Exploring the socio-ecological factors impacting lifestyle management of multiple sclerosis: A scoping review

Sarah Manche; Yasmine Probst

doi:10.1016/j.msard.2023.104958

Exploring the socio-ecological factors impacting lifestyle management of multiple sclerosis: A scoping review

Mult Scler Relat Disord. 2023 Nov:79:104958. doi: 10.1016/j.msard.2023.104958. Epub 2023 Aug 21.

Authors

Sarah Manche¹, Yasmine Probst²

Affiliations

¹ School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
² School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia. Electronic address: yasmine@uow.edu.au.

PMID: 37708822
DOI: 10.1016/j.msard.2023.104958

Abstract

Background: Multiple sclerosis (MS) is a chronic, autoimmune, neurodegenerative disorder affecting over 2.9 million people worldwide. First line care revolves around disease modifying therapy and supporting people living with MS to manage their disease. Early management often sees lifestyle modification as people living with MS try to gain a sense of control. Lifestyle management is an evolving area of care with variable strength of evidence for different lifestyle factors.

Objective: To explore factors that impact on the self-management of MS with a socio-ecological focus.

Methods: A scoping review following the Joanna Briggs Institute guidelines for a systematic search was conducted across six databases with 9241 articles identified and 51 included in the review. The results were analysed in conjunction with the socio-ecological model considering the categories: individual, interpersonal, organisational, community, and public policy.

Results: A map of health behaviour (lifestyle) factors extending across all levels of the socio-ecological model revealed a complex web of pathways to behavioural patterns impacting MS self-management. Factors followed a cascading effect towards either of two key principles: (1) self-identity or (2) accessibility. These principles in-turn impact on an individual's self-efficacy, and hence, effectiveness of MS self-management strategies.

Conclusions: MS care is highly individualised to the personal context and circumstances of the individual, with consideration towards suitable management strategies required. Healthcare professionals must consider these lifestyle influences and coordinate an approach to assisting people living with MS to self-manage their disease in relation to their personal circumstances. Person-centred care addressing both barriers and motivators to health behaviour changes is key to effective MS self-management.

Keywords: Behaviour change; Lifestyle factors; Multiple sclerosis; Scoping review; Self-management; Socio-ecological model.

Publication types

Review

MeSH terms

Humans
Life Style
Multiple Sclerosis* / therapy