Dean Cassidy, Parks Samantha, Titcomb Tyler J, Arthofer Andrea, Meirick Paul, Grogan Nicole, Ehlinger Mary A, Bisht Babita, Fox Sara Shuger, Daack-Hirsch Sandra, Snetselaar Linda G, Wahls Terry L
Department of Internal Medicine, Carver College of Medicine (CD, SP, TJT, AA, PM, NG, MAE, BB, TLW), University of Iowa, Iowa City, IA, USA.
Department of Epidemiology, College of Public Health (TJT, LGS), University of Iowa, Iowa City, IA, USA.
Int J MS Care. 2022 Sep-Oct;24(5):235-241. doi: 10.7224/1537-2073.2021-051. Epub 2022 May 26.
People with multiple sclerosis (MS) frequently report implementing dietary strategies as part of their personal wellness programs; however, little is known about the perceived themes of healthy behavior change in people with MS.
Semistructured one-on-one interviews were conducted with 20 women with MS enrolled in 2 different restrictive dietary intervention studies and their 18 self-identified support persons consisting of partners and adult children. Interviews were transcribed, coded, categorized, and then grouped into summative themes. The frequency of issues being mentioned as facilitators of or barriers to diet adherence was evaluated to identify possible differences in perceived experiences between women with MS and their support persons during the studies.
Five qualitative themes were identified: (1) personal motivation, (2) diet components, (3) time, (4) support, and (5) resource access. Major facilitators of dietary adherence were positive support from support persons and study staff, access to resources, symptom improvement, and personal motivation. Major barriers included the novelty of the study diet, lack of cooking skills, no change in or worsening of symptoms, lack of diet knowledge, and food preferences and temptations. Symptom severity was more frequently reported as a barrier to study diet adherence among participants with secondary progressive MS.
Methods to enhance personal motivation and ensure positive support from support persons and study staff may improve study diet adherence. Due to the unique challenges faced by people with MS, future studies should tailor interventions to their unique MS cohort to increase diet adherence.
多发性硬化症（MS）患者经常报告称，他们将饮食策略作为个人健康计划的一部分；然而，对于MS患者健康行为改变的认知主题却知之甚少。
对参与两项不同限制性饮食干预研究的20名患有MS的女性及其18名由伴侣和成年子女组成的自我认定的支持人员进行了半结构化一对一访谈。访谈内容被转录、编码、分类，然后归纳为总结性主题。评估被提及作为饮食依从性促进因素或障碍的问题出现频率，以确定在研究期间MS女性患者及其支持人员在感知体验上可能存在的差异。
确定了五个定性主题：（1）个人动机，（2）饮食成分，（3）时间，（4）支持，（5）资源获取。饮食依从性的主要促进因素包括支持人员和研究人员的积极支持、资源获取、症状改善和个人动机。主要障碍包括研究饮食的新奇性、烹饪技能缺乏、症状无变化或恶化、饮食知识缺乏以及食物偏好和诱惑。在继发进展型MS患者中，症状严重程度更常被报告为研究饮食依从性的障碍。
增强个人动机并确保支持人员和研究人员给予积极支持的方法可能会提高研究饮食的依从性。由于MS患者面临独特的挑战，未来的研究应针对其独特的MS群体量身定制干预措施，以提高饮食依从性。
