Motivational and Volitional Variables Associated With Stages of Change for Exercise in Multiple Sclerosis

Abstract

The main objective of this study was to determine whether motivational and volitional variables identified in the health action process approach (HAPA) model can be used to successfully differentiate people with multiple sclerosis (MS) in different stages of change for exercise and physical activity. Ex-post-facto design using multiple discriminant analysis was used. Participants were 215 individuals with MS. The outcome variable was measured by the Physical Activity Stages of Change Instrument, along with motivational and volitional measures (severity, action self-efficacy, outcome expectancy, risk perception, perceived barriers, intention, maintenance self-efficacy, action and coping planning, and recovery self-efficacy). Participants in the precontemplation, contemplation, and action groups can be maximally separated by two significant canonical discriminant functions, volition and motivation. The action group can be differentiated from other groups based on high group mean (centroid) score on the volition function, and the precontemplation group can be differentiated based on low group means on both the motivation and volition functions. The contemplation group can be differentiated based on high centroid score on the motivation function. Research findings of this study support the concept of stage-matching exercise and physical activity intervention. The HAPA framework can be used to design health promotion behavioral interventions for people with MS in vocational rehabilitation.

Positive thinking and physical activity motivation for one individual with multiple sclerosis: A qualitative case-study

“…He scored very highly on self-efficacy and was in the maintenance stage both for regular PA and choosing to think positively. In combination, these findings are consistent with research by Chiu et al (2012), showing individuals with MS in a more advanced stage of change for PA had higher levels of self-efficacy. Norman's case also shows that high self-efficacy may present itself in a maintenance stage of change for PA, as well as the action stage examined by Chiu et al (2012).…”

“…In combination, these findings are consistent with research by Chiu et al (2012), showing individuals with MS in a more advanced stage of change for PA had higher levels of self-efficacy. Norman's case also shows that high self-efficacy may present itself in a maintenance stage of change for PA, as well as the action stage examined by Chiu et al (2012). Physiotherapists may consider assessing self-efficacy for both PA and wider contexts, using tools such as the MSSS.…”

‘The positive feel’: Unpacking the role of positive thinking in people with multiple sclerosis’s thinking aloud about staying physically active

“…A corollary of this theory is that an individual's stage of change is an important reflection of their readiness to exercise when they have MS, as per the transtheoretical model (Prochaska, 1979). Chiu et al (2012) found that people with MS in the action stage of change for PA have higher selfefficacy and outcome expectancy than those in a contemplative or pre-contemplative stage, but the role of positive thinking was not examined in their study. Hence, there is a need to explore whether positive thinking also distinguishes people in the stages of change and whether positive thinking could promote a more active stage of change for PA.…”

Further validation of the Multiple Sclerosis Self-Efficacy Scale

“…In contrast, either the 9-item or 6-item Control subscale was correlated equally strongly with the EXSE and SPS. Social support has been regarded as an important mediator and moderator in the adjustment mechanism of coping with MS [14][15][16][17][18]42,43], but also as a resource to build and maintain selfefficacy [7]. For instance, Bandura postulated four resources to develop an individual's self-efficacy, which are previous mastery experience (e.g.…”