Patients with Multiple Sclerosis in Psychotherapy: Processes of Meaning Making and Self Transformation (original) (raw)
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Disability and rehabilitation, 2016
To explore perspectives and experiences of people with multiple sclerosis (MS) and health care professionals of mental health support for MS in the UK. 24 people with MS, 13 practice nurses, 12 general practitioners (GPs) and 9 MS specialist nurses were recruited through community groups and primary care practices across North West England. Semi-structured interviews were conducted, and data analyzed thematically using constant comparative analysis within and across the data sets. The theoretical framework of candidacy was used to interrogate data. Four themes were identified: candidates for care, management choices, defining roles, and permeability and responsiveness. Candidacy for care, and symptom management, depended on the framing of symptoms through a social or medical model of depression. Normalizing symptoms could prevent help-seeking by patients. Reported referral behavior varied by professional group, based on perceived remit, competency and training needs. GPs were percei...
International Journal of Qualitative Studies on Health and Well-being
Purpose: To investigate how psychotherapists experience using individual, face-to-face cognitive behavioural therapy (CBT) aimed at alleviating depressive symptoms in persons with multiple sclerosis (MS). Method: Semi-structured interviews with three psychotherapists were conducted after CBT with 12 participants with MS, and analysed using qualitative content analysis. Results: Two main themes emerged: Trusting their expertise as psychotherapists whilst lacking MS-specific knowledge, and The process of exploring the participants' readiness for CBT with modifications of content and delivery. The psychotherapists perceived it difficult to know whether a symptom was attributable to depression or to MS, and for some participants the CBT needed to be adapted to a more concrete content. Conclusions: Psychotherapists may need more MS-specific knowledge and an insight into the individual's functioning. The content of CBT in terms of concrete home assignments and behavioural activation needs to be individualised.
Edorium Journal of Disability and Rehabilitation, 2019
Aims: To describe patients' experiences of being diagnosed with multiple sclerosis (MS) and their needs for support and guidance in the first year with the disease. Methods: A qualitative, semistructured interview study with five patients with MS was conducted. Data were transcribed and analyzed using interpretative phenomenological analysis. Results: Three themes emerged: Frightening to get the diagnosis, needs from family and network, and the importance of continuity in contacts with nurses. The participants struggled with thoughts about serious disabilities and stigmatization, although for some the disease moved more into the background after a period. The patients expressed a need for support and guidance from both families and nurses. They primarily used their families for support, and this was influenced by the family's emotional involvement. Family members typically did not have the necessary experience to give appropriate guidance. The patients were aware of the impact the disease had on their families, and this sometimes stopped them from seeking support from them. The nurse should develop the contact with the individual patient to become familiar with the patient's illness narrative and previous
Individual Face-to-Face Cognitive Behavioural Therapy in Multiple Sclerosis: A Qualitative Study
Journal of Clinical Psychology, 2016
To investigate how people with multiple sclerosis (MS) experience their participation in individual, face-to-face cognitive behavioural therapy (CBT) aimed at alleviating depressive symptoms. Method: Semistructured interviews with 12 participants were conducted after CBT and analyzed using qualitative content analysis. Results: Two main themes emerged: CBT as a demanding process and confronting everyday life after CBT with self-knowledge and well-being. The participants had gained strategies for handling feelings of depression and anxiety. The therapist was considered important for guiding them through the demanding therapy. Conclusion: It is important to inform the participants of what CBT entails so that they are mentally prepared for the demanding process and can make the necessary adjustments in their daily life. Knowledge of MS among the therapists as well as collaboration with the multidisciplinary MS care may facilitate participation in CBT.
Individual Supportive Psychotherapy in Multiple Sclerosis: A Single-Case Study
This individual case study follows a 47-yearold woman who was directed by her treating physicians to individual psychotherapy after being diagnosed with Multiple Sclerosis (MS). The main methods our study was based on were clinical observations and neuropsychological assessments. The patient's concerns revolved around her self-care and her inability to set boundaries in her interpersonal relationships. During her first sessions, she demonstrated symptoms of anxiety, depression, and self-destructive behavior. Due to these facts, psycho-supportive medication was deemed essential. The main purpose of this case study was to investigate whether supportive psychotherapy may be of additional help to patients with MS. In this individual case, we will present how effective supportive psychotherapy can be for the patient, which is part of the treatment for a personalized holistic intervention programme. Given the lack of relevant research in Greece, this study can help expand the knowledge and deepen the understanding in this field. Moreover, this study may reinforce the importance the care of MS patients to be carried out in a holistic intervention program. After one year of individual psychotherapy, the patient demonstrated significant improvement. Psychotherapeutic and supportive interventions, combined with MS medication, have been proved to be a more appropriate treatment for coping with and managing this chronic disease.
Selected social aspects in the life of patients with multiple sclerosis
Kontakt
Aim: To describe and interpret the impact of multiple sclerosis (MS) on selected social aspects of life, on the family and working life. Design: A qualitative cross-sectional study. Methods: The group consisted of 14 probands with MS, with an average age of 44.7 years (± 9.8) and average disease duration of 9.93 years (± 5.97). To collect empirical data, we used a semi-structured interview according to a pre-prepared protocol of our own design, in the period between January-October 2018. The interviews were analysed via an Interpretative Phenomenological Analysis. Results: Due to the disease symptoms, the probands experienced limitations when performing daily activities. They also experienced fear of losing self-sufficiency and were worried about the future. With the progression of the disease, there were also limitations in their working life which affected the quality of their lives. For most of them, MS also had an impact on the quality of family relationships including relations with their partners. Although the partners and children of probands were a source of social support, these people needed some time to accept MS and live with it. Conclusions: Knowledge of selected aspects of life in individuals with MS can contribute to knowing their problems, and makes it possible to provide specific help within complex care provision.
Psychological Changes in Patients With Multiple Sclerosis
2019
Introduction: Multiple Sclerosis (MS) as a stressful event, despite causing negative psychological changes, may lead to positive ones as well. Objective: This study was mainly conducted to examine the implications of posttraumatic growth and demoralization and also to determine the relationship between them in patients with MS. Materials and Methods: This was a cross-sectional study, in which the research population included all patients with MS who were the member of Ardabil Multiple Sclerosis Association. Using convenience sampling method, 146 eligible patients completed the posttraumatic growth tool and the demoralization scale. The obtained data were analyzed by using descriptive (mean, range, frequency, standard deviation) and inferential (Pearson correlation coefficient) statistics. Results: The Mean±SD age of the participants was 33.59±8.70 years, and most of them were female (67.8%), married (67.1%) and had a high school diploma (49.3%). The Mean±SD scores of posttraumatic growth and demoralization were 65.23±17.1 and 34.71±18.22, respectively. Also, a significant inverse correlation was obtained between demoralization with posttraumatic growth (P<0.001; r=-0.57) and its dimensions (P<0.001; r=-0.23 to -0.57). Conclusion: By decreasing the score of negative psychological changes (demoralization), the score of positive psychological changes (posttraumatic growth) increases in the MS patients. Nurses, psychological counselors, and other community caregivers can provide the context to create positive changes in MS patients, by reducing demoralization and resolving patients’ psychological problems.