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Wenzel L, Haker M, Heesen C, Kasper J, Köpke S, Rahn AC. Evaluating Relapse Knowledge in People with Multiple Sclerosis: A Cross-Sectional Study on the Development and Validation of the Relapse Knowledge Questionnaire. Mult Scler Relat Disord 2024; 83:105381. [PMID: 38308915 DOI: 10.1016/j.msard.2023.105381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 10/06/2023] [Accepted: 12/08/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) knowledge is a prerequisite for active patient engagement in medical decision-making. Treatment of relapses in MS is a clinical field with many uncertainties and each acute relapse requires decisions regarding possible options for action, indicating the need for patient involvement. However, there is no validated instrument assessing relapse knowledge in people with MS. Our study aims to develop a valid MS relapse questionnaire for use as an outcome instrument for educational interventions. METHODS A multidisciplinary panel developed the relapse knowledge questionnaire (RKQ) based on a previously developed questionnaire. We tested the RKQ on MS patients for comprehensibility, usability and acceptance in qualitative think-aloud interviews and conducted a cross-sectional quantitative online survey to validate the questionnaire. People with suspected or confirmed relapsing-remitting MS and a recent relapse experience were eligible for inclusion. We checked normal distribution of the RKQ score and determined the item difficulty. Construct validity was analysed using correlational analysis. RESULTS The final RKQ consists of 10 items. After minor changes of the RKQ during pre-testing (n = 2), pilot testing (n = 10) confirmed the usability and acceptance of the instrument. The subsequent validation study (n = 203) resulted in a mean item difficulty of 0.44, ranging from 0.18 to 0.83. Seven items were particularly difficult and answered incorrectly by more than 50 % of participants. Construct validity of the RKQ was satisfactory. The RKQ score correlated only weakly with participants' degree of education (|rp|>0.1), years since diagnosis (|rp|>0.1), and the intention to receive corticosteroids (|rp|>0.1). CONCLUSION This study indicates the validity of the RKQ and proposes that the RKQ is a suitable instrument to assess relapse knowledge in people with MS participating in educational interventions.
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Affiliation(s)
- Lisa Wenzel
- Institute of Nursing Science, University of Cologne, Medical Faculty & University Hospital Cologne, Cologne, Germany; Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Michel Haker
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Heesen
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen Kasper
- Institute of Nursing Sciences and Health Promotion, Faculty of Health Sciences, OsloMet, Metropolitan University, Oslo, Norway
| | - Sascha Köpke
- Institute of Nursing Science, University of Cologne, Medical Faculty & University Hospital Cologne, Cologne, Germany
| | - Anne Christin Rahn
- Institute of Social Medicine and Epidemiology, Nursing Research Unit, University of Lübeck, Lübeck, Germany
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Hamama L, Hamama-Raz Y, Lebowitz-Sokolover K, Ganelin-Cohen E. Well-being among parents of youth with multiple sclerosis: a preliminary longitudinal study. Front Psychol 2024; 15:1308141. [PMID: 38356769 PMCID: PMC10865376 DOI: 10.3389/fpsyg.2024.1308141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Background In 2021, the annual rate of pediatric-onset multiple sclerosis (POMS) in Israel among children was 1.5, and 4.5% among youth aged 14-18, out of a total of 5,000 multiple sclerosis cases nationwide. Children diagnosed with POMS often display various deficiencies across psychological, cognitive, sensory, and physical areas. As such, POMS poses significant challenges for parents' well-being, with heightened emotional, financial, and physical strains linked to both the immediate and long-term care requirements of their children. In this preliminary study, we examined changes over three time-points in two measures of well-being: satisfaction with life and psychological distress. In addition, the role of perceived social support (PSS) and coping flexibility was examined through a multilevel causal mediation model which suggested that PSS 1 month post-diagnosis would predict coping flexibility at 6 months post-diagnosis, which in turn would predict parents' life satisfaction and psychological distress at 12 months post-diagnosis. Methods The research was conducted at a tertiary university-affiliated children's hospital in central Israel. Preliminary data were obtained from 36 parents at three times-points. Participants provided demographic information and filled out the following standardized self-report questionnaires: the Diener's Satisfaction with Life Scale, Kessler's inventory for measuring psychological distress (K6), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Perceived Ability to Cope with Trauma Scale (PACT) for measuring coping flexibility. Results Over time (12 months), parents reported stable levels of PSS, coping flexibility, satisfaction with life, and psychological distress. In addition, mothers reported significantly greater PSS from friends than did fathers. Regarding the causal mediation model, greater PSS from friends at T1 was significantly associated with an increase in coping flexibility from T1 to T2. In turn, an increase in coping flexibility was associated with a decrease in psychological distress from T1 to T3 (after controlling for PSS). Yet the causal mediation path via coping flexibility to satisfaction with life was not significant. Conclusion This preliminary study emphasizes the important role of both PSS and coping flexibility for the well-being of parents whose children are affected by POMS, a subject that merits heightened consideration among healthcare professionals dealing with long-term chronic diseases.
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Affiliation(s)
- Liat Hamama
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | | | | | - Esther Ganelin-Cohen
- Institute of Pediatric Neurology, Schneider Children’s Medical Center, Petach Tikva, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Tarantino S, Proietti Checchi M, Papetti L, Monte G, Ferilli MAN, Valeriani M. Parental Experiences in Pediatric Multiple Sclerosis: Insights from Quantitative Research. CHILDREN (BASEL, SWITZERLAND) 2024; 11:71. [PMID: 38255384 PMCID: PMC10814813 DOI: 10.3390/children11010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/31/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024]
Abstract
Multiple sclerosis (MS) is a chronic and unpredictable inflammatory disease impacting the central nervous system. The disabling nature of this disease is not limited to only physical symptoms. MS, even at a pediatric age, often includes cognitive impairment, fatigue, and psychological issues, affecting education and social life, causing emotional distress, and reducing quality of life. Despite the paucity of quantitative data in the existing literature, our review demonstrates that the impact of pediatric MS extends beyond the patients themselves, affecting their parents as well. There is evidence suggesting that having a child with MS may be associated with a reduction in the parental quality of life, even in families of MS patients with low or no disability and without clinical relapses. Moreover, an increased risk of parents' mental illness has been described, particularly in mothers, leading to a heightened utilization of mental health services. Research data show that inadequate information about MS may impact parents' anxiety and their sense of competence. Since parents' involvement has been found to also play a role in their child's adherence to treatment, special attention should be paid to parental psychological health. Additional research exploring family adaptation to their children's illness is required.
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Affiliation(s)
- Samuela Tarantino
- Developmental Neurology Unit, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00165 Rome, Italy (L.P.); (M.V.)
| | - Martina Proietti Checchi
- Developmental Neurology Unit, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00165 Rome, Italy (L.P.); (M.V.)
| | - Laura Papetti
- Developmental Neurology Unit, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00165 Rome, Italy (L.P.); (M.V.)
| | - Gabriele Monte
- Developmental Neurology Unit, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00165 Rome, Italy (L.P.); (M.V.)
| | - Michela Ada Noris Ferilli
- Developmental Neurology Unit, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00165 Rome, Italy (L.P.); (M.V.)
| | - Massimiliano Valeriani
- Developmental Neurology Unit, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00165 Rome, Italy (L.P.); (M.V.)
- Systems Medicine Department, Tor Vergata University of Rome, 00133 Rome, Italy
- Center for Sensory-Motor Interaction, Aalborg University, 9220 Aalborg, Denmark
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Natali L, Cardi V, Lunghi M, Ferrara R, Marconi L, Bottesi G. The Acceptability of a Psychoeducation and Skill-Based Training for Carers and Teachers to Cope with Risky Behaviours in Adolescence. CHILDREN (BASEL, SWITZERLAND) 2023; 11:38. [PMID: 38255352 PMCID: PMC10814090 DOI: 10.3390/children11010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/21/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
Childhood and adolescence psychopathology is associated with an increased risk of psychological difficulties in adulthood. Early interventions for youth should provide carers and teachers with knowledge and skills to respond to adolescents' risky behaviours. This study evaluated the acceptability and effectiveness of a single 3-h workshop, combining psychoeducation and skills training to promote knowledge about, and confidence to address, adolescents' risky behaviours in carers and teachers of adolescents aged 10-14. Demographics and perceived self-efficacy in the parental or teaching role were collected at baseline using self-report questionnaires. Motivation and confidence to respond to adolescents' risky behaviours were measured before and after the workshop using motivational rulers. Participants provided written feedback about their experience about the workshop. Twenty-seven carers and 27 teachers attended the workshops. Teachers reported a significant increase in both importance (p = 0.021) and confidence (p < 0.001) to respond to risky behaviours following the workshop. This change was associated with baseline self-efficacy levels (importance: p = 0.011; confidence: p = 0.002). Carers also reported greater confidence to address risky behaviours following the workshop (p = 0.002). Participants found the contents and methods of the workshop highly acceptable. Online and multiple-session workshops might increase reach and effectiveness.
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Affiliation(s)
- Ludovica Natali
- Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padova, 35131 Padova, Italy; (L.N.); (V.C.); (M.L.); (R.F.); (L.M.)
- Department of General Psychology, University of Padova, 35131 Padova, Italy
| | - Valentina Cardi
- Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padova, 35131 Padova, Italy; (L.N.); (V.C.); (M.L.); (R.F.); (L.M.)
- Department of General Psychology, University of Padova, 35131 Padova, Italy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Marco Lunghi
- Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padova, 35131 Padova, Italy; (L.N.); (V.C.); (M.L.); (R.F.); (L.M.)
- Department of Developmental Psychology and Socialisation, University of Padova, 35131 Padova, Italy
| | - Rosanna Ferrara
- Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padova, 35131 Padova, Italy; (L.N.); (V.C.); (M.L.); (R.F.); (L.M.)
| | - Linda Marconi
- Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padova, 35131 Padova, Italy; (L.N.); (V.C.); (M.L.); (R.F.); (L.M.)
| | - Gioia Bottesi
- Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padova, 35131 Padova, Italy; (L.N.); (V.C.); (M.L.); (R.F.); (L.M.)
- Department of General Psychology, University of Padova, 35131 Padova, Italy
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Salmani S, Mousavi SH, Navardi S, Hosseinzadeh F, Pashaeypoor S. The barriers and facilitators to health-promoting lifestyle behaviors among people with multiple sclerosis during the coronavirus disease 2019 pandemic: a content analysis study. BMC Neurol 2022; 22:490. [PMID: 36536302 PMCID: PMC9761038 DOI: 10.1186/s12883-022-03019-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND AIM Health-promoting lifestyle behaviors (HPLBs) have a significant impact on disease management among people with multiple sclerosis (MS). However, the coronavirus disease 2019 (COVID-19) pandemic has significantly affected lifestyle of all individuals, particularly patients with chronic diseases. The present study aimed to explore the barriers and facilitators to HPLBs among people with MS during the COVID-19 pandemic. METHODS This qualitative study was conducted in Iran. Participants were sixteen people with MS purposively selected from the central MS clinic of a referral specialty neuroscience hospital in Tehran, Iran. Data were collected via in-depth semi-structured face-to-face interviews and concurrently analyzed through conventional content analysis. FINDINGS The mean of participants' age was 37.93 years and most participants were female (81.25%). The major barriers to HPLBs were lack of knowledge, limited access to resources, and poor health status, while the major facilitators were attention to inner abilities and social support. CONCLUSION Many different factors such as lack of knowledge, limited access to resources, poor health status, awareness, and social support can influence engagement in HPLBs among people with MS. Healthcare authorities and policymakers need to use quality educational and supportive interventions to improve knowledge, health literacy, perceived support, self-efficacy, and self-care ability among people with MS during the COVID-19 pandemic.
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Affiliation(s)
- Soheileddin Salmani
- Department of Nursing, Rozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Samira Navardi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hosseinzadeh
- Department of Community Health Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahzad Pashaeypoor
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Community Based Participatory Research Center, Iranian Institute for Reduction of High – Risk Behaviors,, Tehran University of Medical Sciences, Tehran, Iran
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Podda J, Uccelli MM, Tacchino A, Pedullà L, Bragadin MM, Battaglia MA, Brichetto G, Ponzio M. Predictors of Mood Disorders in Parents With Multiple Sclerosis: The Role of Disability Level, Coping Techniques, and Perceived Social Support. Int J MS Care 2022; 24:224-229. [PMID: 36090243 PMCID: PMC9461724 DOI: 10.7224/1537-2073.2021-101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
BACKGROUND Being a parent can be demanding and stressful, especially for people with chronic diseases such as multiple sclerosis (MS). Parenting can be disrupted by flareups, disease worsening, and other MS symptoms, including mobility problems, pain, fatigue, and cognitive impairment. Mood disorders, such as depression and anxiety, have been found to occur at much higher rates in people with MS than in the general population. Surprisingly, less is known about which factors may predict mood disorders in parents with MS. This study aims to identify potential demographic, clinical, and self-reported predictors that contribute to mood disorders measured by the Hospital Anxiety and Depression Scale. METHODS A total of 285 parents with MS completed an anonymous online questionnaire combining sociodemographic, clinical, and family characteristics and scales, validated in Italian, related to coping strategies and social support. Associations between each variable and mood disorders were assessed using univariate and multivariate logistic regression analyses. RESULTS Disability level, emotional and dysfunctional coping strategies, and perceived social support were significant predictors of mood disorders in parents with MS. CONCLUSIONS These findings confirm the importance of identifying risk factors for mood disorders in parents with MS so that early intervention can minimize mood disruptions caused by the disease.
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Affiliation(s)
- Jessica Podda
- From Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy (JP, MMU, AT, LP, MMB, GB, MP)
| | - Michele Messmer Uccelli
- From Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy (JP, MMU, AT, LP, MMB, GB, MP)
| | - Andrea Tacchino
- From Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy (JP, MMU, AT, LP, MMB, GB, MP)
| | - Ludovico Pedullà
- From Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy (JP, MMU, AT, LP, MMB, GB, MP)
| | - Margherita Monti Bragadin
- From Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy (JP, MMU, AT, LP, MMB, GB, MP)
- From AISM Rehabilitation Service, Italian Multiple Sclerosis Society, Genoa, Italy (MMB, GB)
| | - Mario Alberto Battaglia
- From the Department of Physiopathology, Experimental Medicine, and Public Health, University of Siena, Siena, Italy (MAB)
| | - Giampaolo Brichetto
- From Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy (JP, MMU, AT, LP, MMB, GB, MP)
- From AISM Rehabilitation Service, Italian Multiple Sclerosis Society, Genoa, Italy (MMB, GB)
| | - Michela Ponzio
- From Scientific Research Area, Italian Multiple Sclerosis Foundation, Genoa, Italy (JP, MMU, AT, LP, MMB, GB, MP)
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Messmer Uccelli M, Ponzio M, Traversa S. What factors influence feeling competent as a parent with multiple sclerosis? Chronic Illn 2022; 18:46-57. [PMID: 31865757 DOI: 10.1177/1742395319895310] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify factors that influence the perception parents with multiple sclerosis have of their competence in parenting. METHOD/DESIGN Subjects were parents of a child with a maximum of 18 years of age recruited through a national multiple sclerosis organization's social media channels. Data on demographic and disease information, mood, coping, quality of life and perceived social support were collected using an anonymous online questionnaire. Univariate and multivariate analyses were performed to assess associations between these variables and subjects' perception of parenting sense of competence. RESULTS The sample consisted of 285 parents with multiple sclerosis, with a mean age of 41 years and a mean disease duration of 10.4 years. In the multivariate analysis, independent determinants of lower parenting sense of competence were anxiety (p = 0.012), depression (p = 0.001) and dysfunctional coping (p = 0.005). Problem-focused coping (p = 0.029) and higher physical and mental scores on the SF-12 (p = 0.006, p < 0.001, respectively) were related to a higher parenting sense of competence. Higher parent age correlated with a lower sense of parenting competence (p = 0.002). CONCLUSIONS The perception parents with multiple sclerosis have of their parenting competence was most strongly correlated with mood, coping strategies and health-related quality of life, factors that are potentially modifiable.
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Affiliation(s)
| | - Michela Ponzio
- Italian Multiple Sclerosis Society Research Foundation, Genoa, Italy
| | - Silvia Traversa
- Italian Multiple Sclerosis Society Research Foundation, Genoa, Italy
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Ghai S, Kasilingam E, Lanzillo R, Malenica M, van Pesch V, Burke NC, Carotenuto A, Maguire R. Needs and Experiences of Children and Adolescents with Pediatric Multiple Sclerosis and Their Caregivers: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2021; 8:445. [PMID: 34070298 PMCID: PMC8226634 DOI: 10.3390/children8060445] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/19/2021] [Accepted: 05/23/2021] [Indexed: 01/21/2023]
Abstract
In the present study we conduct a systematic review to evaluate the needs and experience of people with pediatric multiple sclerosis (MS) and their caregivers. The literature search was conducted across 10 academic databases, adhering to PRISMA-P guidelines. Quality appraisal was conducted using the mixed method appraisal test for individual studies, and GRADE-CERQual to establish overall confidence of findings. Results were analyzed using a process of narrative synthesis. We identified 26 studies which included 2253 children/adolescents with MS (CAMS) and 1608 caregivers. MS was reported to negatively impact experiences for CAMS in domains such as of school performance, social relationships, mental health, and overall physical functioning. Specifically, fatigue and social support were reported as the most important barriers and facilitators for CAMS, respectively. In terms of caregiver experience, negative impacts were reported on social functioning, mental health, and quality of life. Additionally, lack of awareness concerning MS was one of the biggest challenges reported. Caregivers expressed needs for psychological and social support. This study provides the first evidence regarding the needs and experiences of CAMS and their caregivers. Findings can be used to address policy gaps for supporting families affected by pediatric MS.
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Affiliation(s)
- Shashank Ghai
- School of Physical and Occupational Therapy, McGill University, Montréal, QC H3G 1Y5, Canada
- Feil & Oberfeld Research Centre of the Jewish Rehabilitation Hospital—CISSS Laval, a Research Site of the Centre for Interdisciplinary Research of Greater Montreal (CRIR), Laval, QC H7V 1R2, Canada
- Department of Family Medicine, McGill University, Montréal, QC GRM MDI, Canada
| | | | - Roberta Lanzillo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, 80138 Naples, Italy; (R.L.); (A.C.)
| | - Masa Malenica
- Department of Child Neurology, Associated Member of the ERN EpiCARE, Sestre Milosrdnice University Hospital Center, 10000 Zagreb, Croatia;
| | - Vincent van Pesch
- Department of Neurology, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium;
| | - Niamh Caitlin Burke
- Department of Psychology, Maynooth University, Maynooth W23 F2K8, Ireland; (N.C.B.); (R.M.)
| | - Antonio Carotenuto
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, 80138 Naples, Italy; (R.L.); (A.C.)
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth W23 F2K8, Ireland; (N.C.B.); (R.M.)
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Bessing B, Honan CA, van der Mei I, Taylor BV, Claflin SB. Development and psychometric properties of the Multiple Sclerosis Knowledge Assessment Scale: Rasch analysis of a novel tool for evaluating MS knowledge. Mult Scler 2021; 27:767-777. [PMID: 33739199 DOI: 10.1177/1352458520929626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Multiple sclerosis (MS)-related knowledge is an important evaluation metric for health education interventions. However, few MS knowledge assessment tools are currently available for use. OBJECTIVES This study aims to develop a reliable and valid Multiple Sclerosis Knowledge Assessment Scale (MSKAS) for use in the MS community and the general public. METHODS The MSKAS was developed using a Delphi study methodology and was administered to participants in the first open enrolment of the Understanding Multiple Sclerosis (UMS) online course. Rasch analysis was used to examine its psychometric properties and develop the final scale. RESULTS Experts from across the MS community participated in the development of the MSKAS, resulting in an initial scale of 42 items. Five hundred and forty-three UMS participants completed the MSKAS; 89% were female and 30% were people with MS. The final unidimensional 22-item scale has a person separation index of 2.16, a person reliability index of 0.82, an item separation index of 11.19, and a Cronbach's alpha (kr-20) test reliability of 0.87. CONCLUSION The MSKAS is a unidimensional scale with good construct validity and internal consistency. The MSKAS has the potential to be useful for the assessment of MS knowledge in research and clinical practice.
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Affiliation(s)
- Barnabas Bessing
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Cynthia A Honan
- Division of Psychology, School of Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Ingrid van der Mei
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Bruce V Taylor
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Suzi B Claflin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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Cross TP, Shanks AK, Duffy LV, Rintell DJ. Families' Experience of Pediatric Onset Multiple Sclerosis. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2019; 12:425-435. [PMID: 32318212 PMCID: PMC7163806 DOI: 10.1007/s40653-018-0243-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study interviewed parents to understand families' experience with pediatric onset multiple sclerosis (POMS), which make up 2.7% to 10.5% of all MS cases. 21 sets of parents of children with a confirmed diagnosis of POMS were recruited from two pediatric MS centers. Families experienced stress from the uncertainty prior to diagnosis, anxiety over symptoms and possible progression of the disease, frustrations with the uncertain effects of disease-modifying treatments (DMTs), and difficulties with injections. Families had to cope with cognitive and physical effects of POMS at school, decisions about expectations and independence for the child, and extra demands POMS placed on the family. Most parents reported benefitting from support from physicians, the National Multiple Sclerosis Society, and the MS community. Families had benefitted from DMTs, and, despite the stresses, most had adapted successfully to the illness. Advice from interviewees to other parents and recommendations for improving family support are presented.
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Affiliation(s)
- Theodore P. Cross
- Children and Family Research Center, University of Illinois at Urbana-Champaign, 1010 W. Nevada St, Urbana, IL 61801 USA
| | - Alane K. Shanks
- Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital, Boston, MA USA
- Present Address: Renga Consulting, Brookline, MA 02445 USA
| | - Lisa V. Duffy
- Pediatric Multiple Sclerosis & Related Disorders Program, Department of Neurology, Boston Children’s Hospital, Boston, MA USA
- Bouve College of Health Sciences, Northeastern University, Boston, MA USA
| | - David J. Rintell
- Partners Pediatric Multiple Sclerosis Center, Massachusetts General Hospital, Boston, MA USA
- Present Address: BridgeBio, Palo Alto, CA USA
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Hebert D, Geisthardt C, Hoffman H. Insights and Recommendations From Parents Receiving a Diagnosis of Pediatric Multiple Sclerosis for Their Child. J Child Neurol 2019; 34:464-471. [PMID: 31012369 DOI: 10.1177/0883073819842420] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Forty-two parents of 41 children reported on their experiences receiving a diagnosis of pediatric-onset multiple sclerosis for their child through semistructured phone interviews. Time to diagnosis ranged from 8 hours to 16 years, with the mean age at diagnosis of 13.7 years. The most common initial symptoms included visual disturbances and numbness. The mean number of medical visits to receive a diagnosis was 3.6. Parents reported feeling frustrated and overwhelmed during the diagnosis process, as well as shocked when told their child had multiple sclerosis. Parents emphasized the need for more awareness of pediatric-onset multiple sclerosis. Numerous parents reported encountering physicians who believed multiple sclerosis did not occur in childhood, contributing to a longer time to diagnosis. Parents preferred physicians first share the diagnosis with the parents without the child present. Finally, parents appreciated when physicians provided a variety of resources to help them cope with the diagnosis.
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Affiliation(s)
- Danielle Hebert
- 1 Central Michigan University College of Medicine, Mount Pleasant, MI, USA
| | - Cheryl Geisthardt
- 2 College of Education and Human Services, Central Michigan University, Mount Pleasant, MI, USA
| | - Holly Hoffman
- 2 College of Education and Human Services, Central Michigan University, Mount Pleasant, MI, USA
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O’Mahony J, Marrie RA, Laporte A, Bar-Or A, Yeh EA, Brown A, Dilenge ME, Banwell B. Pediatric-onset multiple sclerosis is associated with reduced parental health–related quality of life and family functioning. Mult Scler 2018; 25:1661-1672. [DOI: 10.1177/1352458518796676] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Diagnosis of multiple sclerosis (MS) during childhood has the potential to impact the affected child’s self-perception and the health-related quality of life (HRQoL) of the family. Objective: To evaluate the impact of chronic disease, in children ascertained as having MS and their families, when compared to those with monophasic acquired demyelinating syndrome (monoADS). Methods: In a national prospective cohort study of pediatric acquired demyelinating syndromes (ADS), the HRQoL of children and their families was captured using the Pediatric Quality of Life Inventory (PedsQL™) Modules. Results: Participants (58 MS; 178 monoADS) provided cross-sectional HRQoL data a median (interquartile range (IQR)) of 4.1 (2.0–6.0) years after disease onset. The HRQoL of parents of children with MS and their family functioning was lower when compared to that of parents and families of children with monoADS (both p < 0.001); parents of children with MS reported greater emotional dysfunction, worry, worse communication, and lower family functioning irrespective of clinical disease activity. Self-reports of the MS and monoADS participants did not suggest a difference in overall HRQoL or fatigue after adjusting for age of the child at the time of assessment. Conclusion: While children with MS did not self-report lower HRQoL compared to children who experienced monoADS, the diagnosis of MS during childhood was negatively associated with parental HRQoL and family functioning.
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Affiliation(s)
- Julia O’Mahony
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada/The Hospital for Sick Children, Toronto, ON, Canada/Canadian Centre for Health Economics, Toronto, ON, Canada
| | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Audrey Laporte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada/Canadian Centre for Health Economics, Toronto, ON, Canada
| | - Amit Bar-Or
- Center for Neuroinflammation and Experimental Therapeutics and Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - E Ann Yeh
- Department of Pediatrics, University of Toronto, Canada; Division of Neurology, The Hospital for Sick Children, Neurosciences and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada
| | - Adalsteinn Brown
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | - Brenda Banwell
- Division of Child Neurology, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Uccelli MM. The impact of multiple sclerosis on family members: a review of the literature. Neurodegener Dis Manag 2014; 4:177-85. [PMID: 24832035 DOI: 10.2217/nmt.14.6] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Multiple sclerosis (MS) is one of the most common neurological diseases in young adults and involves inflammatory demyelination of the CNS. MS typically manifests between 20 and 40 years of age, and can lead to significant disability in some cases. The disease course is unpredictable. MS has a significant impact on families, influencing their wellbeing and quality of life, often creating psychological stress in each family member as well as on family functioning in general. Common themes include the impact of the emotional state of the person with MS on family members, the role of the healthy parent on how children cope, the effect of a lack of information about MS, communication within the family and with healthcare professionals, and the importance of assessing and treating families as a dynamic unit in order to assure comprehensive intervention plans. The current literature review is based on 30 full research articles meeting inclusion criteria related to partners/couples, family caregivers, children with a parent with MS and parents of young children with MS.
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Affiliation(s)
- Michele Messmer Uccelli
- * Italian Multiple Sclerosis Society, Healthcare Professional & Client Programs, Via Operai 40, Genoa 16149, Italy;
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Abstract
As a consequence of the current shortened diagnostic workup, people with multiple sclerosis (PwMS) are rapidly confronted with a disease of uncertain prognosis that requires complex treatment decisions. This paper reviews studies that have assessed the experiences of PwMS in the peri-diagnostic period and have evaluated the efficacy of interventions providing information at this critical moment. The studies found that the emotional burden on PwMS at diagnosis was high, and emphasised the need for careful monitoring and management of mood symptoms (chiefly anxiety). Information provision did not affect anxiety symptoms but improved patients’ knowledge of their condition, the achievement of ‘informed choice’, and satisfaction with the diagnosis communication. It is vital to develop and implement information and decision aids for PwMS, but this is resource intensive, and international collaboration may be a way forward. The use of patient self-assessed outcome measures that appraise the quality of diagnosis communication is also important to allow health services to understand and meet the needs and preferences of PwMS.
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