1,721,011 research outputs found
Factors and processes involved in adjustment to multiple sclerosis
No full textMultiple sclerosis (MS) creates numerous ongoing challenges which, for some, result in negative outcomes such as depression, poor quality of life, and impaired functioning. This thesis aimed to investigate the nature of psychological adjustment to MS and elucidate factors that interventions could address in order to promote successful adjustment. A review of the theoretical literature on chronic illness and a systematic review of the empirical MS literature suggested that various theoretical approaches are useful for explaining aspects of adjustment to MS but no single existing theory offered a comprehensive framework. An integrative cognitive behavioural model of adjustment to MS was proposed and elements of this were examined in the empirical chapters.In an initial qualitative study, people with MS (n=30) were interviewed about their experiences of living with the disease. Inductively-derived themes characterised the context and process of adjustment and the resources, actions, thoughts and feelings that have a bearing on it. Findings supported and elaborated on the model, and new insights were used to revise it. The quantitative studies were nested within a trial of interventions for adjustment to MS (n=94). A cross-sectional study using pre-therapy data found that cognitive and behavioural variables explained substantial variance in distress and functional impairment. Unhelpful beliefs and behaviours relating to MS itself (illness perceptions and responses to symptoms) appeared most relevant for explaining functional impairment. Beliefs about the self and about experiencing and sharing emotions were important correlates of distress. In an analysis of change within the treatment trial, reductions in unhelpful cognitions and behaviours mediated the improvements observed within interventions. Cognitive and behavioural variables also moderated the effects of the interventions on outcomes. A final qualitative study (n=30) explored participants‘ experiences of the adjustment interventions. The set of interlinked themes provided insights into the broad range of positive outcomes of interventions, perceived therapeutic processes and factors that appear to promote engagement in interventions in this patient group.Overall, the suggested cognitive behavioural model appears to be a useful means of understanding adjustment. This thesis pinpointed a number of potential cognitions and behaviours which may be important targets for adjustment interventions. Continued research efforts to understand factors that determine a range of adjustment outcomes and to determine what people with MS find helpful and appropriate is necessary for a more complete understanding of successful adjustment to MS and how it can be promote
Cognitive behavioural therapy: what benefits can it offer people with Multiple Sclerosis?
No full textCognitive-behavioral therapy (CBT) originated as a treatment for emotional disorders. However, it is increasingly used to help people with chronic illnesses manage symptoms and improve psychosocial outcomes, such as depression and quality of life. In this article, we focus on uses of CBT in patients with multiple sclerosis, an incurable neurological disease that causes potentially debilitating symptoms and poses numerous challenges to psychological well-being. We examine the rationale for using CBT to deal with distress, symptoms, impairment and disease exacerbation and progression, and discuss examples of existing research on the efficacy and acceptability of these interventions. Finally, we consider areas where CBT could potentially benefit people with multiple sclerosis in the future. Ongoing challenges in this field are discussed. <br/
A review of psychological correlates of adjustment in patients with multiple sclerosis
No full textMultiple Sclerosis (MS) is a chronic neurological disease which poses significant psychological adjustment challenges. The purpose of this systematic review was to identify factors that are related to adjustment in people with MS and may be modifiable through psychological intervention. It aimed to gain an overview of the strength of evidence for relationships between psychological factors and adjustment and identify limitations to existing studies and directions for future research. Seventy two studies met inclusion criteria and were included in the review and a narrative synthesis was conducted. A wide range of psychological factors have been studied in relation to adjustment outcomes. The strongest and most consistent finding was that perceived stress and certain emotion-focussed coping strategies are related to worse adjustment in MS. Uncertainty was fairly robustly associated with worse adjustment. There was also more tentative evidence available for relationships between adjustment outcomes and a range of other factors including social support and interactions with others, cognitive errors and biases, illness and symptom cognitions, control perceptions, positive psychology factors, and health behaviours. Implications for therapeutic interventions are discussed and a preliminary model of adjustment to MS is outlined. In light of the shortcomings of extant studies, suggestions for future research are offered
Emotional distress and well-being among people with motor neurone disease (MND) and their family caregivers: a qualitative interview study
No full textObjective: We aimed to get an in-depth understanding of the emotions experienced by people with motor neurone disease (MND) and their caregivers, and to explore what impacts emotional distress and well-being.Design: Qualitative study using semi-structured interviews with people with MND and caregivers.Setting: Participants were recruited from across the UK and took part in interviews conducted either face to face, by telephone or email to accommodate for varying levels of disability.Participants: 25 people with MND and 10 caregivers took part. Participants were purposively sampled based on their MND diagnosis, symptoms and time since diagnosis.Data analysis: Data were analysed using inductive reflexive thematic analysis.Results: Eight broad themes were generated (20 subthemes). Participants described the emotional distress of losing physical function and having a threatened future because of poor prognosis. Keeping up with constant changes in symptoms and feeling unsupported by the healthcare system added to emotional distress. Finding hope and positivity, exerting some control, being kinder to oneself and experiencing support from others were helpful strategies for emotional well-being.Conclusion: The study provides a broad understanding of what impacts emotional distress and well-being and discusses implications for psychological interventions for people with MND and caregivers. Any communication and support provided for people with MND and their caregivers, needs to pay attention to concepts of hope, control and compassion.<br/
Dataset to support the publication 'Perceptions of people with Parkinson's and their caregivers of falling and falls-related healthcare services- a qualitative study
No full textDataset of interview transcripts to support the journal publication 'Perceptions of people with Parkinson's and their caregivers of falling and falls-related healthcare services- a qualitative study' to be published in PLOS One
This dataset is only available to bone fide researchers please complete the request form attached to request access.</span
Using mixed methods to develop and evaluate an online weight management intervention
No full textPurpose: This article illustrates the use of mixed methods in the development and evaluation of the Positive Online Weight Reduction (POWeR) programme, an e-health intervention designed to support sustainable weight loss. The studies outlined also explore how human support might enhance intervention usage and weight loss. Methods: Mixed methods were used to develop and evaluate POWeR. In the development phase, we drew on both quantitative and qualitative findings to plan and gain feedback on the intervention. Next, a feasibility trial, with nested qualitative study, explored what level of human support might lead to the most sustainable weight loss. Finally, a large community based trial of POWeR, with nested qualitative study, explored whether the addition of brief telephone coaching enhances usage. Results: Findings suggest that POWeR is acceptable and potentially effective. Providing human support enhanced usage in our trials, but was not unproblematic. Interestingly, there were some indications that more basic (brief) human support may produce more sustainable weight loss outcomes than more regular support. Qualitative interviews suggested that more regular support might foster reliance, meaning patients cannot sustain their weight losses when support ends. Qualitative findings in the community trial also suggested explanations for why many people may not take up the opportunity for human support. Conclusions: Integrating findings from both our qualitative and quantitative studies provided far richer insights than would have been gained using only a single method of inquiry. Further research should investigate the optimum delivery of human support needed to maximise sustainable weight loss in online interventions. <br/
Opportunities and challenges for smartphone applications in supporting health behavior change
No full textBackground: There is increasing interest from academics and clinicians in harnessing smartphone applications (apps) as a means of delivering behavioral interventions for health. Despite the growing availability of a range of health-related apps on the market, academic research on the development and evaluation of such apps is in the relatively early stages. A few existing studies have explored the views of various populations on using mobile phones for health-related issues and some studies are beginning to report user feedback on specific apps. However, there remains little in depth research on users’ (and potential users’) experiences and views on a wide range of features and technologies that apps are, or will soon be, capable of. In particular, research on young adults is lacking, which is an unfortunate omission considering that this group comprises of a good number of mobile technology adoptors.Objective: The current study sought to explore young adults’ perspectives on apps related to health behavior change. It sought their experiences and views of features that might support health behavior change and issues that contribute to interest in and willingness to use such apps.Methods: Four focus groups were conducted with 19 students and staff at a University in the United Kingdom. Participants included 13 females and 6 males with a mean age of 23.79 (SD 7.89). The focus group discussions centred on participants’ experiences of using smartphone apps to support a healthy lifestyle, and their interest in and feelings about features and capabilities of such apps. The focus groups were recorded, transcribed, and analyzed using inductive thematic analysis.Results: Study findings suggested that young, currently healthy adults have some interest in apps that attempt to support health-related behavior change. Accuracy and legitimacy, security, effort required, and immediate effects on mood emerged as important influences on app usage. The ability to record and track behavior and goals and the ability to acquire advice and information “on the go” were valued. Context-sensing capabilities and social media features tended to be considered unnecessary and off-putting.Conclusions: This study provided insight into the opportunities and challenges involved in delivering health-related behavioral interventions through smartphone apps. The findings suggested a number of valued features and characteristics that app developers may wish to consider when creating health behavior apps. Findings also highlighted several major challenges that appeared to need further consideration and research to ensure the development of effective and well-accepted behavior change apps
Dataset for the Southampton doctoral thesis 'Developing and evaluating a digital mental health intervention for MND'
No full textThis dataset contains 3 separate datasets of interview transcripts conducted for the PhD thesis 'Development and evaluation of a digital mental health intervention for people with Motor Neurone Disease and their caregivers'</span
Young people’s experiences of viewing the fitspiration social media trend: Qualitative study
No full textBackground: Social media use has become ubiquitous in the lives of many people, especially young adults. A popular recent trend emerging on social media is that of posting and following ‘Fitspirational’ content - material that purports to motivate and showcase healthy lifestyle habits, particularly relating to exercise and diet. There is very limited existing literature on how engaging with this type of content influences people’s psychological and physical heath. Initial studies have focused on concerns over potential negative effects on psychological wellbeing including body image, self-esteem and eating disorders.
Objective: We aimed to address a gap in the literature for exploratory research on this topic from the perspective of users. We used a qualitative approach to explore how people experience viewing Fitspiration on social media including why and how they engage with this material and how they perceive that it affects their thoughts, emotions, behaviour and health.
Methods: We recruited 20 young adults (14 females, 6 males, aged 18-25) who self-declared themselves to be Fitspiration followers to participate in either focus groups or individual interviews. We asked detailed, open-ended questions about their motivations for following Fitspiration, experiences of viewing this content and its perceived impact. We used inductive thematic analysis to derive themes that represented common and salient features of the data set.
Results: Four main themes were developed: 1) A tool with the potential to support healthy living, 2) Unrealistic, untrustworthy content, 3) Negative effects on emotional wellbeing, and 4) Vulnerability and protective factors. Following Fitspirational posts on social media can provide young people with knowledge and motivation that may support healthy lifestyle behaviours. However, a range of harms also appeared to arise from Fitspiration viewing ranging from minor annoyances and frustrations to more meaningful negative effects on psychological & physical health. These negative effects seemed to persist despite individuals acknowledging that the material can be unrealistic, and believing that they are personally equipped to minimise harms to themselves.
Conclusions: This study suggests that Fitspiration on social media can be attractive and compelling for young people but appears to bring about negative as well as positive effects. Future research should aim to confirm the scale and intensity of positive and negative effects and investigate ways of harnessing desirable outcomes and minimising undesirable outcomes
Falls self-management interventions for people with Parkinson’s: a systematic review
No full textFalls are common in Parkinson’s disease (PD). Increased involvement of people with Parkinson’s (PwP) in their care has been associated with enhanced satisfaction. Self-management programmes in other long-term conditions (LTCs) have led to improvements in physical and psychological outcomes. These have been more effective when targeted toward a specific behavior. Objective: this paper aimed to identify and review falls self-management interventions for PwP.Methods: a systematic review was conducted. Electronic databases were searched in June 2018. Primary research studies (any design) reporting the delivery of falls self-management interventions to PwP were included. Data was extracted from each article and synthesised narratively. Results: six articles were identified, relating to five different self-management interventions. All described a self-management intervention delivered alongside physiotherapy. Intervention delivery was through either group discussion (n=3) or falls booklets (n=3). Interventions were often incompletely described; the most common components were information about the condition, training/ rehearsal for psychological strategies and lifestyle advice and support. Arising from the design of articles included the effects of self-management and physiotherapy could not be separated. Three articles measured falls, only one led to a reduction. Four articles measured quality of life, only one led to improvement. No articles assessed skill acquisition or adherence to the self-management intervention. Conclusions: few falls self-management interventions for PwP have been evaluated and reported. The components of an effective intervention remain unclear. Given the benefits of self-management interventions in other LTCs, it is important that falls self-management interventions are developed and evaluated to support PwP. <br/
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