Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA.
Disabil Rehabil. 2021 Nov;43(22):3175-3188. doi: 10.1080/09638288.2020.1731612. Epub 2020 Mar 2.
To examine the possible contributions of capability, opportunity, and motivation for explaining long-term physical activity among people with multiple sclerosis and to report the results of a German survey study.
The questionnaire, which was based on an expert interview study and behavior change theory, was structured and detailed applying the Theoretical Domains Framework. A total of 1027 people with multiple sclerosis provided data on sociodemographics, disease-related characteristics, and a set of constructs possibly related to long-term adherence. Participants were assigned to three groups: not regularly active, currently regularly active, and long-term regularly active. Eta squared was calculated to assess the magnitude of differences between groups using ANOVA.
Moderate or large differences between groups were identified for many domains within capability, opportunity, and motivation. For the following theoretical domains, large differences ( ≥0.140) were observed: Intention, Behavioural Regulation, Beliefs about Capabilities and Goals.
Our results suggest that capability, opportunity, and motivation should be targeted simultaneously when designing future interventions. Inactive people with multiple sclerosis might benefit most from interventions increasing action self-efficacy and intention. Boosting autonomous motivation, goal setting, action planning as well as maintenance and recovery self-efficacy could have a positive effect on long-term adherence.IMPLICATIONS FOR REHABILITATIONThis study applied the COM-B model and Theoretical Domains Framework to identify a set of constructs for explaining long-term physical activity among people with MS.Behaviour change and maintenance interventions for people with MS should include techniques that foster intention, perceived self-efficacy and self-regulatory skills, and promote goal setting and autonomy of motivation for regular physical activity.Although barriers of the physical and social environmental context did not seem to be that important in our sample, scientists should consider addressing them in interventions for inactive and more disabled people with MS.Information about the benefits of physical activity should be regularly provided in MS rehabilitation, while further research should explore the relevance of information provision and knowledge for behaviour change in different groups of people with MS.
探讨能力、机会和动机对解释多发性硬化症患者长期体力活动的可能贡献，并报告德国调查研究的结果。
该问卷基于专家访谈研究和行为改变理论，应用理论领域框架进行构建和详细说明。共有 1027 名多发性硬化症患者提供了社会人口统计学、与疾病相关的特征以及一组可能与长期坚持相关的构念的数据。参与者被分为三组：不经常活动、目前经常活动和长期经常活动。使用方差分析（ANOVA）计算 eta 平方来评估组间差异的大小。
在能力、机会和动机的许多领域都发现了组间存在中等或较大差异。对于以下理论领域，观察到了较大的差异（≥0.140）：意图、行为调节、对能力和目标的信念。
我们的结果表明，在设计未来的干预措施时，应同时针对能力、机会和动机。不活跃的多发性硬化症患者可能从提高行动自我效能感和意图的干预措施中受益最大。提高自主动机、目标设定、行动计划以及维持和恢复自我效能感可能对长期坚持产生积极影响。
本研究应用 COM-B 模型和理论领域框架确定了一组解释多发性硬化症患者长期体力活动的构念。多发性硬化症患者的行为改变和维持干预措施应包括促进意图、感知自我效能感和自我调节技能的技术，并促进定期体力活动的目标设定和动机自主性。尽管在我们的样本中，身体和社会环境背景的障碍似乎并不重要，但科学家们应该考虑在针对不活跃和更残疾的多发性硬化症患者的干预措施中解决这些障碍。在多发性硬化症康复中应定期提供有关体力活动益处的信息，而进一步的研究应探索不同组别的人在信息提供和知识方面对行为改变的相关性多发性硬化症患者。
