The Psychological Processes of Adaptation and Hope in Patients with Multiple Sclerosis: A Thematic Synthesis (original) (raw)
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A review of psychological correlates of adjustment in patients with multiple sclerosis
Clinical Psychology Review, 2009
Multiple Sclerosis (MS) is a chronic neurological disease which poses significant psychological adjustment challenges. The purpose of this systematic review was to identify factors that are related to adjustment in people with MS and may be modifiable through psychological intervention. It aimed to gain an overview of the strength of evidence for relationships between psychological factors and adjustment and identify limitations to existing studies and directions for future research. Seventy two studies met inclusion criteria and were included in the review and a narrative synthesis was conducted. A wide range of psychological factors have been studied in relation to adjustment outcomes. The strongest and most consistent finding was that perceived stress and certain emotion-focussed coping strategies are related to worse adjustment in MS. Uncertainty was fairly robustly associated with worse adjustment. There was also more tentative evidence available for relationships between adjustment outcomes and a range of other factors including social support and interactions with others, cognitive errors and biases, illness and symptom cognitions, control perceptions, positive psychology factors, and health behaviours. Implications for therapeutic interventions are discussed and a preliminary model of adjustment to MS is outlined. In light of the shortcomings of extant studies, suggestions for future research are offered.
Understanding hope in patients with Multiple Sclerosis
Physiotherapy
Objectives To understand how patients with Multiple Sclerosis experience and express hope within a rehabilitation setting and use this information to help therapists in a clinical setting. Design One guided interview was undertaken. Setting Two locations were used for interviews: (1) a rehabilitation centre in Oxfordshire. (2) A meeting location for the MS society in London. Participants Eleven patients with Multiple Sclerosis were selected (54.5 ± 8.8 years). Six patients were classified as being in the secondary progressive stage and 5 were classified as relapsing remitting phase. Method The patients selected were part of a 12-week Multiple Sclerosis rehabilitation program. One interview took place mid way through the rehabilitation program and immediately following the end of the rehabilitation program. The semi-structured interview comprised of 5 sub-sections. Categorical content analysis was used to analyse the results. Results Three main themes were identified that related to the paradox of chronic illness: (1) defiance and the patient (2) accepting the diagnosis and prognosis and (3) accepting deterioration. These themes provide a basis for the different types of hopes expressed by patients. Conclusion It is vital to understand the paradox of chronic illness as an expression common among patients with Multiple Sclerosis. This research illustrates the importance of listening to a patient's narrative during rehabilitation.
Journal of Clinical Medicine
The aim of the study is to investigate the impact of coping strategies on Health-Related Quality of Life (HRQoL) and physical disability assessed with the Expanded Disability Status Scale (EDSS) of people with multiple sclerosis (pwMS). PwMS were asked to focus on “MS diagnosis” as the core stressor. One hundred eight pwMS completed the Coping Responses Inventory-Adult form (CRI-Adult), the Multiple Sclerosis Quality of Life-29 (MSQoL-29), and the Depression Anxiety Stress Scale-21 (DASS-21). Multiple regression analyses (first block: EDSS, disease duration, and DASS-21) revealed that physical MSQoL-29 was positively associated with Alternative Rewards and negatively with Resigned Acceptance of the CRI-Adult. The mental MSQoL-29 was positively associated with Problem-Solving and negatively with Emotional Discharge. The Expanded Disability Status Scale (EDSS; first block: disease duration and general distress) was negatively associated with Positive Reappraisal. The Analysis of covar...
Concept analysis of coping with multiple sclerosis
International Journal of Nursing Sciences, 2018
Objective: The concept of coping with disease appears frequently in the literature; however, there is no precise definition of coping. The aim of this study is to clarify coping concept, and to identify its attributes, antecedents, and consequences in patients with multiple sclerosis. Methods: Rodgers' evolutionary method of concept analysis was used to clarify the concept of coping. A literature review was conducted with key terms 'multiple sclerosis', 'coping', 'adjustment', and 'deal with'. After searching databases, 1370 papers were found for the period 1995e2017. Finally, 55 articles and texts were selected for analysis. Data analysis was carried out using thematic analysis. An independent researcher checked the process to ensure credibility and reduce personal bias. Results: Coping with multiple sclerosis is a multidimensional concept with three main attributes: maintenance of emotional balance, acceptance of the disease, and self-regulation. Social support, awareness toward the disease, attitude toward the disease, and religious-spiritual beliefs were found as antecedents. Health promotion, adherence to treatment regimen, independence in personal life and social relationships, and improvement of family relationships were found as consequences of these attributes. Conclusion: These findings not only add to the body of knowledge in health science, but also serve as an important motivation for further theory development and research in this context. Nurses and health professions can also benefit from a deeper understanding of coping concept in providing and planning healthcare for these patients.
Coping and its importance for quality of life in patients with multiple sclerosis
Disability and Rehabilitation, 2013
The aim of this study was to analyse whether problem-focused coping, coping focused on getting support and coping focused on stopping unpleasant emotions and thoughts are associated with different levels of physical and mental quality of life (PCS, MCS), controlling for gender, age and disease severity among MS patients. Method: The sample consisted of 113 consecutive MS patients (response rate: 79.6%; 77.0% women; mean age 40.8 AE 9.2). Patients completed the Short-Form Health Survey (SF-36) and the Coping Self-Efficacy Scale (CSE). Disability was assessed by Expanded Disability Status Scale (EDSS). The associations between CSE and PCS and MCS were analysed using linear regression. Results: EDSS and age were significantly associated only with PCS. The regression model for problem-focused coping, coping focused on getting support and coping focused on stopping unpleasant emotions and thoughts explained 29%, 24% and 35% of the variance in MCS, respectively. In PCS coping was not significant. Conclusions: Coping is significantly associated with MCS, but not with PCS. Stopping unpleasant emotions and thoughts seems to be the most important type of coping in MS patients. Thus, patients, their caregivers and their physicians should be educated about this type of coping and its positive association with MCS. ä Implications for Rehabilitation All types of coping are associated positively with mental component of Quality of life. Coping focused on stopping negative emotions and thoughts seems to be very adaptive for patients with MS. This type of coping can help patients with chronic conditions when problem-focused coping can not effectively solve the problem.
Physical and Psychosocial Adaptation Strategies for Patients with Multiple Sclerosis
Egyptian Journal of Health Care, 2021
Background: Multiple sclerosis (MS) is one of the most serious autoimmune neurological diseases. It can restrict the patient's functional abilities, social relationship, life pattern, occupational maintenance and wellbeing. Aim: This study aims to determine the physical and psychosocial adaptation strategies used by patients with multiple sclerosis. Research design: A cross sectional descriptive design was adopted to carry out this study. Settings: The study was conducted at neuropsychiatric outpatient clinic of Al Hadara Alexandria University Hospital. Subjects: A purposive sample of 110 patients admitted to the above mentioned setting and diagnosed with multiple sclerosis was recruited in this study. Tools: Four tools were used for data collection namely: Patients' demographic characteristics and clinical data sheet, Multiple Sclerosis Patients' Physical and Psychosocial Assessment Structured Interview Schedule, Physical Adaptation Strategies Structured Interview Schedule of Patients with Multiple Sclerosis and Psychosocial Adjustment to Illness Scale-Self-Report (PAIS-SR). Results: The study results revealed that sensory and motor symptoms scores was the highest mean of all physical disturbances parameters. More than half of the patients had high psychological and social disturbance. Physical, psychological, social disturbance score was negatively correlated with the total physical, psychosocial adaptation strategies score. Conclusion: MS has a negative impact not only on the physical activities, but also on the psychological, social and financial aspects of life. Recommendations: The developed booklet with its simple instructions and illustrations should be utilized in hospitals as a teaching aid for patient with MS. Periodic training program should be carried out for nurses working in the MS unit about health education and rehabilitation programs.
Development and validation of the coping with multiple sclerosis questionnaire A R T I C L E I N F O
2017
Background: Development of a self-report measure of coping with multiple sclerosis is required based on cultural factors, which can advance our understanding of the level of coping for care planning and improvement of coping and quality of life. The current study aimed to develop and validate the scale of coping with Multiple Sclerosis. Methods: This methodological study was conducted in three phases. In the first phase, the concept of coping with MS was defined by the hybrid model. In the second phase, the item pool was generated from findings of the first phase. In the third phase, psychometric properties of the scale were evaluated including face, content and construct validity as well as reliability. Results: 192 items in primary item pool were finally reduced to 35 items after evaluating the validity (face, content and construct validity) and reliability. Factor analyses revealed five factors: self-efficacy, self-regulation, accepting the current situation, treatment seeking and adherence to it, and emotional balance. Internal consistency and stability of the developed questionnaire confirmed with 0.93 and 0.96 respectively that indicated excellent reliability. Conclusion: The 35-item developed questionnaire is valid and reliable for assessment of levels of coping in Iranian people with MS.
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.
Quality of Life, Coping, and Social Support in Patients with Multiple Sclerosis: A Pilot Study
Objective: The aim of this study was to obtain information concerning the relationship between the sociodemographic attributes, social support systems, coping strategies, and quality of life of patients with multiple sclerosis (MS). Results: Sociodemographic variables have an impact on the coping styles of patients with MS. When the relationship between coping and quality of life is examined, there is a positive correlation between the use of problem-focused coping strategies and quality of life, whereas there is a negative correlation between the use of emotion-focused coping strategies and quality of life. The scores of active coping, planning, use of emotional support, and use of instrumental support of patients who received social support were higher, whereas their denial scores were lower. Conclusions: According to the findings of our study, the sociodemographic attributes and social support mechanisms of patients have an impact on their quality of life, as well as the way they cope with MS.
Coping strategies and mood profiles in patients with multiple sclerosis
Arquivos de Neuro-Psiquiatria, 2014
Objective: The aim of the present study was to investigate the coping strategies, mood characteristics and the association between these aspects in patients diagnosed with multiple sclerosis and healthy subjects. Method: Fifty consecutive patients who were diagnosed with multiple sclerosis according to McDonald criteria and thirty-one healthy subjects were included in the study. In addition to the sociodemographic form, Expanded Disability Status Scale (EDSS), Coping Orientation for Problem Experiences Scale (COPE), and Profile of Mood States (POMS) tests were applied to the participants. Results: Non-functional coping strategies were significantly higher in the secondary-progressive type (p≤0.05). Depression-dejection, fatigue-inertia and total POMS scores were significantly higher in the secondary-progressive type (p≤0.05). Conclusion: The results of our study demonstrate the importance of rehabilitation programs that encourage exercise among patients with multiple sclerosis to in...