The 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.
Arch Phys Med Rehabil 2024:S0003-9993(24)01006-2. [PMID:
38782232 DOI:
10.1016/j.apmr.2024.05.017]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
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 of 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 eight weeks. Participants in the control group (n = 36) received an eight-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, post-intervention, and three-month follow-up. Focus-group interviews were conducted post-intervention.
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 three-month follow-up [Cohen's d = 0.70 (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 impacts on physical and psychosocial well-being indicate its value to address major health challenges of community-dwelling SCI survivors.
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