A questionnaire study to explore the views of people with multiple sclerosis of using smartphone technology for health care purposes.

PURPOSE: Delivering interventions over the lifetime of people with chronic conditions is an international healthcare challenge. The benefits of technology in healthcare have been demonstrated in many health conditions. This study aims to seek the views of People with multiple sclerosis (MS) of the feasibility and perceived acceptability of smartphone use for healthcare purposes. METHODS: Using SurveyMonkey™, respondents answered 21 items about their smartphone use and acceptance of smartphones in healthcare. Descriptive statistics were used to summarize data from closed questions. Content analysis was used for open questions. RESULTS: Most of the self-selected 197 respondents were female (138/197;70.1%), aged 42.78 ± 10.29 years, had relapsing-remitting MS (143/187;76.5%), and mobilized without an aid (154/197;78.17%). Most respondents reported having smartphone access (174/191;91.1%) and owning smartphones (167/192;86.97%). Perceived benefits of smartphones included improved healthcare access (119/190;62.63%) and greater independence (124/190;65.26%). The top three concerns included reduced contact with Healthcare Professionals (66/186;35.48%), data security (60/186;32.26%) and visual impairment (47/184;25.54%). CONCLUSION: These findings suggest that smartphone use is extensive, frequent, and acceptable for healthcare purposes in this self-selected sample. People with MS should be consulted during the design of smartphone-based interventions, as specific concerns were raised. Future studies should explore how this technology may be best used and implemented in practice. Implications for Rehabilitation Smartphones may have the potential to improve the implementation of best practice among people with multiple sclerosis (MS) This study found that smartphone use is widespread among people with MS, the majority of whom would accept using smartphones in healthcare. Some potential issues were raised, and would need to be considered during the development and implementation of smartphone-based interventions. Issues included potential lack of contact with health-care professionals, data security, and visual impairment.

How Beliefs About Bladder Dysfunction Among Health-Care Professionals Influence Clinical Practice Development: Perspectives of Allied Health Professionals, Nurses, and Managers.

BACKGROUND: Bladder dysfunction can affect up to 75% of people with multiple sclerosis (MS) on several important life domains. It is a multifaceted problem that remains underdiagnosed by health-care professionals. The aims of this study were to understand the perceptions of Irish health-care professionals regarding bladder dysfunction and to explore current service provision for people with MS. METHODS: Two focus groups, three dyadic interviews, and one semistructured interview with 14 health-care professionals lasting up to 90 minutes were audio-recorded. Participants included eight physiotherapists, two occupational therapists, three nurses, and one clinical case manager from acute and community settings. RESULTS: Thematic analysis of transcripts yielded two key themes. The first theme involves the underlying beliefs of health-care professionals, their clinical practice, and experiential knowledge in the model of clinical practice development in relation to bladder management. The second theme addresses the pivotal points in this model where change can be implemented to optimize bladder management. The first element of change encompasses the interaction between clinical practice and experiential knowledge of health-care professionals. The second element of change incorporates how acknowledgment of individual beliefs of health-care professionals can further inform clinical practice and experiential knowledge. CONCLUSIONS: These findings suggest that health-care professionals need to be aware of their beliefs in relation to bladder dysfunction. Examining these beliefs may influence how people with MS access health service provision for this disabling symptom. This type of reflexive practice may facilitate changes to existing perceptions and reduce the reluctance to discuss bladder symptoms.

Bladder dysfunction and quality of life for people with multiple sclerosis.

PURPOSE: Bladder dysfunction affects 75% of people with multiple sclerosis (MS). People with MS are reluctant to seek treatment for this distressing symptom. This is the first-known study to explore in depth how bladder dysfunction interferes with quality of life for people with MS. METHODS: Nineteen individual semi-structured interviews were conducted (M = 8, F = 11). Participants had a definite diagnosis of MS, aged between 37 and 64 years and had at least one bladder dysfunction symptom. The audio-recorded interviews lasted up to 90 min and were transcribed verbatim. RESULTS: Thematic analysis within NVivo10 yielded two key themes: (1) Disruptions and loss and (2) ways of knowing. "Disruptions and Loss" explores how bladder dysfunction interrupted daily living activities and how this contributed to experiencing loss. "Ways of knowing" portrays the types of knowledge that existed around bladder dysfunction. Participants described using their experiential knowledge to self-manage bladder symptoms without advice from healthcare providers. CONCLUSIONS: Bladder dysfunction imposes major disruptions on daily life. People with MS attempt to self-manage their bladder symptoms, despite current barriers to navigating existing healthcare infrastructure. Understanding these barriers and the individual strategies employed by people with MS are the first steps in facilitating independent management of bladder dysfunction. Implications for Rehabilitation Each individual's experience of bladder dysfunction is unique. Healthcare professionals must be prepared to discuss all disruptions and losses associated with bladder dysfunction for people with MS. People with MS have a vast range of knowledge in relation to their own bladder symptoms and healthcare professionals need to explore their existing self-management strategies during assessment. People with MS and healthcare professionals need to be educated on the wider health implications relating to bladder dysfunction.

The Effect of Community Exercise Interventions for People with MS Who Use Bilateral Support for Gait.

Background. Mobility limitations are a key feature of MS and 25% will require the use of a walking aid 15 years after diagnosis. Few studies have specifically evaluated the effectiveness of physiotherapy and exercise interventions delivered in the community for those with significant disability. Methods. An assessor blind, block randomised, and controlled study recruited participants who required bilateral assistance for gait and who occasionally used wheelchairs for longer distances. They were randomised to 10 weeks of group physiotherapy (balance and strengthening exercises), individual physiotherapy, yoga group, or a control group. Results. Repeated measures ANOVA found significant time effects for physical component of MSIS-29v2 (f = 7.993, P = 0.006) and MFIS (f = 8.695, P = 0.004). The group × time interaction was significant for the BBS (f = 4.391, P = 0.006). Post hoc analysis revealed no difference between group and individual physiotherapy for BBS. There was no significant difference between groups but the 6MWT improved for individual physiotherapy (P = 0.001) and MSIS-29v2 psychological score for group physiotherapy (P = 0.005). Discussion. This study found that balance and strengthening exercises, delivered in the community to those with significant mobility limitations, improve balance. The effect on walking endurance and patient-reported outcomes are unclear and warrants further investigation with a larger control group with similar baseline characteristics to the intervention groups.