Benefits of wellness interventions for persons with chronic and disabling conditions: A review of the evidence

Abstract

According to current estimates, more than 54 million Americans live with some type of long lasting condition or disability [1]. While these conditions are diverse and some are due to trauma (e.g., spinal cord injury), many are the result of common chronic diseases such as arthritis, heart disease, emphysema, and multiple sclerosis [2]. In an effort to influence the trajectory of functional limitations, disability, and quality of life in persons with chronic disabling conditions, a number of investigators and clinicians have begun to develop and test innovative interventions to promote the health (rather than control the disease or condition) of persons with chronic disabling conditions [3]. Some interventions have focused on a single behavior such as exercise or stress management, while others have taken a more comprehensive "lifestyle" approach [4,5]. As a group, these interventions clearly reflect the philosophical perspective of the International Classification of Functioning, Disability and Health that individuals with chronic and disabling conditions (e.g. multiple sclerosis, spinal cord injury) are fully capable of being healthy and experiencing a good quality of life [6}. The purpose of this study was to review and evaluate existing evidence supporting the use of wellness/health promotion interventions in persons with chronic disabling conditions. Health Promotion within the Context of Chronic Disabling ConditionsIn the U.S. Surgeon General's Call to Action to Improve the Health and Wellness of Persons with Disabilities [7], one of the four broad program statements to be achieved is "Persons with disabilities can promote their own good health by developing and maintaining healthy lifestyles" [7, p2]. Health promotion, activities "motivated by the desire to increase well-being and actualize human potential ' [8, p.7], encompasses a number of self-initiated health behaviors and emphasizes the need to enhance each person's responsibility and commitment to a healthy lifestyle. A variety of health promoting behaviors such as physical activity, stress © 2009 Elsevier Inc. All rights reserved. ** Corresponding Author: Alexa Stuifbergen, The University of Texas at Austin, School of Nursing, 1700 Red River, Austin, TX 78701-1499, Phone: 512-232-4764, Fax: 512-475-8755, astuifbergen@mail.utexas.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. It is important to differentiate conceptually between health promotion/wellness interventions and the disease and symptom management interventions for persons with varied chronic conditions commonly described in the literature. Pen...

Physical activity and depression in middle and older-aged adults with multiple sclerosis

“…This is an important finding, as moderate activity would likely be less challenging than vigorous activity in individuals with MS who may find the regular performance of vigorous physical activity difficult. Research is needed to replicate the current findings in other samples of individuals with MS, and in particular to systematically examine the causal influences of both moderate and vigorous physical activity on depression and other important health outcomes in persons with MS [31,32]. Such research will provide clinicians with an important empirical foundation for making clear recommendations to their patients with MS.…”

Self-efficacy and health status improve after a wellness program in persons with multiple sclerosis

“…However, not all programs have been evaluated for effectiveness. Those programs that are based on accepted theory can result in improvement in health related behaviors in persons with MS as well as other chronic conditions [1][2][3][4]. Of particular emphasis in these wellness programs is the enhancement of self-efficacy to promote change and improve QOL [10,11].…”

“…Although strides have been made in the use of disease-modifying agents and symptom management, there remains no cure for this chronic disease. As with other chronic diseases, lifestyle and wellness management are increasingly recognized as important components of care for persons with MS as well as other chronic diseases [1][2][3][4]. The overall importance of health and wellness access for people with disabilities is further highlighted by its incorporation as an objective in Healthy People 2020 [5].…”

The effect of a person-centred and strength-based health intervention on recovery among people with chronic illness

“…There is a need for interventions that address the emotional and social aspects of living with chronic illness, taking account of patients' and families' strength and utilizing their resources for health, especially as such interventions are scarce [37,38]. The BKP was introduced in community care because it was designed to promote coping, health and recovery in chronic illness and was applicable across diagnostic categories, ages and gender.…”