Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Psychology & Methods, Jacobs University Bremen gGmbH, Bremen, Germany.
Disabil Rehabil. 2020 Oct;42(21):3059-3071. doi: 10.1080/09638288.2019.1584253. Epub 2019 Mar 23.
To explore the views of experts on facilitators and barriers of long-term physical activity among people with multiple sclerosis living in different European countries. We conducted semi-structured telephone or face to face interviews with twelve multiple sclerosis and physical activity experts (scientists, practitioners, patient representatives) from five European countries. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analysis. We identified 20 themes and categorized them into environmental and personal factors. The most frequently mentioned and intensively discussed themes were environmental factors. The themes were structured according to possible intervention level: organizational, interpersonal and intrapersonal level themes. Themes at the organizational level comprised availability, access and quality of exercise/physical activity options; health system characteristics like services and organization, health professionals and information provision. The interpersonal level comprised social support and peer support. Disease related factors were the most frequently mentioned intrapersonal level theme. In our study, more codes were obtained for environmental factors than for personal factors. The results suggested that environmental factors may need to be addressed in particular to increase long-term physical activity adherence. This study will inform the design of a survey questionnaire assessing possible barriers and facilitators among people with multiple sclerosis. Implications for rehabilitationLong-term physical activity among people with multiple sclerosis is subject to a number of modifiable determinants: personal and environmental factors.Multiple sclerosis exercise experts emphasized the importance of environmental factors on the organizational and interpersonal level.Future physical activity interventions should be guided by a social-ecological perspective.Addressing environmental and personal factors simultaneously to reach optimal long-term outcomes should be considered in future interventions.
探索居住在不同欧洲国家的多发性硬化症患者长期进行身体活动的促进因素和阻碍因素的专家观点。方法：我们对来自五个欧洲国家的 12 名多发性硬化症和身体活动专家（科学家、从业者、患者代表）进行了半结构式电话或面对面访谈。访谈进行了录音，逐字转录，并使用主题分析进行了分析。我们确定了 20 个主题，并将其分类为环境和个人因素。被提及最多且讨论最多的主题是环境因素。这些主题是根据可能的干预水平构建的：组织、人际和个体水平的主题。组织层面的主题包括锻炼/身体活动选择的可用性、可及性和质量；服务和组织、卫生专业人员和信息提供等健康系统特征。人际层面包括社会支持和同伴支持。疾病相关因素是个体层面最常被提及的主题。在我们的研究中，环境因素的代码比个人因素的代码多。结果：研究结果表明，可能需要特别关注环境因素，以提高长期身体活动的依从性。这项研究将为评估多发性硬化症患者中可能存在的障碍和促进因素的问卷调查设计提供信息。结论：多发性硬化症患者的长期身体活动受到许多可改变的决定因素的影响：个人和环境因素。多发性硬化症运动专家强调了组织和人际层面环境因素的重要性。未来的身体活动干预措施应遵循社会生态学观点。在未来的干预措施中，应同时考虑环境和个人因素，以达到最佳的长期效果。
