Effect of a Mindfulness and Motivational Interviewing-Oriented Physical-Psychological Integrative Intervention for Community-Dwelling Spinal Cord Injury Survivors: A Mixed-Methods Randomized Controlled Trial

IF 3.7 2区 医学 Q1 REHABILITATION Archives of physical medicine and rehabilitation Pub Date : 2024-09-01 DOI:10.1016/j.apmr.2024.05.017
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Abstract

Objective

To evaluate the feasibility, acceptability, and efficacy of a mindfulness and motivational interviewing-oriented physical-psychological integrated intervention in community-dwelling spinal cord injury (SCI) survivors.

Design

A mixed-methods randomized controlled trial.

Setting

Local organizations for handicapped in Hong Kong.

Participants

Community-dwelling adults with SCI (N=72).

Interventions

Participants in the intervention group (n=36) received video-guided exercise for daily practice and online group psychological (mindfulness and motivational interviewing-oriented) weekly sessions for 8 weeks. Participants in the control group (n=36) received an 8-week online group didactic education on lifestyle discussions and general health suggestions.

Main Outcomes Measures

Primary outcomes included quality of life, physical activity, depression, and chronic pain. Secondary outcomes included exercise self-efficacy and mindfulness. Outcomes were measured at baseline, postintervention, and 3-month follow-up. Focus-group interviews were conducted postintervention.

Results

The recruitment, retention, and adherence rates were 84.7%, 100%, and 98.6%, respectively. The intervention showed significant positive effects on preventing declines in quality of life at 3-month follow-up (Cohen d=0.70, 95% CI=0.22-1.18). Positive trends manifested in physical activity, depression, chronic pain, and exercise self-efficacy. Three qualitative categories were identified: subjective improvements in exercise, physical, and social well-being; perceived changes in mindfulness and mental well-being; and intervention facilitators and barriers.

Conclusions

The mindfulness and motivational interviewing-oriented physical-psychological integrated intervention is feasible and acceptable. The significant prolonged effect in maintaining quality of life and positive effects on physical and psychosocial well-being indicate its value to address major health challenges of community-dwelling SCI survivors.

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以正念和动机访谈为导向的生理-心理综合干预对社区脊髓损伤幸存者的影响:混合方法随机对照试验。
目的评估以正念和动机访谈为导向的生理-心理综合干预对社区脊髓损伤(SCI)幸存者的可行性、可接受性和有效性:设计:混合方法随机对照试验:环境:香港本地残障人士组织:干预:干预组参与者(N=72):干预组:干预组参与者(36 人)接受视频指导的日常练习和每周一次的在线团体心理辅导(正念和动机访谈导向),为期八周。对照组参与者(36 人)接受为期八周的在线小组授课教育,内容包括生活方式讨论和一般健康建议:主要结果包括生活质量、体育锻炼、抑郁和慢性疼痛。次要结果包括运动自我效能感和正念。结果在基线、干预后和三个月随访时进行测量。干预后进行了焦点小组访谈:招募率、保留率和坚持率分别为 84.7%、100% 和 98.6%。在三个月的随访中,干预对防止生活质量下降有明显的积极作用[Cohen's d = 0.70 (0.22, 1.18)]。积极趋势体现在体育锻炼、抑郁、慢性疼痛和运动自我效能方面。研究确定了三个定性类别:运动、身体和社会福利方面的主观改善;正念和心理健康方面的感知变化;以及干预的促进因素和障碍:结论:以正念和动机访谈为导向的生理-心理综合干预是可行和可接受的。结论:以正念和动机访谈为导向的生理-心理综合干预是可行的、可接受的,在维持生活质量方面具有明显的长期效果,对生理和心理健康也有积极影响,这表明其在应对社区居住的 SCI 幸存者的主要健康挑战方面具有价值。
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来源期刊
CiteScore
6.20
自引率
4.70%
发文量
495
审稿时长
38 days
期刊介绍: The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.
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