June Halper - Academia.edu (original) (raw)
Papers by June Halper
International Journal of MS Care, 2005
International Journal of MS Care, 2002
International journal of MS care, 2014
Specialist certification among interdisciplinary multiple sclerosis (MS) team members provides fo... more Specialist certification among interdisciplinary multiple sclerosis (MS) team members provides formal recognition of a specialized body of knowledge felt to be necessary to provide optimal care to individuals and families living with MS. Multiple sclerosis specialist certification (MS Certified Specialist, or MSCS) first became available in 2004 for MS interdisciplinary team members, but prior to the present study had not been evaluated for its perceived value, challenges, and satisfaction. A sample consisting of 67 currently certified MS specialists and 20 lapsed-certification MS specialists completed the following instruments: Perceived Value of Certification Tool (PVCT), Perceived Challenges and Barriers to Certification Scale (PCBCS), Overall Satisfaction with Certification Scale, and a demographic data form. Satisfactory reliability was shown for the total scale and four factored subscales of the PVCT and for two of the three factored PCBCS subscales. Currently certified MS spe...
International journal of MS care, 2012
Multiple sclerosis (MS) is the most common cause of neurologic disease in young and middle-aged a... more Multiple sclerosis (MS) is the most common cause of neurologic disease in young and middle-aged adults, and 75% of patients are female. Nearly one in two patients with MS will experience clinically significant depression-approximately three times the prevalence rate in the general population. This study used a cross-sectional approach to examine the link between depression levels and use of interferon medications among individuals with MS. Data were collected from 694 patients of the Multiple Sclerosis Comprehensive Care Center at Holy Name Medical Center in Teaneck, New Jersey. Analysis of variance was used to compare depression scores between patients taking and not taking interferons. Regression analyses with depression scores as the dependent variable were also conducted. The Beck Depression Inventory (BDI) was reduced to a set of dimensions by principal components analysis. Two components were identified, reflecting somatic and cognitive symptoms. The results showed no signific...
International journal of MS care, 2012
There are currently no assessment tools that focus on evaluating patients with multiple sclerosis... more There are currently no assessment tools that focus on evaluating patients with multiple sclerosis (MS) who are experiencing a relapse or that evaluate patients' response to acute relapse treatment. In practice, assessments are often subjective, potentially resulting in overlooked symptoms, unaddressed patient concerns, unnoticed or underrecognized side effects of therapies (both disease modifying and symptomatic), and suboptimal therapeutic response. Systematic evaluation of specific symptoms and potential side effects can minimize the likelihood of overlooking important information. However, given the number of potential symptoms and adverse events that patients may experience, an exhaustive evaluation can be time-consuming. Clinicians are thus challenged to balance thoroughness with brevity. A need exists for a brief but comprehensive objective assessment tool that can be used in practice to 1) help clinicians assess patients when they present with symptoms of a relapse, and 2...
International Journal of MS Care, 2011
Optimal health of people with multiple sclerosis (MS) can be promoted by patients&amp... more Optimal health of people with multiple sclerosis (MS) can be promoted by patients' sharing of health information gained through periodic self-monitoring with their health-care providers. The purpose of this study was to develop a valid and reliable self-administered scale to obtain information about MS patients' health status and the impact of the disease on their daily lives. We named this scale "Monitoring My Multiple Sclerosis" (MMMS). A cross-sectional survey was conducted of 171 MS patients who completed the MMMS and Patient-Determined Disease Steps (PDDS) scales and provided information on their MS disease classification and demographic characteristics. Data analysis included several parametric procedures. Factor analysis of the 26-item MMMS resulted in four factors with satisfactory α reliability coefficients for the total scale (0.90) and factored subscales: Physical (0.85), Relationships (0.80), Energy (0.70), and Cognitive/Mental (0.67). Analysis of variance demonstrated that the total scale and the Physical subscale, but not the Relationships subscale, showed significantly worse functioning for patients with either moderate or severe disability as measured by the PDDS than for patients with mild disability (P < .001). The Cognitive/Mental subscale showed significantly worse functioning for patients with moderate disability than for patients with mild disability (P < .05). However, the Energy subscale showed significantly worse functioning among moderately disabled patients than among severely disabled patients (P < .01). Independent t tests demonstrated that patients classified as having secondary progressive multiple sclerosis had significantly worse scores on the total MMMS (P < .05) and the Physical subscale (P < .001) than those classified as having relapsing-remitting multiple sclerosis. The MMMS demonstrated satisfactory reliability and validity and is recommended for use by MS patients and their health-care providers as a mechanism to promote the sharing of health information, to the benefit of both patients and providers.
Archives of Physical Medicine and Rehabilitation, 2005
Goverover Y, Kalmar J, Gaudino-Goering E, Shawaryn M, Moore NB, Halper J, DeLuca J. The relation ... more Goverover Y, Kalmar J, Gaudino-Goering E, Shawaryn M, Moore NB, Halper J, DeLuca J. The relation between subjective and objective measures of everyday life activities in persons with multiple sclerosis.
Annals of Behavioral Medicine, 1997
The aim of this study was to determine if learned helplessness, self-efficacy, and cognitive dist... more The aim of this study was to determine if learned helplessness, self-efficacy, and cognitive distortions would predict depression in a sample of 80 individuals with multiple sclerosis (MS) and 80 individuals with a spinal cord injury (SCI). As MS and SCI usually present with disparate disease courses and etiologies, a secondary objective was to determine if individuals with MS would
Rehabilitation Psychology, 2004
Objective: To describe and contrast physical functioning, mental health, and quality of life of o... more Objective: To describe and contrast physical functioning, mental health, and quality of life of older individuals with multiple sclerosis (MS) with those of younger individuals with MS. Design/Participants: Thirty older (age Ն 60 years) and 30 younger participants with MS (age Ͻ 60 years) completed telephone interviews.
Neuropsychology, 2008
Considerable evidence indicates that cognitive dysfunction and impairments in everyday life activ... more Considerable evidence indicates that cognitive dysfunction and impairments in everyday life activities are common in multiple sclerosis (MS). However, the relationship between these cognitive and functional deficits has not been thoroughly investigated. The purpose of this study was to examine the role of cognitive dysfunction in the functional status of individuals with MS. Participants were 74 adults with MS and 35 healthy comparison participants (HCs) who underwent neuropsychological testing and completed the Executive Functions Performance Test (EFPT; Baum, , an objective measure of everyday life activities. Between-groups comparisons and correlational analyses were conducted to examine the relationship between cognition and functional capacity. Significant differences in EFPT performance were revealed between individuals with MS with and without cognitive impairment and HCs. In individuals with MS, performance on cognitive constructs was related to performance on the EFPT. Furthermore, a linear regression model comprised of indices of cognitive functioning explained a significant portion of the variance in everyday life activities. Findings suggest that individuals with and without cognitive impairment differ in functional status and that aspects of cognition are predictive of functional status in MS.
Journal of Neuroscience Nursing, 2007
Several studies document high levels of job satisfaction among certified nurses, but no study has... more Several studies document high levels of job satisfaction among certified nurses, but no study has examined job satisfaction and factors influencing job satisfaction of certified multiple sclerosis (MS) nurses. This study tested a theoretical model proposing that two organizational factors, colleague relationships and benefits, will predict job satisfaction. Job satisfaction was represented by four factors: autonomy, professional status, professional growth, and time efficiency. Participants included MS nurses certified for 6 months or more practicing mostly in three countries (Canada, Great Britain, and the United States) who anonymously completed the Misener Nurse Practitioner Job Satisfaction Scale, an overall job satisfaction rating, and demographic information. Findings indicate that colleague relationships and benefits significantly estimated organization structure and that autonomy, professional status, professional growth, and time efficiency significantly estimated job satisfaction; furthermore, organization factors such as colleague relationships and benefits significantly predict job satisfaction. Among the countries, several statistically significant differences were observed between job satisfaction factors as well as items in both organization and job satisfaction subscales. Average factor scores among the countries were mostly rated satisfactory. The International Organization of Multiple Sclerosis Nurses Executive Board plans to use the study findings to see how it needs to focus efforts as an organization toward enhancing and standardizing MS care and develop MS nurse professionalism worldwide.
Journal of Neuroscience Nursing, 2009
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. The unde... more Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. The underlying pathology can be both inflammatory and degenerative. It affects over 400,000 Americans per year and usually strikes in the prime of life. The disease can result in serious and debilitating impairment of physical, emotional, and cognitive functions that limit patients' overall status, halt their hopes and dreams, and alter their quality of life. To slow disease progression, administration of disease-modifying treatments early in the course of disease is thought to offer the best option for patients to achieve safe and effective management of this lifelong condition. This strategy, along with symptomatic management, encompasses the newest philosophy of comprehensive MS care. From an evidence-based understanding of MS, the role of the MS nurse has been transformed from a supportive, educative role to that of a highly skilled, knowledgeable and specialized professional. The nurse is a lynchpin in a multidisciplinary team dedicated to a patient's continuing care. In addition, the role of the MS nurse has evolved to incorporate supervising MS clinical trials, monitoring patients, implementing protocols, evaluating outcomes, and ultimately contributing to evidence-based practice. Although it is important that patients receive the appropriate therapy that may slow disease progression and manage symptoms, the individualized support provided by the MS nurse is essential to the sustained use of long-term treatments. Industry-supported nurse-administered patient assistance support programs, such as the Betaseron Education, Training and Assistance Nurse/BETAPLUS TM , MS Lifelines, Shared Solutions, and Avonex Services, employ nurses who offer valuable emotional, educational, and technical support to MS patients, ensuring that their needs are met throughout the course of therapy. These MS nurse specialist programs impart knowledge about self-administration of injections and facilitate self-management to reduce adverse events and promote sustained adherence. Regular contact with patients, a consistent level of care, a trusting relationship, and a greater understanding of prescribed treatment have resulted in increased adherence to complex protocols. As the specialty of MS nursing continues to evolve within the MS healthcare team, the MS nurse will continue to have a profound influence on treatment and improving quality of life in patients with MS.
Journal of Neuroscience Nursing, 2003
Cognitive impairment is a common problem in multiple sclerosis (MS); up to 65% of patients exhibi... more Cognitive impairment is a common problem in multiple sclerosis (MS); up to 65% of patients exhibit some neuropsychological dysfunction during the course of their disease. It is a major contributing factor to unemployment, accidents, impairment of daily functioning, and loss of social activity in those affected by MS. The areas of cognition typically impaired are memory, attention, information processing, executive functions, and visuospatial skills. Cognitive dysfunction is independent of disease duration and level of disability; cognitive decline may begin in the earliest stages of MS before patients become even mildly disabled. Structural brain imaging studies show a positive correlation between the extent of brain atrophy and cognitive dysfunction. Despite its prevalence in MS, cognitive dysfunction often goes undiagnosed or is misdiagnosed as depression, stress, stubbornness, lack of intelligence, or psychosis. Because nurses play such an important role in the care of patients with MS, they are in a position to identify patients with cognitive dysfunction, educate patients and their families on ways to cope with cognitive deficits, and counsel patients on available treatment options. Practical guidelines help nurses identify and care for cognitively impaired MS patients.
Journal of Community Health Nursing, 1984
Journal of Clinical Neuroscience, 1999
... Michel G Clanet and Cecile Azais-Vuillemin Chapter 18 243 Depression and suicide in multiple ... more ... Michel G Clanet and Cecile Azais-Vuillemin Chapter 18 243 Depression and suicide in multiple sclerosis Ronald A Remick and A Dessa Sadovnick Chapter 19 253 Cognitive dysfunction in multiple sclerosis. What are we measuring and why does it matter? ...
Disability & Rehabilitation, 2008
This qualitative investigation was designed to identify themes that underlie adaptation in older ... more This qualitative investigation was designed to identify themes that underlie adaptation in older individuals with multiple sclerosis (MS). Thirteen individuals (age 60 and above) with MS were recruited from an MS Comprehensive Care Centre and local chapters of the National Multiple Sclerosis Society. Participants completed The Perceptions of Aging Interview by telephone. This open-ended interview was developed to explore two lines of inquiry: MS: Perceptions of Aging, which was based on the literature on adaptation in MS, and Life Strengths, which was adapted from Kivnick's Life Strengths Inventory. The majority of participants reported having adapted to MS and aging. They described several themes and subthemes that seemed to influence their levels of adaptation: Social comparisons, mobility/independence, integration of MS into self-identity, acceptance, pacing and planning, finding meaning/cognitive reframing, social support, religion/spirituality and generativity. The themes identified in this investigation are generally supported by the literatures on adaptation to MS and adaptation to aging. However, this is the first study to examine these factors in an older MS sample. Moreover, many of these themes are potentially modifiable through clinical intervention, and should be examined in future research with this population.
Disability & Rehabilitation, 2003
Despite the increasing number of older individuals with multiple sclerosis (MS), there is a pauci... more Despite the increasing number of older individuals with multiple sclerosis (MS), there is a paucity of research on this subpopulation. Health-related quality of life (HRQOL) has received extensive attention in MS; however samples tend to be young. The present study assesses the internal consistency reliability and construct validity of the MS Quality of Life Inventory (MSQLI), a widely employed measure of HRQOL, in older individuals. Select subscales of the MSQLI and other measures of mental health and physical functioning were administered by telephone to 30 randomly selected older ( >or= 60) individuals and a gender-matched sample of younger ( < 60) individuals. Reliability estimates were calculated separately for each group. Construct (convergent) validity was assessed by examining the pattern of correlations between MSQLI subscales and measures of related constructs in the two groups. Reliability estimates were similar in the two groups. With few exceptions, the correlations measuring convergent validity were in the expected direction, and of considerable magnitude, in both groups. Results provide preliminary evidence that the MSQLI is a reliable and valid instrument for use with older individuals. The slightly different pattern of results observed in the validity analysis might be explained by an adjustment hypothesis. Future research on HRQOL in this subpopulation is encouraged.
International Journal of MS Care, 2005
International Journal of MS Care, 2002
International journal of MS care, 2014
Specialist certification among interdisciplinary multiple sclerosis (MS) team members provides fo... more Specialist certification among interdisciplinary multiple sclerosis (MS) team members provides formal recognition of a specialized body of knowledge felt to be necessary to provide optimal care to individuals and families living with MS. Multiple sclerosis specialist certification (MS Certified Specialist, or MSCS) first became available in 2004 for MS interdisciplinary team members, but prior to the present study had not been evaluated for its perceived value, challenges, and satisfaction. A sample consisting of 67 currently certified MS specialists and 20 lapsed-certification MS specialists completed the following instruments: Perceived Value of Certification Tool (PVCT), Perceived Challenges and Barriers to Certification Scale (PCBCS), Overall Satisfaction with Certification Scale, and a demographic data form. Satisfactory reliability was shown for the total scale and four factored subscales of the PVCT and for two of the three factored PCBCS subscales. Currently certified MS spe...
International journal of MS care, 2012
Multiple sclerosis (MS) is the most common cause of neurologic disease in young and middle-aged a... more Multiple sclerosis (MS) is the most common cause of neurologic disease in young and middle-aged adults, and 75% of patients are female. Nearly one in two patients with MS will experience clinically significant depression-approximately three times the prevalence rate in the general population. This study used a cross-sectional approach to examine the link between depression levels and use of interferon medications among individuals with MS. Data were collected from 694 patients of the Multiple Sclerosis Comprehensive Care Center at Holy Name Medical Center in Teaneck, New Jersey. Analysis of variance was used to compare depression scores between patients taking and not taking interferons. Regression analyses with depression scores as the dependent variable were also conducted. The Beck Depression Inventory (BDI) was reduced to a set of dimensions by principal components analysis. Two components were identified, reflecting somatic and cognitive symptoms. The results showed no signific...
International journal of MS care, 2012
There are currently no assessment tools that focus on evaluating patients with multiple sclerosis... more There are currently no assessment tools that focus on evaluating patients with multiple sclerosis (MS) who are experiencing a relapse or that evaluate patients' response to acute relapse treatment. In practice, assessments are often subjective, potentially resulting in overlooked symptoms, unaddressed patient concerns, unnoticed or underrecognized side effects of therapies (both disease modifying and symptomatic), and suboptimal therapeutic response. Systematic evaluation of specific symptoms and potential side effects can minimize the likelihood of overlooking important information. However, given the number of potential symptoms and adverse events that patients may experience, an exhaustive evaluation can be time-consuming. Clinicians are thus challenged to balance thoroughness with brevity. A need exists for a brief but comprehensive objective assessment tool that can be used in practice to 1) help clinicians assess patients when they present with symptoms of a relapse, and 2...
International Journal of MS Care, 2011
Optimal health of people with multiple sclerosis (MS) can be promoted by patients&amp... more Optimal health of people with multiple sclerosis (MS) can be promoted by patients' sharing of health information gained through periodic self-monitoring with their health-care providers. The purpose of this study was to develop a valid and reliable self-administered scale to obtain information about MS patients' health status and the impact of the disease on their daily lives. We named this scale "Monitoring My Multiple Sclerosis" (MMMS). A cross-sectional survey was conducted of 171 MS patients who completed the MMMS and Patient-Determined Disease Steps (PDDS) scales and provided information on their MS disease classification and demographic characteristics. Data analysis included several parametric procedures. Factor analysis of the 26-item MMMS resulted in four factors with satisfactory α reliability coefficients for the total scale (0.90) and factored subscales: Physical (0.85), Relationships (0.80), Energy (0.70), and Cognitive/Mental (0.67). Analysis of variance demonstrated that the total scale and the Physical subscale, but not the Relationships subscale, showed significantly worse functioning for patients with either moderate or severe disability as measured by the PDDS than for patients with mild disability (P < .001). The Cognitive/Mental subscale showed significantly worse functioning for patients with moderate disability than for patients with mild disability (P < .05). However, the Energy subscale showed significantly worse functioning among moderately disabled patients than among severely disabled patients (P < .01). Independent t tests demonstrated that patients classified as having secondary progressive multiple sclerosis had significantly worse scores on the total MMMS (P < .05) and the Physical subscale (P < .001) than those classified as having relapsing-remitting multiple sclerosis. The MMMS demonstrated satisfactory reliability and validity and is recommended for use by MS patients and their health-care providers as a mechanism to promote the sharing of health information, to the benefit of both patients and providers.
Archives of Physical Medicine and Rehabilitation, 2005
Goverover Y, Kalmar J, Gaudino-Goering E, Shawaryn M, Moore NB, Halper J, DeLuca J. The relation ... more Goverover Y, Kalmar J, Gaudino-Goering E, Shawaryn M, Moore NB, Halper J, DeLuca J. The relation between subjective and objective measures of everyday life activities in persons with multiple sclerosis.
Annals of Behavioral Medicine, 1997
The aim of this study was to determine if learned helplessness, self-efficacy, and cognitive dist... more The aim of this study was to determine if learned helplessness, self-efficacy, and cognitive distortions would predict depression in a sample of 80 individuals with multiple sclerosis (MS) and 80 individuals with a spinal cord injury (SCI). As MS and SCI usually present with disparate disease courses and etiologies, a secondary objective was to determine if individuals with MS would
Rehabilitation Psychology, 2004
Objective: To describe and contrast physical functioning, mental health, and quality of life of o... more Objective: To describe and contrast physical functioning, mental health, and quality of life of older individuals with multiple sclerosis (MS) with those of younger individuals with MS. Design/Participants: Thirty older (age Ն 60 years) and 30 younger participants with MS (age Ͻ 60 years) completed telephone interviews.
Neuropsychology, 2008
Considerable evidence indicates that cognitive dysfunction and impairments in everyday life activ... more Considerable evidence indicates that cognitive dysfunction and impairments in everyday life activities are common in multiple sclerosis (MS). However, the relationship between these cognitive and functional deficits has not been thoroughly investigated. The purpose of this study was to examine the role of cognitive dysfunction in the functional status of individuals with MS. Participants were 74 adults with MS and 35 healthy comparison participants (HCs) who underwent neuropsychological testing and completed the Executive Functions Performance Test (EFPT; Baum, , an objective measure of everyday life activities. Between-groups comparisons and correlational analyses were conducted to examine the relationship between cognition and functional capacity. Significant differences in EFPT performance were revealed between individuals with MS with and without cognitive impairment and HCs. In individuals with MS, performance on cognitive constructs was related to performance on the EFPT. Furthermore, a linear regression model comprised of indices of cognitive functioning explained a significant portion of the variance in everyday life activities. Findings suggest that individuals with and without cognitive impairment differ in functional status and that aspects of cognition are predictive of functional status in MS.
Journal of Neuroscience Nursing, 2007
Several studies document high levels of job satisfaction among certified nurses, but no study has... more Several studies document high levels of job satisfaction among certified nurses, but no study has examined job satisfaction and factors influencing job satisfaction of certified multiple sclerosis (MS) nurses. This study tested a theoretical model proposing that two organizational factors, colleague relationships and benefits, will predict job satisfaction. Job satisfaction was represented by four factors: autonomy, professional status, professional growth, and time efficiency. Participants included MS nurses certified for 6 months or more practicing mostly in three countries (Canada, Great Britain, and the United States) who anonymously completed the Misener Nurse Practitioner Job Satisfaction Scale, an overall job satisfaction rating, and demographic information. Findings indicate that colleague relationships and benefits significantly estimated organization structure and that autonomy, professional status, professional growth, and time efficiency significantly estimated job satisfaction; furthermore, organization factors such as colleague relationships and benefits significantly predict job satisfaction. Among the countries, several statistically significant differences were observed between job satisfaction factors as well as items in both organization and job satisfaction subscales. Average factor scores among the countries were mostly rated satisfactory. The International Organization of Multiple Sclerosis Nurses Executive Board plans to use the study findings to see how it needs to focus efforts as an organization toward enhancing and standardizing MS care and develop MS nurse professionalism worldwide.
Journal of Neuroscience Nursing, 2009
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. The unde... more Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. The underlying pathology can be both inflammatory and degenerative. It affects over 400,000 Americans per year and usually strikes in the prime of life. The disease can result in serious and debilitating impairment of physical, emotional, and cognitive functions that limit patients' overall status, halt their hopes and dreams, and alter their quality of life. To slow disease progression, administration of disease-modifying treatments early in the course of disease is thought to offer the best option for patients to achieve safe and effective management of this lifelong condition. This strategy, along with symptomatic management, encompasses the newest philosophy of comprehensive MS care. From an evidence-based understanding of MS, the role of the MS nurse has been transformed from a supportive, educative role to that of a highly skilled, knowledgeable and specialized professional. The nurse is a lynchpin in a multidisciplinary team dedicated to a patient's continuing care. In addition, the role of the MS nurse has evolved to incorporate supervising MS clinical trials, monitoring patients, implementing protocols, evaluating outcomes, and ultimately contributing to evidence-based practice. Although it is important that patients receive the appropriate therapy that may slow disease progression and manage symptoms, the individualized support provided by the MS nurse is essential to the sustained use of long-term treatments. Industry-supported nurse-administered patient assistance support programs, such as the Betaseron Education, Training and Assistance Nurse/BETAPLUS TM , MS Lifelines, Shared Solutions, and Avonex Services, employ nurses who offer valuable emotional, educational, and technical support to MS patients, ensuring that their needs are met throughout the course of therapy. These MS nurse specialist programs impart knowledge about self-administration of injections and facilitate self-management to reduce adverse events and promote sustained adherence. Regular contact with patients, a consistent level of care, a trusting relationship, and a greater understanding of prescribed treatment have resulted in increased adherence to complex protocols. As the specialty of MS nursing continues to evolve within the MS healthcare team, the MS nurse will continue to have a profound influence on treatment and improving quality of life in patients with MS.
Journal of Neuroscience Nursing, 2003
Cognitive impairment is a common problem in multiple sclerosis (MS); up to 65% of patients exhibi... more Cognitive impairment is a common problem in multiple sclerosis (MS); up to 65% of patients exhibit some neuropsychological dysfunction during the course of their disease. It is a major contributing factor to unemployment, accidents, impairment of daily functioning, and loss of social activity in those affected by MS. The areas of cognition typically impaired are memory, attention, information processing, executive functions, and visuospatial skills. Cognitive dysfunction is independent of disease duration and level of disability; cognitive decline may begin in the earliest stages of MS before patients become even mildly disabled. Structural brain imaging studies show a positive correlation between the extent of brain atrophy and cognitive dysfunction. Despite its prevalence in MS, cognitive dysfunction often goes undiagnosed or is misdiagnosed as depression, stress, stubbornness, lack of intelligence, or psychosis. Because nurses play such an important role in the care of patients with MS, they are in a position to identify patients with cognitive dysfunction, educate patients and their families on ways to cope with cognitive deficits, and counsel patients on available treatment options. Practical guidelines help nurses identify and care for cognitively impaired MS patients.
Journal of Community Health Nursing, 1984
Journal of Clinical Neuroscience, 1999
... Michel G Clanet and Cecile Azais-Vuillemin Chapter 18 243 Depression and suicide in multiple ... more ... Michel G Clanet and Cecile Azais-Vuillemin Chapter 18 243 Depression and suicide in multiple sclerosis Ronald A Remick and A Dessa Sadovnick Chapter 19 253 Cognitive dysfunction in multiple sclerosis. What are we measuring and why does it matter? ...
Disability & Rehabilitation, 2008
This qualitative investigation was designed to identify themes that underlie adaptation in older ... more This qualitative investigation was designed to identify themes that underlie adaptation in older individuals with multiple sclerosis (MS). Thirteen individuals (age 60 and above) with MS were recruited from an MS Comprehensive Care Centre and local chapters of the National Multiple Sclerosis Society. Participants completed The Perceptions of Aging Interview by telephone. This open-ended interview was developed to explore two lines of inquiry: MS: Perceptions of Aging, which was based on the literature on adaptation in MS, and Life Strengths, which was adapted from Kivnick's Life Strengths Inventory. The majority of participants reported having adapted to MS and aging. They described several themes and subthemes that seemed to influence their levels of adaptation: Social comparisons, mobility/independence, integration of MS into self-identity, acceptance, pacing and planning, finding meaning/cognitive reframing, social support, religion/spirituality and generativity. The themes identified in this investigation are generally supported by the literatures on adaptation to MS and adaptation to aging. However, this is the first study to examine these factors in an older MS sample. Moreover, many of these themes are potentially modifiable through clinical intervention, and should be examined in future research with this population.
Disability & Rehabilitation, 2003
Despite the increasing number of older individuals with multiple sclerosis (MS), there is a pauci... more Despite the increasing number of older individuals with multiple sclerosis (MS), there is a paucity of research on this subpopulation. Health-related quality of life (HRQOL) has received extensive attention in MS; however samples tend to be young. The present study assesses the internal consistency reliability and construct validity of the MS Quality of Life Inventory (MSQLI), a widely employed measure of HRQOL, in older individuals. Select subscales of the MSQLI and other measures of mental health and physical functioning were administered by telephone to 30 randomly selected older ( >or= 60) individuals and a gender-matched sample of younger ( < 60) individuals. Reliability estimates were calculated separately for each group. Construct (convergent) validity was assessed by examining the pattern of correlations between MSQLI subscales and measures of related constructs in the two groups. Reliability estimates were similar in the two groups. With few exceptions, the correlations measuring convergent validity were in the expected direction, and of considerable magnitude, in both groups. Results provide preliminary evidence that the MSQLI is a reliable and valid instrument for use with older individuals. The slightly different pattern of results observed in the validity analysis might be explained by an adjustment hypothesis. Future research on HRQOL in this subpopulation is encouraged.