The impact of a walking program on self-management, anxiety, stress, depression, quality of life, and seizure frequency in patients with epilepsy: A mixed methods approach using the COM-B behaviour change model

Abstract

Objective: This study aimed to investigate the effect of a walking program based on the COM-B Behavior Change Model on self-management, anxiety, stress, depression, quality of life, and seizure frequency in individuals with epilepsy. Methods: A prospective, parallel-group controlled experimental design and mixed methods were used. A total of 78 individuals with epilepsy were included in the study and randomly assigned to the intervention (n = 38) and control (n = 40) groups. The intervention group participated in a weekly, twice-a-week, walking program for 12 weeks. The program was based on the COM-B model, focusing on increasing individuals’ capability, opportunity, and motivation levels. The control group received standard treatment. Self-management, anxiety, stress, depression, and quality of life were measured using scales. Seizure frequency was measured using daily logs. Qualitative data was collected through semi-structured interviews with 10 participants to understand barriers to walking in individuals with epilepsy. Results: Qualitative data revealed time constraints, lack of motivation, and safety concerns as barriers to walking participation. After a 12-week intervention, a significant increase in self-management levels, a significant decrease in anxiety, stress, and depression levels, a significant improvement in quality of life, and a significant reduction in seizure frequency were observed in the intervention group. No significant changes were observed in these variables in the control group. Conclusion: This study demonstrated that a walking program based on the COM-B Behavior Change Model had a positive impact on self-management, mental health, and quality of life in individuals with epilepsy and may help reduce seizure frequency. © 2024 Elsevier Inc.