基于网络的多发性硬化症生活方式干预后对疾病控制、一致性和自我效能的感知：半结构化访谈的定性分析。
Perceptions of Illness Control, Coherence, and Self-Efficacy Following a Web-Based Lifestyle Program for Multiple Sclerosis: A Qualitative Analysis of Semistructured Interviews.
机构信息
Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia.
Department of Psychiatry, IN STEP Children's Mental Health Research Center, University of California, San Diego, La Jolla, CA, United States.
出版信息
J Med Internet Res. 2024 Nov 29;26:e60240. doi: 10.2196/60240.
BACKGROUND
Evidence suggests that illness perceptions held by people living with multiple sclerosis (MS) impact affective distress and physical health outcomes. In a randomized controlled trial, we developed 2 MS Online Courses-the standard care course and the intervention course (IC). The IC was adapted from an evidence-based lifestyle program. Modifying lifestyle risk factors offers an opportunity to impact illness perceptions. Research on illness perceptions in people living with MS has focused predominately on quantitative methods.
OBJECTIVE
This study aimed to explore the experiences and health outcomes of randomized controlled trial participants, including individuals' perceived changes in attitudes toward MS and their health (ie, illness perceptions).
METHODS
Qualitative responses provided by 38 participants (22 in the IC and 16 in the standard care course) were derived from semistructured interviews 1 month after completing the MS Online Course. The impact of course engagement and lifestyle modification on illness perceptions was explored using inductive thematic analysis.
RESULTS
Themes of changes in illness perceptions were most prominent in the IC arm. Qualitative responses from 22 people living with MS informed the development of three themes: "self-efficacy for disease management," "personal control," and "illness coherence."
CONCLUSIONS
Findings provide novel insights into the formation and modification of illness perceptions. Lifestyle modification may serve as a valuable adjunct to clinician-administered therapies, improving the sense of personal control over MS, illness coherence, and self-efficacy for disease management.
TRIAL REGISTRATION
Australian New Zealand Clinical Trials Registry ACTRN12621001605886; https://tinyurl.com/2vyve9p9.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12883-023-03298-0.
背景
有证据表明，多发性硬化症（MS）患者的疾病认知会影响其情感困扰和身体健康结果。在一项随机对照试验中，我们开发了 2 个多发性硬化症在线课程——标准护理课程和干预课程（IC）。IC 改编自循证生活方式计划。改变生活方式风险因素为影响疾病认知提供了机会。针对多发性硬化症患者疾病认知的研究主要集中在定量方法上。
目的
本研究旨在探讨随机对照试验参与者的经验和健康结果，包括个体对 MS 态度的感知变化及其健康状况（即疾病认知）。
方法
38 名参与者（IC 组 22 名，标准护理课程组 16 名）在完成多发性硬化症在线课程 1 个月后提供了半结构化访谈的定性回复。采用归纳主题分析方法探讨课程参与和生活方式改变对疾病认知的影响。
结果
IC 组的疾病认知变化主题最为突出。22 名多发性硬化症患者的定性回复为三个主题的发展提供了信息：“疾病管理的自我效能”、“个人控制”和“疾病一致性”。
结论
研究结果为疾病认知的形成和改变提供了新的见解。生活方式改变可能是临床医生管理疗法的有价值的辅助手段，可以提高对 MS 的个人控制感、疾病一致性和疾病管理的自我效能感。
试验注册
澳大利亚和新西兰临床试验注册中心 ACTRN12621001605886；https://tinyurl.com/2vyve9p9。
国际注册报告标识符（IRRID）：RR2-10.1186/s12883-023-03298-0。
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