Publication: Fibromiyalji sendromunda dijital destekli davranışsal fiziksel aktivite müdahalesinin etkinliği
Abstract
Amaç: Bu çalışmanın amacı, fibromiyalji (FM) tanılı kadın bireylerin fiziksel aktivite (FA) algılarını ve davranışlarını incelemek ve bu bulgular doğrultusunda geliştirilen dijital destekli davranışsal bir FA müdahalesinin etkinliğini değerlendirmektir. Gereç ve Yöntem: Çalışma, iki aşamalı karma yöntem deseniyle yürütüldü. İlk aşama nitel olarak tasarlandı ve Sosyal Bilişsel Kuram’ın beş bileşenine dayalı olarak FM tanılı 10 kadın ile yarı yapılandırılmış görüşmeler yapıldı. Tematik analiz sonucunda elde edilen sekiz ana tema, müdahale içeriğinin oluşturulmasına katkı sağladı. Nicel olarak tasarlanan ikinci aşamada ise FM tanılı 34 kadın randomize şekilde müdahale (n=17) ve kontrol (n=17) gruplarına atandı. Müdahale grubuna, 8 hafta süren dijital destekli davranışsal FA hasta eğitimi birlikte uygulanırken; kontrol grubuna yalnızca hasta eğitimi verildi. Değerlendirmeler başlangıçta ve 8. hafta sonunda yapıldı. FA düzeyi Uluslararası Fiziksel Aktivite Anketi – Kısa Form ile, adım sayısı pedometre ile ve yaşam kalitesi Fibromiyalji Etki Anketi ile değerlendirildi. İkincil ölçütlerde ise; ağrı Vizüel Analog Skala ile, yorgunluk Yorgunluk Şiddet Ölçeği ile, uyku kalitesi Pittsburgh Uyku Kalitesi İndeksi ile, fonksiyonel kapasite Sandalyede Otur-Kalk Testi ile ve egzersize yönelik bilişsel eğilimler Bilişsel Davranışçı Fiziksel Aktivite Ölçeği ile değerlendirildi. Bulgular: Nitel aşamada, kişiye özel stratejilere duyulan ihtiyaç ve bilişsel/ sosyal etmenlerin FA davranışını etkilediği görüldü. Nicel bulgularda, gruplar arasında yaşam kalitesi, subjektif FA, uyku kalitesi, fonksiyonel kapasite ve bilişsel eğilimlerde müdahale grubu lehine anlamlı fark saptandı (p<0,05) ancak ağrı, yorgunluk ve adım sayısında fark saptanmadı (p>0,05). Sonuç: Bu çalışmanın nitel bulguları, FM tanılı kadın bireylerde FA davranışını şekillendiren sosyal ve bilişsel faktörleri ortaya koyarak müdahalenin içeriğinin yapılandırılmasına temel oluşturmuştur. Nicel sonuçlara göre ise, hasta eğitimine ek olarak uygulanan dijital destekli davranışsal FA müdahalesinin, subjektif FA düzeyi, yaşam kalitesi, uyku kalitesi, fonksiyonel kapasite ve egzersize yönelik bilişsel eğilimleri iyileştirmede etkili olduğunu göstermektedir.
Objective: The study aimed to examine the perceptions and behaviors related to physical activity (PA) in women with fibromyalgia (FM), and to evaluate the effectiveness of a digitally supported behavioral PA intervention developed based on these findings. Materials and Methods: Two-phase mixed methods design was employed. First, a qualitative study based on Social Cognitive Theory involving semi-structured interviews with 10 women diagnosed with FM was conducted. Thematic analysis revealed eight themes, which informed intervention development. The second phase was quantitative, with 34 women with FM randomly assigned to an intervention group (n=17) or control group (n=17). The intervention group received an 8-week digitally supported behavioral PA program with patient education, while the control group received patient education only. Assessments were conducted at baseline and post-intervention (week 8). Primary outcome measures included self-reported PA (International Physical Activity Questionnaire – Short Form), step count measured by pedometer, and quality of life assessed by the Fibromyalgia Impact Questionnaire. Secondary outcomes were pain (Visual Analog Scale), fatigue (Fatigue Severity Scale), sleep quality (Pittsburgh Sleep Quality Index), functional capacity (Sit-to-Stand Test), and cognitive attitudes toward exercise (Cognitive Behavioral Physical Activity Questionnaire). Results: In the qualitative phase, the need for individualized strategies and cognitive/ social factors were found to influence PA behavior. According to the quantitative findings, there was a significant difference between the groups in terms of quality of life, self-reported PA, sleep quality, functional capacity and cognitive attitudes towards exercise in favor of the intervention group (p<0.05), but no difference was found in terms of pain, fatigue and step count (p>0.05). Conclusion: The qualitative findings provided the basis for structuring the intervention by revealing factors shaping PA behavior in women with FM. Quantitative results show that the digitally assisted behavioral PA intervention with patient education improved self-reported PA level, quality of life, sleep quality, functional capacity and cognitive attitudes towards exercise.
Objective: The study aimed to examine the perceptions and behaviors related to physical activity (PA) in women with fibromyalgia (FM), and to evaluate the effectiveness of a digitally supported behavioral PA intervention developed based on these findings. Materials and Methods: Two-phase mixed methods design was employed. First, a qualitative study based on Social Cognitive Theory involving semi-structured interviews with 10 women diagnosed with FM was conducted. Thematic analysis revealed eight themes, which informed intervention development. The second phase was quantitative, with 34 women with FM randomly assigned to an intervention group (n=17) or control group (n=17). The intervention group received an 8-week digitally supported behavioral PA program with patient education, while the control group received patient education only. Assessments were conducted at baseline and post-intervention (week 8). Primary outcome measures included self-reported PA (International Physical Activity Questionnaire – Short Form), step count measured by pedometer, and quality of life assessed by the Fibromyalgia Impact Questionnaire. Secondary outcomes were pain (Visual Analog Scale), fatigue (Fatigue Severity Scale), sleep quality (Pittsburgh Sleep Quality Index), functional capacity (Sit-to-Stand Test), and cognitive attitudes toward exercise (Cognitive Behavioral Physical Activity Questionnaire). Results: In the qualitative phase, the need for individualized strategies and cognitive/ social factors were found to influence PA behavior. According to the quantitative findings, there was a significant difference between the groups in terms of quality of life, self-reported PA, sleep quality, functional capacity and cognitive attitudes towards exercise in favor of the intervention group (p<0.05), but no difference was found in terms of pain, fatigue and step count (p>0.05). Conclusion: The qualitative findings provided the basis for structuring the intervention by revealing factors shaping PA behavior in women with FM. Quantitative results show that the digitally assisted behavioral PA intervention with patient education improved self-reported PA level, quality of life, sleep quality, functional capacity and cognitive attitudes towards exercise.