard, Marsden Jonathan, Freeman Jennifer
a School of Health Professions , Plymouth University , Plymouth , UK.
b School of Nursing and Midwifery , Plymouth University , Plymouth , UK.
Disabil Rehabil. 2018 Dec;40(24):2857-2866. doi: 10.1080/09638288.2017.1362041. Epub 2017 Aug 7.
To utilise stakeholder input to inform the structure, format and approach of a multiple sclerosis (MS) balance, safe mobility and falls management programme.
Using a three-round nominal group technique, participants individually rated their agreement with 20 trigger statements, followed by a facilitated group discussion and re-rating. Three mixed groups included service users (n = 15) and providers (n = 19). Quantitative analysis determined agreement, whilst qualitative responses were analysed thematically.
Median scores for each of the 20 trigger statements did not change significantly over sequential rounds, however, deviations around the medians indicated more agreement amongst participants over time. Key recommendations were: Aims and approach: The programme should be tailored to the needs of people with MS. Falls and participation-based outcomes are equally important. Structure and format: The programme should balance expected burden and anticipated benefit, moving away from models requiring weekly attendance and promoting and supporting self-efficacy. Optimising engagement: Support to maintain engagement and intensity of practice over the long term is essential. Sustainability: Adequate funding is necessary. Staff should have MS specific knowledge and experience.
Participants collaboratively identified critical components of a MS balance, safe mobility and falls management programme. They also highlighted the importance of a collaborative, user-centred, MS-specific approach. Implications for Rehabilitation People with multiple sclerosis need condition-specific interventions focussed on maximising balance and safe mobility and reducing falls. Programme design should support self-efficacy and flexible engagement. Adequate support and funding are seen as essential by both service users and providers.
利用利益相关者的意见，为多发性硬化症（MS）平衡、安全移动及跌倒管理项目的结构、形式和方法提供参考。
采用三轮名义小组技术，参与者先各自对20条触发陈述的认同程度进行评分，随后进行小组讨论并重新评分。三个混合小组包括服务使用者（n = 15）和提供者（n = 19）。定量分析确定认同程度，定性回答则进行主题分析。
20条触发陈述中每条的中位数得分在连续几轮中没有显著变化，然而，中位数周围的偏差表明参与者之间随着时间推移达成了更多共识。关键建议如下：目标与方法：该项目应根据MS患者的需求进行调整。跌倒和基于参与的结果同样重要。结构与形式：该项目应在预期负担和预期收益之间取得平衡，摒弃要求每周出勤的模式，促进并支持自我效能感。优化参与度：长期维持参与度和练习强度的支持至关重要。可持续性：充足的资金是必要的。工作人员应具备MS相关的专业知识和经验。
参与者共同确定了MS平衡、安全移动及跌倒管理项目的关键组成部分。他们还强调了采用协作式、以用户为中心且针对MS病症的方法的重要性。对康复的启示 多发性硬化症患者需要针对特定病症的干预措施，重点在于最大限度地提高平衡能力和安全移动能力并减少跌倒。项目设计应支持自我效能感和灵活参与。服务使用者和提供者都认为充足的支持和资金至关重要。
