为患有多种长期疾病的人共同设计和开发个性化的基于运动的康复和自我管理计划:PERFORM干预。

IF 3
Journal of multimorbidity and comorbidity Pub Date : 2025-09-18 eCollection Date: 2025-01-01 DOI:10.1177/26335565251367326
Paulina Daw, Colin J Greaves, Nikki Gardiner, Patrick Doherty, Thomas M Withers, Amy C Barradell, Paul O'Halloran, Zahira Ahmed, Shaun Barber, Gwen Barwell, Sophie E Brown, Sarah Dean, Carlos Echevarria, Rachael A Evans, Tracy Ibbotson, Bhautesh D Jani, Kate Jolly, James R Manifield, Frances S Mair, Emma McIntosh, Daniel Miller, Paula Ormandy, Susan M Smith, Sharon A Simpson, Ghazala Waheed, Rod S Taylor, Sally J Singh, On Behalf Of The Perform Research Team
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引用次数: 0

摘要

背景:运动和自我管理支持可能是临床上有效和经济的治疗一系列个体长期疾病(LTCs)的方法,因为它们激活了多种有益的生理和心理机制。我们的目标是开发一种复杂的干预措施,为多发性LTCs患者提供锻炼和自我管理支持。方法:采用以人为本的干预措施开发方法,我们与MLTCs患者、家人和朋友进行了10次共同开发研讨会;医疗服务提供者;服务专员和政策制定者。讲习班反复确定了多语母语者未得到满足的需要,并提供了一种方案理论,概述了改变的理论机制和改变目标行为的干预战略。他们还确定了有效交付和服务提供者培训需求的想法。来自多种长期疾病患者个性化运动康复(PERFORM)可行性研究(在其他地方报道)的混合方法反馈为干预改进提供了信息。结果:不同的利益相关者群体(26名MLTCs/支持者,13名服务提供者,16名慢性病专家和14名服务专员)帮助制定了PERFORM干预措施。这包括16个有监督的锻炼课程和16个“健康与幸福”自我管理支持课程,在医院或社区环境中进行,为期8周,外加4个月和6个月的报到课程。自我管理课程包括保持锻炼/身体活动、健康饮食和管理常见症状(疼痛、疲劳、呼吸困难、压力)。结论:PERFORM干预是一种综合的、循证的、理论驱动的自我管理和基于运动的康复干预,是由MLTCs患者、服务提供者和服务专员共同开发的。PERFORM现已准备好进行临床效果和成本效益评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Co-design and development of a Personalised Exercise-based Rehabilitation and self-management programme FOR people with Multiple long-term conditions: The PERFORM intervention.

Background: Exercise and self-management support may be clinically effective and cost-effective treatments for a range of individual long-term conditions (LTCs), as they activate multiple beneficial physiological and psychological mechanisms. We aimed to develop a complex intervention to deliver exercise and self-management support for people with multiple LTCs (MLTCs).

Methods: Following the Person Based Approach to intervention development, we conducted ten co-development workshops with people with MLTCs, family and friends; healthcare providers; service commissioners and policymakers. The workshops iteratively identified the unmet needs of people with MLTCs and informed a programme theory outlining theoretical mechanisms of change and intervention strategies to change the targeted behaviours. They also identified ideas for efficient delivery and service providers' training needs. Mixed methods feedback from the Personalised Exercise-Rehabilitation FOR people with Multiple long-term conditions (PERFORM) feasibility study (reported elsewhere) informed intervention refinement.

Results: A diverse group of stakeholders (26 people with MLTCs/supporters, 13 service providers, 16 experts in chronic illness and 14 service commissioners) helped to develop the PERFORM intervention. This included 16 supervised exercise sessions and 16 'Health and Wellbeing' self-management support sessions, delivered in hospital or community settings over eight weeks, plus check-in sessions at four and six months. The self-management sessions covered maintenance of exercise/physical activity, healthy eating and managing common symptoms (pain, fatigue, breathlessness, stress).

Conclusion: The PERFORM intervention is a comprehensive, evidence-informed, theoretically driven self-management and exercise-based rehabilitation intervention, co-developed with people with MLTCs, service providers and service commissioners. PERFORM is now ready for evaluation regarding clinical effectiveness and cost-effectiveness.

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