Skip to main content
Top
Published in: BMC Psychiatry 1/2021

Open Access 01-12-2021 | Multiple Sclerosis | Research

Explaining stress coping behaviors in patients with multiple sclerosis based on the PRECEDE model: a qualitative directed content analysis

Authors: Atefeh Homayuni, Zahra Hosseini, Sedigheh Abedini

Published in: BMC Psychiatry | Issue 1/2021

Login to get access

Abstract

Background

Stress can be regarded as one of the consequences of Multiple Sclerosis (MS) and a factor in exacerbating or recurring the symptoms resulting from the disease. This study aimed to explain the stress coping behaviors in patients with MS based on the PRECEDE model.

Methods

This study is a qualitative directed content analysis research based on the PRECEDE model. Data were obtained through in-depth semi-structured interviews with 26 patients with MS, who were selected using a purposive sampling and maximum diversity in terms of gender, age, education, marital status, and employment. Data collection continued until the saturation occurred. Simultaneously, collected data were analyzed using a qualitative directed content analysis method.

Results

Data analysis led to the identification of 11 sub-categories. Of these, 10 sub-categories were assigned to three categories of predisposing factors (awareness, attitude, self-efficacy, and perceived severity), enabling factors (existence of resources, access to resources, skills of using resources, and educational preferences), and reinforcing factors (social support, important others and behavioral consequences). The social comparison category was a new category identified from the analysis of interviews.

Conclusions

Based on the results, individual, environmental and social factors play a role in the stress of these patients. Designing programs that lead to their empowerment and improvements in the environmental and social conditions can be effective in controlling stress in these patients. Based on the results, planners can adopt the most appropriate strategies to change these determinants, help reduce stress, and promote the psychological standard of living in these patients.
Literature
1.
go back to reference Tobore TO. Oxidative/nitroxidative stress and multiple sclerosis. J Mol Neurosci. 2021;71(3):506–14.CrossRef Tobore TO. Oxidative/nitroxidative stress and multiple sclerosis. J Mol Neurosci. 2021;71(3):506–14.CrossRef
2.
go back to reference Huang WJ, Chen WW, Zhang X. Multiple sclerosis: pathology, diagnosis and treatments. Exp Ther Med. 2017;13(6):3163–6.CrossRef Huang WJ, Chen WW, Zhang X. Multiple sclerosis: pathology, diagnosis and treatments. Exp Ther Med. 2017;13(6):3163–6.CrossRef
3.
go back to reference Hunter SF. Overview and diagnosis of multiple sclerosis. Am J Manag Care. 2016;22(6 Suppl):s141–s50.PubMed Hunter SF. Overview and diagnosis of multiple sclerosis. Am J Manag Care. 2016;22(6 Suppl):s141–s50.PubMed
4.
go back to reference Buljevac D, Hop W, Reedeker W, Janssens A, Van der Meche F, Van Doorn P, et al. Self reported stressful life events and exacerbations in multiple sclerosis: prospective study. Bmj. 2003;327(7416):646.CrossRef Buljevac D, Hop W, Reedeker W, Janssens A, Van der Meche F, Van Doorn P, et al. Self reported stressful life events and exacerbations in multiple sclerosis: prospective study. Bmj. 2003;327(7416):646.CrossRef
5.
go back to reference Ackerman KD, Heyman R, Rabin BS, Anderson BP, Houck PR, Frank E, et al. Stressful life events precede exacerbations of multiple sclerosis. Psychosom Med. 2002;64(6):916–20.PubMed Ackerman KD, Heyman R, Rabin BS, Anderson BP, Houck PR, Frank E, et al. Stressful life events precede exacerbations of multiple sclerosis. Psychosom Med. 2002;64(6):916–20.PubMed
6.
go back to reference Mohr DC, Hart SL, Julian L, Cox D, Pelletier D. Association between stressful life events and exacerbation in multiple sclerosis: a meta-analysis. Bmj. 2004;328(7442):731.CrossRef Mohr DC, Hart SL, Julian L, Cox D, Pelletier D. Association between stressful life events and exacerbation in multiple sclerosis: a meta-analysis. Bmj. 2004;328(7442):731.CrossRef
7.
go back to reference Gold SM, Mohr DC, Huitinga I, Flachenecker P, Sternberg EM, Heesen C. The role of stress-response systems for the pathogenesis and progression of MS. Trends Immunol. 2005;26(12):644–52.CrossRef Gold SM, Mohr DC, Huitinga I, Flachenecker P, Sternberg EM, Heesen C. The role of stress-response systems for the pathogenesis and progression of MS. Trends Immunol. 2005;26(12):644–52.CrossRef
8.
go back to reference Malcomson KSDL, Lowe-strong AS. Psychological intervention in people with multiple sclerosis. J Neurol. 2007;254(1):1–13.CrossRef Malcomson KSDL, Lowe-strong AS. Psychological intervention in people with multiple sclerosis. J Neurol. 2007;254(1):1–13.CrossRef
9.
go back to reference Linden W. Stress management: from basic science to better practice. California: Sage Publications; 2004. Linden W. Stress management: from basic science to better practice. California: Sage Publications; 2004.
10.
go back to reference Noar SM. A health educator's guide to theories of health behavior. Int Q Community Health Educ. 2004;24(1):75–92.CrossRef Noar SM. A health educator's guide to theories of health behavior. Int Q Community Health Educ. 2004;24(1):75–92.CrossRef
11.
go back to reference Green LW KM. Health program planning: an educational and ecological approach. 4th ed. New York: McGraw-Hill; 2004. p. 7–23. Green LW KM. Health program planning: an educational and ecological approach. 4th ed. New York: McGraw-Hill; 2004. p. 7–23.
12.
go back to reference Sabzmakan L, Morowatisharifabad MA, Mohammadi E, Mazloomy-Mahmoodabad SS, Rabiei K, Naseri MH, et al. Behavioral determinants of cardiovascular diseases risk factors: a qualitative directed content analysis. ARYA Atheroscler. 2014;10(2):71.PubMedPubMedCentral Sabzmakan L, Morowatisharifabad MA, Mohammadi E, Mazloomy-Mahmoodabad SS, Rabiei K, Naseri MH, et al. Behavioral determinants of cardiovascular diseases risk factors: a qualitative directed content analysis. ARYA Atheroscler. 2014;10(2):71.PubMedPubMedCentral
13.
go back to reference Lesan S, Ghofranipour FA, Faghihzadeh S, Birashk B. Application of the PRECEDE model for increasing coping behaviors against anxiety in Tehrans’ firemen. Payesh (Health Monitor). 2009;8(2):181–90. Lesan S, Ghofranipour FA, Faghihzadeh S, Birashk B. Application of the PRECEDE model for increasing coping behaviors against anxiety in Tehrans’ firemen. Payesh (Health Monitor). 2009;8(2):181–90.
14.
go back to reference Hazavehei S, Sabzmakan L, Hassanzadeh A, Rabiei K. The effect of PRECEDE model-based educational program on depression level in patients with coronary artery bypass grafting. J Inflamm Dis. 2008;12(2):32–40. Hazavehei S, Sabzmakan L, Hassanzadeh A, Rabiei K. The effect of PRECEDE model-based educational program on depression level in patients with coronary artery bypass grafting. J Inflamm Dis. 2008;12(2):32–40.
15.
go back to reference Hazavehei MM, Moghimbeigi A, Hamidi Y. Assessing stress level and stress management among Hamadan hospital nurses based on precede model. Horiz Med Sci. 2012;18(2):78–85. Hazavehei MM, Moghimbeigi A, Hamidi Y. Assessing stress level and stress management among Hamadan hospital nurses based on precede model. Horiz Med Sci. 2012;18(2):78–85.
16.
go back to reference Sharifirad G, Ghaffari M, Zanjani S, Hassanzadeh A. The effect of educational intervention based on PRECEDE model on level of stress among the elderly referred to elderly club of Tehran. Iran J Health Syst Res. 2012;7:596–605. Sharifirad G, Ghaffari M, Zanjani S, Hassanzadeh A. The effect of educational intervention based on PRECEDE model on level of stress among the elderly referred to elderly club of Tehran. Iran J Health Syst Res. 2012;7:596–605.
17.
go back to reference Moeini B, Hazavehei SMM, Hosseini Z, Aghamolaei T, Moghimbeigi A. The impact of cognitive-behavioral stress management training program on job stress in hospital nurses: applying PRECEDE model. JRHS. 2011;11:114.PubMed Moeini B, Hazavehei SMM, Hosseini Z, Aghamolaei T, Moghimbeigi A. The impact of cognitive-behavioral stress management training program on job stress in hospital nurses: applying PRECEDE model. JRHS. 2011;11:114.PubMed
18.
go back to reference Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.CrossRef Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.CrossRef
19.
go back to reference Hosseini Z, Imanzad M, Ghanbarnezhad A, Gharlipour Z. Occupational stress and mental health relationship in nurses. J Shahid Beheshti Sch Nurs Midwifery. 2014;23(82):55–62. Hosseini Z, Imanzad M, Ghanbarnezhad A, Gharlipour Z. Occupational stress and mental health relationship in nurses. J Shahid Beheshti Sch Nurs Midwifery. 2014;23(82):55–62.
20.
go back to reference Kinchen EV, Loerzel V. Nursing students’ attitudes and use of holistic therapies for stress relief. J Holist Nurs. 2019;37(1):6–17.CrossRef Kinchen EV, Loerzel V. Nursing students’ attitudes and use of holistic therapies for stress relief. J Holist Nurs. 2019;37(1):6–17.CrossRef
21.
go back to reference Apolinário-Hagen J, Hennemann S, Fritsche L, Drüge M, Breil B. Determinant factors of public acceptance of stress management apps: survey study. JMIR Ment Health. 2019;6(11):e15373.CrossRef Apolinário-Hagen J, Hennemann S, Fritsche L, Drüge M, Breil B. Determinant factors of public acceptance of stress management apps: survey study. JMIR Ment Health. 2019;6(11):e15373.CrossRef
22.
go back to reference Schwarzer R. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Appl Psychol. 2008;57(1):1–29.CrossRef Schwarzer R. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Appl Psychol. 2008;57(1):1–29.CrossRef
23.
go back to reference Parschau L, Fleig L, Koring M, Lange D, Knoll N, Schwarzer R, et al. Positive experience, self-efficacy, and action control predict physical activity changes: a moderated mediation analysis. Br J Health Psychol. 2013;18(2):395–406.CrossRef Parschau L, Fleig L, Koring M, Lange D, Knoll N, Schwarzer R, et al. Positive experience, self-efficacy, and action control predict physical activity changes: a moderated mediation analysis. Br J Health Psychol. 2013;18(2):395–406.CrossRef
24.
go back to reference Lupien SJ, McEwen BS, Gunnar MR, Heim C. Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev Neurosci. 2009;10(6):434–45.CrossRef Lupien SJ, McEwen BS, Gunnar MR, Heim C. Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev Neurosci. 2009;10(6):434–45.CrossRef
25.
go back to reference Reeve J. Understanding motivation and emotion. New York: Wiley; 2014. Reeve J. Understanding motivation and emotion. New York: Wiley; 2014.
26.
go back to reference Green LW, Kreuter MW. Health promotion planning: an educational and ecological approach. New York: McGraw-Hill; 1993. Green LW, Kreuter MW. Health promotion planning: an educational and ecological approach. New York: McGraw-Hill; 1993.
27.
go back to reference Tudiver F, Talbot Y. Why don't men seek help? Family physicians’ perspectives on help-seeking behavior in men. J Fam Pract. 1999;48:47–52.PubMed Tudiver F, Talbot Y. Why don't men seek help? Family physicians’ perspectives on help-seeking behavior in men. J Fam Pract. 1999;48:47–52.PubMed
28.
go back to reference Sabzmakan L, Mohammadi E, Morowatisharifabad MA, Afaghi A, Naseri MH, Mirzaei M. Environmental determinants of cardiovascular diseases risk factors: a qualitative directed content analysis. Iran Red Crescent Med J. 2014;16(5):e11573.CrossRef Sabzmakan L, Mohammadi E, Morowatisharifabad MA, Afaghi A, Naseri MH, Mirzaei M. Environmental determinants of cardiovascular diseases risk factors: a qualitative directed content analysis. Iran Red Crescent Med J. 2014;16(5):e11573.CrossRef
29.
go back to reference Bartholomew LK, Parcel GS, Kok G, Gottlieb NH, Schaalma HC, Markham CC, et al. Planning health promotion programs: an intervention mapping approach. San Francisco: Jossey-Bass; 2006. Bartholomew LK, Parcel GS, Kok G, Gottlieb NH, Schaalma HC, Markham CC, et al. Planning health promotion programs: an intervention mapping approach. San Francisco: Jossey-Bass; 2006.
30.
go back to reference Shapiro SL, Shapiro DE, Schwartz GE. Stress management in medical education: a review of the literature. Acad Med. 2000;75(7):748–59.CrossRef Shapiro SL, Shapiro DE, Schwartz GE. Stress management in medical education: a review of the literature. Acad Med. 2000;75(7):748–59.CrossRef
31.
go back to reference Bridges LS, Sharma M, Lee JHS, Bennett R, Buxbaum SG, Reese-Smith J. Using the PRECEDE-PROCEED model for an online peer-to-peer suicide prevention and awareness for depression (SPAD) intervention among African American college students: experimental study. Health Promot Perspect. 2018;8(1):15.CrossRef Bridges LS, Sharma M, Lee JHS, Bennett R, Buxbaum SG, Reese-Smith J. Using the PRECEDE-PROCEED model for an online peer-to-peer suicide prevention and awareness for depression (SPAD) intervention among African American college students: experimental study. Health Promot Perspect. 2018;8(1):15.CrossRef
32.
go back to reference Didehvar M, Zareban I, Jalili Z, Bakhshani N-M, Shahrakipoor M, Balouchi A. The effect of stress management training through PRECEDE-PROCEED model on occupational stress among nurses and midwives at Iran hospital, Iranshahr. J Clin Diagn Res JCDR. 2016;10(10):LC01.PubMed Didehvar M, Zareban I, Jalili Z, Bakhshani N-M, Shahrakipoor M, Balouchi A. The effect of stress management training through PRECEDE-PROCEED model on occupational stress among nurses and midwives at Iran hospital, Iranshahr. J Clin Diagn Res JCDR. 2016;10(10):LC01.PubMed
33.
go back to reference King EB, Schlundt DG, Pichert JW, Kinzer CK, Backer BA. Improving the skills of health professionals in engaging patients in diabetes-related problem solving. J Contin Educ Heal Prof. 2002;22(2):94–102.CrossRef King EB, Schlundt DG, Pichert JW, Kinzer CK, Backer BA. Improving the skills of health professionals in engaging patients in diabetes-related problem solving. J Contin Educ Heal Prof. 2002;22(2):94–102.CrossRef
34.
go back to reference Ozdemir D, Tas AF. An investigation of the relationship between social support and coping with stress in women with breast cancer. Psycho-oncology. 2018;27(9):2214–9.CrossRef Ozdemir D, Tas AF. An investigation of the relationship between social support and coping with stress in women with breast cancer. Psycho-oncology. 2018;27(9):2214–9.CrossRef
35.
go back to reference Yıldırım N, Karaca A, Cangur S, Acıkgoz F, Akkus D. The relationship between educational stress, stress coping, self-esteem, social support, and health status among nursing students in Turkey: a structural equation modeling approach. Nurse Educ Today. 2017;48:33–9.CrossRef Yıldırım N, Karaca A, Cangur S, Acıkgoz F, Akkus D. The relationship between educational stress, stress coping, self-esteem, social support, and health status among nursing students in Turkey: a structural equation modeling approach. Nurse Educ Today. 2017;48:33–9.CrossRef
36.
go back to reference Kaya M, Genc M, Kaya B, Pehlivan E. Prevalence of depressive symptoms, ways of coping, and related factors among medical school and health services higher education students. Turk Psikiyatri Dergisi. 2007;18(2):137.PubMed Kaya M, Genc M, Kaya B, Pehlivan E. Prevalence of depressive symptoms, ways of coping, and related factors among medical school and health services higher education students. Turk Psikiyatri Dergisi. 2007;18(2):137.PubMed
37.
go back to reference Saif A. Behavior modification and behavior therapy: theories and methods. Tehran: Dowran. 2014;1387:220–30. Saif A. Behavior modification and behavior therapy: theories and methods. Tehran: Dowran. 2014;1387:220–30.
38.
go back to reference Green LWKM. Health promotion planning: an educational and ecological approach with PowerWeb bind-in card. New York: McGraw-Hill Higher Education; 2004. Green LWKM. Health promotion planning: an educational and ecological approach with PowerWeb bind-in card. New York: McGraw-Hill Higher Education; 2004.
39.
go back to reference Stächele T, Domes G, Wekenborg M, Penz M, Kirschbaum C, Heinrichs M. Effects of a 6-week internet-based stress management program on perceived stress, subjective coping skills, and sleep quality. Front Psychiatr. 2020;11:463.CrossRef Stächele T, Domes G, Wekenborg M, Penz M, Kirschbaum C, Heinrichs M. Effects of a 6-week internet-based stress management program on perceived stress, subjective coping skills, and sleep quality. Front Psychiatr. 2020;11:463.CrossRef
40.
go back to reference Dibb B, Yardley L. Factors important for the measurement of social comparison in chronic illness: a mixed-methods study. Chron Illness. 2006;2(3):219–30.CrossRef Dibb B, Yardley L. Factors important for the measurement of social comparison in chronic illness: a mixed-methods study. Chron Illness. 2006;2(3):219–30.CrossRef
41.
go back to reference Rogers A, Gately C, Kennedy A, Sanders C. Are some more equal than others? Social comparison in self-management skills training for long-term conditions. Chron Illness. 2009;5(4):305–17.CrossRef Rogers A, Gately C, Kennedy A, Sanders C. Are some more equal than others? Social comparison in self-management skills training for long-term conditions. Chron Illness. 2009;5(4):305–17.CrossRef
Metadata
Title
Explaining stress coping behaviors in patients with multiple sclerosis based on the PRECEDE model: a qualitative directed content analysis
Authors
Atefeh Homayuni
Zahra Hosseini
Sedigheh Abedini
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-021-03643-y

Other articles of this Issue 1/2021

BMC Psychiatry 1/2021 Go to the issue