Rehabilitation bei Multipler Sklerose in Deutschland – Ergebnisse einer Umfrage

Experiences of persons with multiple sclerosis with rehabilitation-a qualitative interview study

Background

Managing multiple sclerosis (MS) includes different treatment approaches. Rehabilitation is a key strategy in MS for improving functioning, activity and participation. As part of a larger study on overall patient experiences with different treatment approaches, this study aims to give an overview of different patients’ experiences and perspectives on inpatient rehabilitation in MS.

Methods

We conducted problem-centered interviews in 50 persons with MS in Germany, of whom most had relapsing–remitting MS. We used the maximum variation sampling method during recruitment. Data were analyzed thematically.

Results

As a result of the analysis, three major themes were identified: 1) factors contributing to the decision-making concerning rehabilitation, 2) experience with the rehabilitation setting, 3) benefits of rehabilitation treatments. The treating physicians’ attitude had a major impact on the decision to either opt for rehabilitation or not. Setting goals prior to rehabilitation was given a high priority. Exchanging experiences with other persons with MS presented a major benefit from rehabilitation while for some being separated from regular daily life resulted in a more ambiguous attitude ranging from appreciation of escaping daily hassles to substantial behavioral change management.

Conclusion

Patients reported various experiences in the process of decision-making with regard to rehabilitation. Physicians´ advice, goal setting and the selection of the most suitable rehabilitation clinic were considered most relevant.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-08150-8.

Implementation of a patient education program on multiple sclerosis relapse management

OBJECTIVE

To study the implementation of a patient education program on relapses and relapse therapy into routine care.

METHODS

31 health care professionals took part in a one day train-the-trainer program (TTTP) and subsequently 261 persons with MS (pwMS) took part in the education program. Evaluation was carried out in trainers and pwMS.

RESULTS

Participants (health professionals) in the TTTP understood the program's main goals and reported that the TTTP enabled them to successfully perform the program. The majority of participants in the program (pwMS) understood the core messages. Also, they showed increased risk knowledge and increased decision autonomy preferences. Treatment decisions were reported as autonomous or as "informed choice" in 49%, and as "shared decisions" by 45%. Overall, effects were less marked compared to the results of the underlying randomized-controlled trial.

CONCLUSION

PwMS! appreciate evidence-based information about relapse management and view the unbiased presentation of scientific uncertainty as a chance for decision autonomy.

PRACTICE IMPLICATIONS

The implementation study confirms the program's transferability into clinical practice.