Development of a PERMA-Based Intervention Program to Address Fear of Disease Progression in Systemic Lupus Erythematosus: A Delphi Consensus Study.

PURPOSE: To construct an intervention program based on the PERMA model to address fear of disease progression (FoP) among patients with systemic lupus erythematosus (SLE), aiming to develop a structured, consensus-based intervention protocol for future clinical testing and implementation.

METHODS

This study established a multidisciplinary research team comprising twelve members. Drawing upon the PERMA model within positive psychology and incorporating a comprehensive literature review, the team formulated a preliminary intervention programme. Subsequently, through purposive sampling, sixteen external experts from relevant fields-including rheumatology, nursing, psychology, and healthcare management-were invited to participate in a Delphi consensus consultation. Following statistical analysis of their feedback, the intervention programme underwent optimisation and refinement before being finalised.

RESULTS

The expert consultation achieved a high consensus (Kendall's W = 0.56). The finalized intervention is an 8-week, multi-modal program structured around the five PERMA pillars. It comprises eight core themes, including psychoeducation on positive emotions, strengths identification, mindfulness-based engagement exercises, communication skills training for relationship enhancement, and meaning-making through narrative and film. Key weekly activities involve group discussions, the "Three Good Things" journaling, and role-playing. The program will be delivered via a combination of face-to-face sessions and WeChat-based support.

CONCLUSION

Through a structured Delphi consensus process, this study developed a PERMA-based intervention program designed to address fear of disease progression in patients with systemic lupus erythematosus. The program demonstrates strong expert endorsement, theoretical coherence, and practical relevance. It provides a systematically developed, consensus‑informed framework to guide future feasibility testing and clinical implementation. The actual effectiveness and feasibility of the intervention in reducing fear of progression await empirical evaluation in subsequent pilot and controlled studies.