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Yang MC, Singh G, Sakakibara BM. Social Cognitive Predictors of Health Promotion Self-Efficacy Among Older Adults During the COVID-19 Pandemic. Am J Health Promot 2024; 38:1147-1152. [PMID: 38816954 PMCID: PMC11468113 DOI: 10.1177/08901171241256703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
PURPOSE To examine the relative importance of social cognitive predictors (ie, performance accomplishment, vicarious learning, verbal persuasion, affective state) on health promotion self-efficacy among older adults during COVID-19. DESIGN Cross-sectional. SETTING Data collected online from participants in British Columbia (BC), Canada. SUBJECTS Seventy-five adults (n = 75) aged ≥65 years. MEASURES Health promotion self-efficacy was measured using the Self-Rated Abilities for Health Practices Scale. Performance accomplishment was assessed using the health directed behavior subscale of the Health Education Impact Questionnaire; vicarious learning was measured using the positive social interaction subscale of the Medical Outcomes Survey - Social Support Scale (MOS-SSS); verbal persuasion was assessed using the informational support subscale from the MOS-SSS; and affective state was assessed using the depression subscale from the Depression Anxiety Stress Scale (DASS-21). ANALYSIS Multiple linear regression was used to investigate the relative importance of each social cognitive predictor on self-efficacy, after controlling for age. RESULTS Our analyses revealed statistically significant associations between self-efficacy and performance accomplishment (health-directed behavior; β = .20), verbal persuasion (informational support; β = .41), and affective state (depressive symptoms; β = -.44) at P < .05. Vicarious learning (β = -.15) did not significantly predict self-efficacy. The model was statistically significant (P < .001) explaining 43% of the self-efficacy variance. CONCLUSION Performance accomplishment experiences, verbal persuasion strategies, and affective states may be the target of interventions to modify health promotion self-efficacy among older adults, in environments that require physical and social distancing.
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Affiliation(s)
- Michelle C. Yang
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
- Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, BC, Canada
| | - Gurkaran Singh
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Brodie M. Sakakibara
- Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, BC, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
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Salmani S, Mousavi SH, Navardi S, Hosseinzadeh F, Pashaeypoor S. The barriers and facilitators to health-promoting lifestyle behaviors among people with multiple sclerosis during the coronavirus disease 2019 pandemic: a content analysis study. BMC Neurol 2022; 22:490. [PMID: 36536302 PMCID: PMC9761038 DOI: 10.1186/s12883-022-03019-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND AIM Health-promoting lifestyle behaviors (HPLBs) have a significant impact on disease management among people with multiple sclerosis (MS). However, the coronavirus disease 2019 (COVID-19) pandemic has significantly affected lifestyle of all individuals, particularly patients with chronic diseases. The present study aimed to explore the barriers and facilitators to HPLBs among people with MS during the COVID-19 pandemic. METHODS This qualitative study was conducted in Iran. Participants were sixteen people with MS purposively selected from the central MS clinic of a referral specialty neuroscience hospital in Tehran, Iran. Data were collected via in-depth semi-structured face-to-face interviews and concurrently analyzed through conventional content analysis. FINDINGS The mean of participants' age was 37.93 years and most participants were female (81.25%). The major barriers to HPLBs were lack of knowledge, limited access to resources, and poor health status, while the major facilitators were attention to inner abilities and social support. CONCLUSION Many different factors such as lack of knowledge, limited access to resources, poor health status, awareness, and social support can influence engagement in HPLBs among people with MS. Healthcare authorities and policymakers need to use quality educational and supportive interventions to improve knowledge, health literacy, perceived support, self-efficacy, and self-care ability among people with MS during the COVID-19 pandemic.
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Affiliation(s)
- Soheileddin Salmani
- Department of Nursing, Rozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Samira Navardi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hosseinzadeh
- Department of Community Health Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahzad Pashaeypoor
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Community Based Participatory Research Center, Iranian Institute for Reduction of High – Risk Behaviors,, Tehran University of Medical Sciences, Tehran, Iran
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Thompson CM, Pulido MD, Babu S, Zenzola N, Chiu C. Communication between persons with multiple sclerosis and their health care providers: A scoping review. PATIENT EDUCATION AND COUNSELING 2022; 105:3341-3368. [PMID: 35927111 DOI: 10.1016/j.pec.2022.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/30/2022] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study undertakes a scoping review of research about communication between persons with MS and their health care providers. DESIGN PubMed, PsycInfo, Communication Source, Socindex, Sociological Abstracts, Cinahl, and Proquest Dissertations and Theses were used to identify studies since each database's inception. Research team members engaged in study selection, coding for communication issues, and data extraction for descriptive information. RESULTS Of the 419 empirical articles identified, 175 were included. Codes represented all elements of ecological and pathway models, emphasizing emerging technologies for facilitating communication, uncertainty and anxiety for persons with MS, and communication issues surrounding diagnosis, information seeking, and decision making. CONCLUSION This review synthesizes and organizes influences on communication, communication processes, and health outcomes of communication for persons with MS and their providers. Findings extend the ecological model with illness context and the pathway model with communication breakdowns and provider outcomes. PRACTICE IMPLICATIONS Health care providers should consider the complexity of communication when interacting with persons with MS, including the larger context in which it occurs, communication processes and their purposes, and short-term and long-term consequences of interactions. Ecological and pathway models can be frameworks for developing educational materials, as they succinctly capture key communication issues and outcomes.
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Affiliation(s)
- Charee M Thompson
- Department of Communication, University of Illinois, Urbana-Champaign, Urbana, USA.
| | - Manuel D Pulido
- Department of Communication, University of Illinois, Urbana-Champaign, Urbana, USA
| | - Sara Babu
- Department of Communication, University of Illinois, Urbana-Champaign, Urbana, USA
| | - Nicole Zenzola
- Department of Communication, University of Illinois, Urbana-Champaign, Urbana, USA
| | - Chungyi Chiu
- Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, Urbana, USA
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Abstract
Neurogenic bowel dysfunction ranks as one of the most frequent problems experienced by people with multiple sclerosis (MS); it is one of the first symptoms to appear at disease onset and continues throughout the course of the disease. This review, based on literature searches of Medline and PubMed, examines bowel dysfunction causes and cofactors (ie, impaired mobility, fatigue, depression and anxiety, childbirth) that occur over the course of the disease. Coverage includes management of bowel dysfunction with noninvasive methods, including diet and fluid intake, together with pharmacologic treatments for constipation and fecal incontinence as well as more advanced treatments (ie, biofeedback, abdominal massage, transanal irrigation, posterior tibial nerve stimulation), caregiver-provided treatments and extended care facilities. Bowel dysfunction problems and related cofactors impact quality of life throughout the MS disease course, requiring appropriate interventions to improve and/or maintain the quality of life of the individual with MS.
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Affiliation(s)
- Elsie E Gulick
- School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, USA (EEG)
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5
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Wetherill MS, Duncan AR, Bowman H, Collins R, Santa-Pinter N, Jackson M, Lynn CM, Prentice K, Isaacson M. Promoting nutrition equity for individuals with physical challenges: A systematic review of barriers and facilitators to healthy eating. Prev Med 2021; 153:106723. [PMID: 34271075 DOI: 10.1016/j.ypmed.2021.106723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 07/05/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
Impaired mobility is the most common form of functional disability in the US, affecting one out of every sixteen working-age adults. Little is known about the barriers to and facilitators of healthy eating among people with impaired mobility (PWIM), who are at increased risk for diet-related chronic disease. The pathways by which impaired mobility influence dietary intake are unclear, yet likely involve a complex interplay between structural determinants of health and individual factors. To help advance nutrition equity initiatives for PWIM, this systematic review aimed to qualitatively synthesize factors associated with dietary intake across four levels of ecologic influence. An interprofessional team devised a comprehensive search strategy to identify these factors among working-age (18-64 years) PWIM. We queried Ovid MEDLINE, Web of Science, Scopus, and Embase via Ovid for articles published between January 1, 1990 and April 25, 2021. Twelve studies met our review criteria. We classified factors within one of four ecologic levels of influence: individual, social, environmental, and policy/program. Most studies disproportionately reported on personal level factors of influence, with less information on other levels of influence. This systematic review is an important first step for informing the design of evidence-based strategies to support healthy eating among PWIM. However, it also reveals a wide chasm in the needed information to adequately bridge structural determinants of this nutrition divide. More studies are needed that include rigorous measures of dietary intake and that aim to elicit how social, environmental, and policy-level factors contribute to dietary disparities among PWIM.
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Affiliation(s)
- Marianna S Wetherill
- University of Oklahoma Tulsa Schusterman Center, Hudson College of Public Health, Department of Health Promotion Sciences, 4502 E. 41st St., Tulsa, OK 74135, United States of America; University of Oklahoma Tulsa Schusterman Center, OU-TU School of Community Medicine, 4502 E. 41st St., Tulsa, OK 74135, United States of America.
| | - Ashten R Duncan
- University of Oklahoma Tulsa Schusterman Center, OU-TU School of Community Medicine, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Hartley Bowman
- University of Oklahoma Tulsa Schusterman Center, College of Allied Health, Department of Rehabilitation Sciences, Physical Therapy Program, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Reagan Collins
- University of Oklahoma Tulsa Schusterman Center, College of Allied Health, Department of Rehabilitation Sciences, Occupational Therapy Program, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Natalie Santa-Pinter
- University of Oklahoma Tulsa Schusterman Center, OU-TU School of Community Medicine, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Morgan Jackson
- University of Oklahoma Tulsa Schusterman Center, OU-TU School of Community Medicine, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Catherine M Lynn
- University of Oklahoma Tulsa Schusterman Center, OU-TU School of Community Medicine, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Katherine Prentice
- University of Oklahoma Tulsa Schusterman Center, Schusterman Library, 4502 E. 41st St., Tulsa, OK 74135, United States of America
| | - Mary Isaacson
- University of Oklahoma Tulsa Schusterman Center, College of Allied Health, Department of Rehabilitation Sciences, Occupational Therapy Program, 4502 E. 41st St., Tulsa, OK 74135, United States of America
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Saadat S, Hosseininezhad M, Nasiri P, Vahid Harandi S, Entezari M. The Mediating Role of Psychological Capital in The Relationship Between Self-Management and Nutrition Behavior in People with Multiple Sclerosis. CASPIAN JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.29252/cjhr.5.2.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Holmgren M, Sandberg M, Ahlström G. The complexity of reaching and maintaining a healthy body weight - the experience from adults with a mobility disability. BMC OBESITY 2018; 5:33. [PMID: 30524738 PMCID: PMC6276247 DOI: 10.1186/s40608-018-0212-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 08/29/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND People with a disability affecting their mobility are more likely to be overweight or obese than those without a mobility disability. The guidelines on how to prevent and treat overweight/obese adults in the general population have not been adapted to the needs of people with a mobility disability. A reasonable useful first step in the process of adapting such guidelines is to conduct a qualitative study of the perceived needs of these people. AIM The aim was to explore the experienced importance of body weight among adults with a mobility disability and their perceived needs and actions to reach and maintain a healthy weight. METHOD This was an explorative qualitative study based on individual interviews and qualitative content analysis. An inductive analysis of the interviews formed the basis for the establishment of sub-categories, main categories and, finally, a main theme. The twenty participants included in the study have had a mobility disability for more than two years before being recruited. RESULTS The overall theme, "The complex trajectory to a healthy weight", included four main categories. In the category (i) Vicious circle of problems, the participants perceived that everything was harder with the combination of a mobility disability and being overweight/obese with one factor making the other worse. In (ii) Strategies based on decisions and attempts, the participants talked about different ways of attempting to reach or maintain a healthy weight. In (iii) Internal resources, they spoke of awareness and motivation as contributory factors. In (iv) External resources - experienced and required, they spoke about feelings that their weight problems were not given high priority in primary health care. They found it difficult to get advice designed for persons with a mobility disability and felt that competence was lacking among health professionals. The participants asked for a team of professionals with adequate knowledge concerning mobility disabilities. CONCLUSIONS People with a mobility disability combined with being overweight/obese have a complex living situation and health needs. The experiences communicated by participants may facilitate adaption of existing intervention programs or development of a new evidence-based obesity prevention program for primary health care settings.
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Affiliation(s)
- Marianne Holmgren
- Department of Health Sciences, Lund University, P.O. Box 157, 221 00 Lund, SE Sweden
| | - Magnus Sandberg
- Department of Health Sciences, Lund University, P.O. Box 157, 221 00 Lund, SE Sweden
| | - Gerd Ahlström
- Department of Health Sciences, Lund University, P.O. Box 157, 221 00 Lund, SE Sweden
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Sikes EM, Richardson EV, Cederberg KJ, Sasaki JE, Sandroff BM, Motl RW. Use of the Godin leisure-time exercise questionnaire in multiple sclerosis research: a comprehensive narrative review. Disabil Rehabil 2018; 41:1243-1267. [PMID: 29343122 DOI: 10.1080/09638288.2018.1424956] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE The Godin Leisure-Time Exercise Questionnaire has been a commonly applied measure of physical activity in research among persons with multiple sclerosis over the past decade. This paper provides a comprehensive description of its application and inclusion in research on physical activity in multiple sclerosis. METHOD This comprehensive, narrative review included papers that were published between 1985 and 2017, written in English, involved participants with multiple sclerosis as a primary population, measured physical activity, and cited one of the two original Godin papers. RESULTS AND CONCLUSION There is a broad scope of research that has included the Godin Leisure-Time Exercise Questionnaire in persons with multiple sclerosis. Overall, 8 papers evaluated its psychometric properties, 21 evaluated patterns of physical activity, 24 evaluated correlates or determinants of physical activity, 28 evaluated outcomes or consequences of physical activity, and 15 evaluated physical activity interventions. The Godin Leisure-Time Exercise Questionnaire is a valid self-report measure of physical activity in persons with multiple sclerosis, and further is an appropriate, simple, and effective tool for describing patterns of physical activity, examining correlates and outcomes of physical activity, and provides a sensitive outcome for measuring change in physical activity after an intervention. Implications for rehabilitation There is increasing interest in physical activity and its benefits in multiple sclerosis. The study of physical activity requires appropriate and standardized measures. The Godin Leisure-Time Exercise Questionnaire is a common self-report measure of physical activity for persons with multiple sclerosis. Godin Leisure-Time Exercise Questionnaire scores are reliable measures of physical activity in persons with multiple sclerosis. The Godin Leisure-Time Exercise Questionnaire further is an appropriate, simple, and effective tool for describing patterns of physical activity, examining correlates and outcomes of physical activity participation, and is an advantageous primary outcome for measuring change in physical activity in response to an intervention.
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Affiliation(s)
- Elizabeth Morghen Sikes
- a School of Health Professions - Rehabilitation Science , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Emma V Richardson
- b Department of Physical Therapy , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Katie J Cederberg
- a School of Health Professions - Rehabilitation Science , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Jeffer E Sasaki
- b Department of Physical Therapy , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Brian M Sandroff
- b Department of Physical Therapy , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Robert W Motl
- b Department of Physical Therapy , University of Alabama at Birmingham , Birmingham , AL , USA
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Plow M, Moore SM, Sajatovic M, Katzan I. A mixed methods study of multiple health behaviors among individuals with stroke. PeerJ 2017; 5:e3210. [PMID: 28560091 PMCID: PMC5444372 DOI: 10.7717/peerj.3210] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/21/2017] [Indexed: 12/20/2022] Open
Abstract
Background Individuals with stroke often have multiple cardiovascular risk factors that necessitate promoting engagement in multiple health behaviors. However, observational studies of individuals with stroke have typically focused on promoting a single health behavior. Thus, there is a poor understanding of linkages between healthy behaviors and the circumstances in which factors, such as stroke impairments, may influence a single or multiple health behaviors. Methods We conducted a mixed methods convergent parallel study of 25 individuals with stroke to examine the relationships between stroke impairments and physical activity, sleep, and nutrition. Our goal was to gain further insight into possible strategies to promote multiple health behaviors among individuals with stroke. This study focused on physical activity, sleep, and nutrition because of their importance in achieving energy balance, maintaining a healthy weight, and reducing cardiovascular risks. Qualitative and quantitative data were collected concurrently, with the former being prioritized over the latter. Qualitative data was prioritized in order to develop a conceptual model of engagement in multiple health behaviors among individuals with stroke. Qualitative and quantitative data were analyzed independently and then were integrated during the inference stage to develop meta-inferences. The 25 individuals with stroke completed closed-ended questionnaires on healthy behaviors and physical function. They also participated in face-to-face focus groups and one-to-one phone interviews. Results We found statistically significant and moderate correlations between hand function and healthy eating habits (r = 0.45), sleep disturbances and limitations in activities of daily living (r = − 0.55), BMI and limitations in activities of daily living (r = − 0.49), physical activity and limitations in activities of daily living (r = 0.41), mobility impairments and BMI (r = − 0.41), sleep disturbances and physical activity (r = − 0.48), sleep disturbances and BMI (r = 0.48), and physical activity and BMI (r = − 0.45). We identified five qualitative themes: (1) Impairments: reduced autonomy, (2) Environmental forces: caregivers and information, (3) Re-evaluation: priorities and attributions, (4) Resiliency: finding motivation and solutions, and (5) Negative affectivity: stress and self-consciousness. Three meta-inferences and a conceptual model described circumstances in which factors could influence single or multiple health behaviors. Discussion This is the first mixed methods study of individuals with stroke to elaborate on relationships between multiple health behaviors, BMI, and physical function. A conceptual model illustrates addressing sleep disturbances, activity limitations, self-image, and emotions to promote multiple health behaviors. We discuss the relevance of the meta-inferences in designing multiple behavior change interventions for individuals with stroke.
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Affiliation(s)
- Matthew Plow
- School of Nursing, Case Western Reserve University, Cleveland, OH, United States of America
| | - Shirley M Moore
- School of Nursing, Case Western Reserve University, Cleveland, OH, United States of America
| | - Martha Sajatovic
- Department of Psychiatry and of Neurology, Neurological and Behavioral Outcomes Center, Case Western Reserve University, Cleveland, OH, United States of America
| | - Irene Katzan
- Neurological Institute, Center for Outcomes Research and Evaluation, Cleveland Clinic, Cleveland, OH, United States of America
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Meaning of Self in Multiple Sclerosis: Implications for Treatment and Rehabilitation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 958:43-55. [DOI: 10.1007/978-3-319-47861-6_4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Balto JM, Ensari I, Hubbard EA, Khan N, Barnes JL, Motl RW. Individual and Co-occurring SNAP Risk Factors: Smoking, Nutrition, Alcohol Consumption, and Physical Activity in People with Multiple Sclerosis. Int J MS Care 2016; 18:298-304. [PMID: 27999524 DOI: 10.7224/1537-2073.2016-040] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Smoking, poor nutrition, excess alcohol consumption, and insufficient physical activity underlie most preventable causes of morbidity in the general population and may be associated with comorbidities and health outcomes in multiple sclerosis (MS). However, the frequency of co-occurrence of these risk factors in people with MS remains unclear. Methods: Sixty-nine individuals with MS completed self-report measures of smoking status, nutrition, alcohol use, physical activity levels, and sociodemographic and clinical characteristics. The data were analyzed using t tests and χ2 analyses. Results: Poor diet was the most common risk factor, with 85.5% of the sample not meeting dietary guidelines. Of participants with two risk factors, 90.3% were not meeting dietary and physical activity guidelines. Seventy-three percent of women were not meeting physical activity guidelines, compared with 38% of men (χ2 = 7.5, P < .01). There were also differential rates by sex of the most commonly co-occurring risk factors: 65% of women reported the co-occurrence of insufficient physical activity and poor diet, compared with 38% of men (χ2 = 4.2, P = .05). Conclusions: These results indicate that 85.5% of the sample was not meeting nutrition guidelines, 90.3% of participants with two risk factors reported the co-occurrence of poor diet and insufficient levels of physical activity, and physical activity levels and the total number of risk factors varied across sex.
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Goverover Y, Strober L, Chiaravalloti N, DeLuca J. Factors That Moderate Activity Limitation and Participation Restriction in People With Multiple Sclerosis. Am J Occup Ther 2015; 69:6902260020p1-9. [PMID: 26122682 DOI: 10.5014/ajot.2015.014332] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We examined the variables most associated with activity limitation (i.e., cooking) and participation restriction (i.e., employment) in 72 people with multiple sclerosis (MS). Participants underwent a comprehensive neuropsychological test battery assessing memory, executive functions, visual perception, and processing speed and completed questionnaires assessing activity, participation, fatigue, and affective symptoms. Results showed that processing speed was the only variable consistently significantly related to both activity and participation. When examining specific aspects of activity and participation in isolation, employment status was significantly associated with education level, visual memory, fatigue, and processing speed. Cooking ability was associated with performance on tasks of working memory, verbal memory, and processing speed. These findings suggest that processing speed is a primary cognitive factor in MS influencing quality of both activity and participation in everyday life.
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Affiliation(s)
- Yael Goverover
- Yael Goverover, PhD, is Associate Professor, New York University, New York, NY, and Visiting Scientist, Kessler Foundation, West Orange, NJ;
| | - Lauren Strober
- Lauren Strober, PhD, is Senior Research Scientist, Neuropsychology and Neuroscience Laboratory, Kessler Foundation, West Orange, NJ
| | - Nancy Chiaravalloti
- Nancy Chiaravalloti, PhD, is Director, Neuropsychology and Neuroscience Laboratory and Traumatic Brain Injury Laboratory, Kessler Foundation, West Orange, NJ
| | - John DeLuca
- John DeLuca, PhD, is Senior Vice President for Research, Kessler Foundation, West Orange, NJ
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13
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Hughes AJ, Beier M, Hartoonian N, Turner AP, Amtmann D, Ehde DM. Self-efficacy as a longitudinal predictor of perceived cognitive impairment in individuals with multiple sclerosis. Arch Phys Med Rehabil 2015; 96:913-9. [PMID: 25597915 DOI: 10.1016/j.apmr.2015.01.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 01/06/2015] [Accepted: 01/06/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To determine whether self-efficacy longitudinally predicts 2 types of perceived cognitive impairment (PCI) in multiple sclerosis (MS): general cognitive functioning and executive functioning; and secondarily to assess whether self-efficacy mediates the relationships between depression, fatigue, and PCI. DESIGN Longitudinal analysis of self-report survey data collected over 3 years. Hierarchical regression analyses examined the relationship between self-efficacy and PCI, adjusting for depression and fatigue. Additional analyses tested self-efficacy as a mediator between depression, fatigue, and PCI. SETTING Community. PARTICIPANTS Community-dwelling individuals with MS (N=233; age range, 22-83y) were recruited from a larger longitudinal survey study of individuals with MS (N=562). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Primary outcome measures were the Applied Cognition-General Concerns and the Applied Cognition-Executive Function domains of the Quality of Life in Neurological Disorders (NeuroQoL) measures. RESULTS Self-efficacy was significantly correlated with PCI at baseline (r=.40-.53) and 3 years later (r=.36-.44). In multivariate regression analyses, self-efficacy was a significant longitudinal predictor of PCI, both for general cognitive functioning (β=.20, P<.01) and executive functioning (β=.16, P<.05). Self-efficacy partially mediated the relationships between depression, fatigue, and PCI. CONCLUSIONS Self-efficacy may influence how individuals with MS perceive their cognitive functioning over time. Interventions that target self-efficacy, particularly early in the disease course, may lead to improvements in PCI, as well as improvements in fatigue and depression.
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Affiliation(s)
- Abbey J Hughes
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle, WA.
| | - Meghan Beier
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Narineh Hartoonian
- Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | - Aaron P Turner
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | - Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
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Plow MA, Moore S, Husni E, Kirwan JP. A systematic review of behavioural techniques used in nutrition and weight loss interventions among adults with mobility-impairing neurological and musculoskeletal conditions. Obes Rev 2014; 15:945-56. [PMID: 25266576 PMCID: PMC4321818 DOI: 10.1111/obr.12223] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 05/07/2014] [Accepted: 06/13/2014] [Indexed: 01/21/2023]
Abstract
Obesity is a common comorbidity in adults with mobility-impairing neurological and musculoskeletal conditions, such as stroke and arthritis. The interaction between mobility impairments and environmental factors often compromises motivation and ability to engage in healthy behaviours. Such difficulties to engage in healthy behaviours can result in energy imbalance, weight gain and a cycle of functional declines; i.e. obesity can exacerbate mobility impairments and symptoms and increase the likelihood of other comorbid conditions, all of which make it more difficult to engage in healthy behaviours. To help disrupt this cycle, there is a need to identify strategies to optimize energy balance. Thus, this review summarizes clinical trials of nutrition and weight loss interventions in adults with mobility-impairing conditions. Although adults with osteoarthritis were represented in large rigorous clinical trials, adults with neurological conditions were typically represented in studies characterized by a small number of participants, a short-term follow-up and high attrition rates. Studies varied greatly in outcome measures, description and implementation of the interventions, and the strategies used to promote behaviour change. Nutrition and weight loss research in adults with mobility-impairing conditions is still in its formative stages, and there is a substantial need to conduct randomized controlled trials.
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Affiliation(s)
- Matthew A. Plow
- Frances Payne Bolton School of Nursing Case Western Reserve University
| | - Shirley Moore
- Frances Payne Bolton School of Nursing Case Western Reserve University
| | - Elaine Husni
- Department of Rheumatic and Immunologic Diseases, Cleveland Clinic
| | - John P. Kirwan
- Department of Pathobiology, Cleveland Clinic Lerner Research Institute
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Future of management of multiple sclerosis in the middle East: a consensus view from specialists in ten countries. Mult Scler Int 2013; 2013:952321. [PMID: 24455267 PMCID: PMC3877627 DOI: 10.1155/2013/952321] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 10/28/2013] [Accepted: 10/29/2013] [Indexed: 11/18/2022] Open
Abstract
The prevalence of multiple sclerosis (MS) is now considered to be medium-to-high in the Middle East and is rising, particularly among women. While the characteristics of the disease and the response of patients to disease-modifying therapies are generally comparable between the Middle East and other areas, significant barriers to achieving optimal care for MS exist in these developing nations. A group of physicians involved in the management of MS in ten Middle Eastern countries met to consider the future of MS care in the region, using a structured process to reach a consensus. Six key priorities were identified: early diagnosis and management of MS, the provision of multidisciplinary MS centres, patient engagement and better communication with stakeholders, regulatory body education and reimbursement, a commitment to research, and more therapy options with better benefit-to-risk ratios. The experts distilled these priorities into a single vision statement: "Optimization of patient-centred multidisciplinary strategies to improve the quality of life of people with MS." These core principles will contribute to the development of a broader consensus on the future of care for MS in the Middle East.
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