1
|
Vandenbogaerde I, Van den Block L, Deliens L, Carduff E, van der Heide A, De Bleecker J, De Vleminck A. Experiences with advance care planning in amyotrophic lateral sclerosis: Qualitative longitudinal study with people with amyotrophic lateral sclerosis and their family carers. Palliat Med 2024; 38:572-581. [PMID: 38610119 DOI: 10.1177/02692163241242320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
BACKGROUND It is unclear when people with amyotrophic lateral sclerosis and their family carers think about their future, what they would prefer in terms of care, and how their ideas change over time. AIM Understanding experiences with advance care planning of persons with amyotrophic lateral sclerosis and their family carers-and if, when, how, and why these experiences change over time. DESIGN A qualitative longitudinal interview study. Analysis involved content analysis, followed by a two-step timeline method to describe changes in advance care planning experiences within and across participants. SETTING/PARTICIPANTS Nine persons with amyotrophic lateral sclerosis and nine family carers who were interviewed three times over a 9-month period. RESULTS All participants thought about future care, but few talked about it. Over time, advance care planning experiences were influenced by intertwined elements: (1) experienced physical decline and related future care needs; (2) how persons with amyotrophic lateral sclerosis identify themselves as patients; (3) obtaining information about diagnosis and prognosis; (4) professionals initiating conversations about medical aspects of end-of-life decisions; (5) balancing between hope to remain stable and worry about the future; and (6) protecting themselves and each other from worries about the future. CONCLUSION This study emphasizes how factors such as coping with the disease and relational dynamics shape individuals' thoughts about future care over time and how psychological, social, and medical factors are interwoven in advance care planning. The findings advocate for a process-oriented perspective, portraying advance care planning as an ongoing dialog, encompassing the needs, concerns, and emotions of both people with amyotrophic lateral sclerosis and their family carers.
Collapse
Affiliation(s)
- Isabel Vandenbogaerde
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Universiteit Gent, Brussels, Belgium
- Department of Public Health and Primary Care, Universiteit Gent, Ghent, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| | - Lieve Van den Block
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Universiteit Gent, Brussels, Belgium
- Department of Public Health and Primary Care, Universiteit Gent, Ghent, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| | - Luc Deliens
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Universiteit Gent, Brussels, Belgium
- Department of Public Health and Primary Care, Universiteit Gent, Ghent, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| | | | - Agnes van der Heide
- Erasmus MC, University Medical Centre Rotterdam, Department of Public Health, Rotterdam, The Netherlands
| | - Jan De Bleecker
- Department of Head and Skin, Ghent University Hospital, Universiteit Gent, Ghent, Belgium
| | - Aline De Vleminck
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Universiteit Gent, Brussels, Belgium
- Department of Public Health and Primary Care, Universiteit Gent, Ghent, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| |
Collapse
|
2
|
Finsel J, Rosenbohm A, Peter RS, Bäzner H, Börtlein A, Dempewolf S, Schabet M, Hecht M, Kohler A, Opherk C, Nägele A, Sommer N, Lindner A, Rothenbacher D, Ludolph AC, Nagel G, Lulé DE. Coping as a resource to allow for psychosocial adjustment in fatal disease: results from patients with amyotrophic lateral sclerosis. Front Psychol 2024; 15:1361767. [PMID: 38638511 PMCID: PMC11024296 DOI: 10.3389/fpsyg.2024.1361767] [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: 12/28/2023] [Accepted: 03/11/2024] [Indexed: 04/20/2024] Open
Abstract
Background Amyotrophic lateral sclerosis (ALS) is a fatal disorder, which imposes a severe emotional burden on patients. Appropriate coping mechanisms may alleviate this burden and facilitate wellbeing, with social support known to be a successful coping strategy. This observational study aimed to determine the interplay of general coping traits of hope for success and fear of failure, coping behavior of social activity, and patients' wellbeing. Methods In this cross-sectional study, patients with ALS from a clinical-epidemiological registry in Southwestern Germany were interviewed regarding coping traits (achievement-motivated behavior: hope for success and fear of failure), coping behavior of social activity, and psychosocial adjustment, determined using measures of depressiveness, anxiety [both measured by Hospital Anxiety and Depression Scale (HADS)], and quality of life [Anamnestic Comparative Self-Assessment (ACSA)]. Demographics, clinical [ALS Functional Rating Scale revised version (ALSFRS-R)], and survival data were recorded. Results A total of 868 patients [60.70% male patients, mean age: 64.70 (±10.83) years, mean ALSFRS-R: 37.36 ± 7.07] were interviewed. Anxiety in patients was found to be associated with a high fear of failure. In contrast, a generally positive attitude in patients exemplified in high hopes for success was associated with better wellbeing. Finally, coping behavior of social activity explained up to 65% of the variance of depressiveness among the patients with ALS. Conclusion In this study, we present evidence that the wellbeing of patients with ALS is not an immediate fatalistic consequence of physical degradation but rather determined by coping traits and behavior, which may be trained to substantially increase the wellbeing of patients with ALS.
Collapse
Affiliation(s)
- Julia Finsel
- Department of Neurology, Ulm University, Ulm, Germany
| | | | - Raphael S. Peter
- Institute for Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Hansjörg Bäzner
- Department of Neurology, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - Axel Börtlein
- Department of Neurology, Katharinenhospital Stuttgart, Stuttgart, Germany
| | - Silke Dempewolf
- Department of Neurology, RKH Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Martin Schabet
- Department of Neurology, RKH Klinikum Ludwigsburg, Ludwigsburg, Germany
| | - Martin Hecht
- Department of Neurology, Klinikum Kaufbeuren, Kliniken Oberallgäu-Kaufbeuren, Kaufbeuren, Germany
| | - Andreas Kohler
- Department of Neurology, Klinikum am Gesundbrunnen Heilbronn, Heilbronn, Germany
| | - Christian Opherk
- Department of Neurology, Klinikum am Gesundbrunnen Heilbronn, Heilbronn, Germany
| | - Andrea Nägele
- Department of Neurology, Christophsbad Göppingen, Göppingen, Germany
| | - Norbert Sommer
- Department of Neurology, Christophsbad Göppingen, Göppingen, Germany
| | - Alfred Lindner
- Department of Neurology, Marienhospital Stuttgart, Stuttgart, Germany
| | | | - Albert C. Ludolph
- Department of Neurology, Ulm University, Ulm, Germany
- German Center for Neurodegenerative Diseases (DZNE), Ulm Site, Ulm, Germany
| | - Gabriele Nagel
- Institute for Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | |
Collapse
|
3
|
Canella C, Braun C, Witt CM. Developing a digital mind body medicine supportive care intervention for people with amyotrophic lateral sclerosis using stakeholder engagement and design thinking. Digit Health 2024; 10:20552076241255928. [PMID: 38774156 PMCID: PMC11107314 DOI: 10.1177/20552076241255928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/01/2024] [Indexed: 05/24/2024] Open
Abstract
Background Amyotrophic lateral sclerosis disease (ALS) is also called the disease of a thousand farewells. Consequently, it is important to offer supportive care interventions that can be applied continuously during the whole course of the disease. People with ALS are interested in complementary and integrative medicine. Due to ALS' progressive nature, digital solutions might be most feasible and accessible for people with ALS in the long-term. Objectives In our study, we explored with stakeholders which digital complementary and integrative medicine interventions and formats are considered as supportive for people with ALS, and which settings are needed by the people with ALS to incorporate the interventions in everyday life. Methods We used a participatory research approach and conducted a stakeholder engagement process, applying a design thinking process with qualitative research methods (interviews, workshops). Results Due to the unpredictable course of the disease on their loss of abilities, people with ALS welcome online settings because they are accessible and easy to implement in their daily life. Stakeholders considered the following implementation factors for a complementary and integrative medicine intervention as essential: short-term realization of planned interventions, short duration of interventions, and user-friendliness in terms of accessibility and applicability. Concerning the complementary and integrative medicine interventions, the people with ALS preferred mind body medicine interventions, such as breathing, mindfulness and relaxation exercises. Conclusions Short-term treatment intervals and short online mind body medicine interventions align with the needs of people with ALS. The complementary and integrative medicine interventions as well as the digital infrastructure must meet the special accessibility and applicability needs of people with ALS.
Collapse
Affiliation(s)
- Claudia Canella
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Carina Braun
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Claudia M. Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| |
Collapse
|
4
|
Ando H, Cousins R, Young CA. Flexibility to manage and enhance quality of life among people with motor neurone disease. Disabil Rehabil 2022; 44:2752-2762. [PMID: 33226867 DOI: 10.1080/09638288.2020.1846797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To identify influential factors for quality of life (QoL) among individuals with motor neurone disease (MND) and explore how regulatory flexibility and psychological flexibility may contribute towards maintaining and improving QoL. METHODS Semi-structured interviews were conducted with 26 individuals with MND. Thematic analysis, using both inductive and deductive analyses, was employed to examine subjective QoL in view of previous understanding of QoL. RESULTS Four factors were important for the QoL of participants: perceived illness prognosis, sense of self, concerns for significant others, and life to enjoy. These factors reflected psychological stress caused by MND, the participant's value system, and their beliefs about life. In optimising QoL, both regulatory flexibility and psychological flexibility were essential to maintain and enhance QoL. Often, regulatory flexibility was perceived among those employing a mindful approach, and psychological flexibility was found to involve savouring positive experiences. CONCLUSIONS People with MND reported that seeking ways to both maintain and enhance their QoL is crucial, and that this may be accomplished by increasing flexibility through mindfulness and savouring. (171/200 words)Implications for rehabilitationPeople with motor neurone disease (MND) seek to maintain quality of life (QoL) following changes caused by the condition, whilst attempting to enhance QoL by maximising their positive experiences.Regulatory flexibility is essential to maintain QoL and it was closely associated with mindful approach so that MND is not perceived as an inevitable threat to QoL.Psychological flexibility was found to enhance QoL and it involves savouring positive experiences, while abandoning fault-finding of the current situation.Positive inter-personal interactions can encourage people with MND to engage with mindfulness and savouring for favourable outcomes in terms of QoL; current support services should orient towards both mindfulness and savouring.
Collapse
Affiliation(s)
- Hikari Ando
- The Walton Centre NHS Foundation Trust, Liverpool, UK.,Department of Psychology, Liverpool Hope University, Liverpool, UK
| | - Rosanna Cousins
- Department of Psychology, Liverpool Hope University, Liverpool, UK
| | | |
Collapse
|
5
|
Marr NS, Zainal NH, Newman MG. Focus on and venting of negative emotion mediates the 18-year bi-directional relations between major depressive disorder and generalized anxiety disorder diagnoses. J Affect Disord 2022; 303:10-17. [PMID: 35065091 PMCID: PMC8917061 DOI: 10.1016/j.jad.2022.01.079] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 01/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Myriad emotion regulation and coping theories have proposed that avoidant/emotion-oriented coping is a cause and consequence of anxiety and depression. However, few studies have investigated potential mechanisms underlying the prospective anxiety-depression disorder relation. The current study examined various coping strategies (i.e., denial, focus on and venting of emotion (FOAVE), and behavioral disengagement) as potential longitudinal mediators between generalized anxiety disorder (GAD) and major depressive disorder (MDD). METHODS In a nationally representative sample of adults (N = 3,294), MDD and GAD were assessed at Time 1 (T1) and Time 3 (T3) (Composite International Diagnostic Interview - Short-Form), and avoidant coping strategies (denial, behavioral disengagement, and FOAVE) were measured at Time 2 (T2) (Coping Questionnaire). Assessments occurred over 18 years, each spaced approximately 9 years apart. Structural equation modeling mediation analyses examined whether T1 MDD predicted T3 GAD (and vice versa), and if T2 avoidant coping mediated these relations, above and beyond baseline comorbidity. RESULTS FOAVE mediated the T1 MDD-T3 GAD association, and vice versa. Presence of T1 MDD and GAD predicted more T2 FOAVE, and greater T2 FOAVE forecasted T3 MDD and GAD, accounting for 16-21% of the longitudinal MDD-GAD relations. However, behavioral disengagement and denial did not mediate the prospective MDD-GAD relations. Also, T1 MDD and GAD forecasted greater T2 behavioral disengagement. CONCLUSIONS The use of FOAVE, may be a mechanism by which MDD earlier in life may lead to GAD 18 years later, and vice versa. Theoretical and potential clinical implications are discussed.
Collapse
|
6
|
Sethi A, Everett E, Mehta A, Besbris J, Burke C, Pedowitz E, Kilpatrick M, Foster L, Maiser S. The Role of Specialty Palliative Care for Amyotrophic Lateral Sclerosis. Am J Hosp Palliat Care 2021; 39:865-873. [PMID: 34583569 DOI: 10.1177/10499091211049386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a progressive and incurable neurodegenerative disease resulting in the loss of motor neurons, eventually leading to death. ALS results in complex physical, emotional, and spiritual care needs. Specialty Palliative Care (SPC) is a medical specialty for patients with serious illness that provides an extra layer of support through complicated symptom management, goals of care conversations, and support to patients and families during hard times. Using MEDLINE, APA Psychinfo, and Dynamed databases, we reviewed the literature of SPC in ALS to inform and support an expert opinion perspective on this topic. This manuscript focuses on several key areas of SPC for ALS including insurance and care models, advance care planning, symptom management, quality of life, caregiver support, and end-of-life care. Recommendations to improve specialty palliative care for patients with ALS are reviewed in the discussion section.
Collapse
Affiliation(s)
- Anish Sethi
- University of Minnesota College of Biological Sciences, Minneapolis, MN, USA
| | - Elyse Everett
- John T. Milliken Department of Medicine, Washington University School of Medicine in St. Louis, MO, USA
| | - Ambereen Mehta
- Department of Medicine, John Hopkins Medicine, Baltimore, MD, USA
| | - Jessica Besbris
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Christa Burke
- Division of Palliative Medicine, John T. Milliken Department of Medicine, Barnes-Jewish Hospital, St. Louis, MO, USA
| | - Elizabeth Pedowitz
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Molly Kilpatrick
- Palliative Care and Supportive Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Laura Foster
- Department of Neurology, University of Colorado School of Medicine, Boulder, CO, USA
| | - Sam Maiser
- University of Minnesota College of Biological Sciences, Minneapolis, MN, USA.,Department of Neurology, Hennepin Healthcare, Minneapolis, MN, USA
| |
Collapse
|
7
|
Cleary S, Misiaszek JE, Wheeler S, Kalra S, Genuis SK, Johnston WS. Lung volume recruitment improves volitional airway clearance in amyotrophic lateral sclerosis. Muscle Nerve 2021; 64:676-682. [PMID: 34505708 PMCID: PMC9293446 DOI: 10.1002/mus.27417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 11/11/2022]
Abstract
Introduction/Aims In this study we evaluated the effects of lung volume recruitment treatment (LVR), a low‐tech, low‐cost, manual “breath‐stacking” technique used to help people cough with enough force to clear their airways, thereby reducing the risk of aspiration and choking, on five volitional airway clearance and protection behaviors used by people living with amyotrophic lateral sclerosis (PwALS). Methods Using a repeated‐measures cross‐over design, 29 PwALS performed five volitional airway clearance and protection behaviors in LVR treatment and in no‐treatment, control conditions. Peak cough flow (PCF) was used to measure maximum expiratory rate during forced expiration, throat clearing, hawking, post‐swallow coughing, and the supraglottic swallowing maneuver. Comparisons were made as a function of condition (treatment or control) and three time‐points (pretreatment, and 15 and 30 minutes posttreatment). Results LVR treatment had a significant positive effect on maximum expiratory rates during all tested airway clearance and protection behaviors. Increased PCF values lasted for up to 30 minutes post‐LVR for all tested behaviors in the treatment condition. Discussion We found that LVR treatment could increase control over airway clearance in PwALS, as well as provide improved airway protection for up to 30 minutes, the duration of a typical meal. This study has implications for patient care. These include offering patients control over some of the most feared symptoms of ALS, particularly choking during activities of daily living, and enhanced ALS respiratory care in low‐resource settings. Findings may have implications for other neurodegenerative disorders in which dysphagia occurs with retained sensory function.
Collapse
Affiliation(s)
- Stuart Cleary
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - John E Misiaszek
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Sonya Wheeler
- Misericordia Hospital, Covenant Health Group, Edmonton, Alberta, Canada
| | - Sanjay Kalra
- Division of Neurology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Shelagh K Genuis
- Division of Neurology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Wendy S Johnston
- Division of Neurology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
8
|
Pinto C, Geraghty AWA, Yardley L, Dennison L. Emotional distress and well-being among people with motor neurone disease (MND) and their family caregivers: a qualitative interview study. BMJ Open 2021; 11:e044724. [PMID: 34404695 PMCID: PMC8372816 DOI: 10.1136/bmjopen-2020-044724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We aimed to get an in-depth understanding of the emotions experienced by people with motor neurone disease (MND) and their caregivers, and to explore what impacts emotional distress and well-being. DESIGN Qualitative study using semi-structured interviews with people with MND and caregivers. SETTING Participants were recruited from across the UK and took part in interviews conducted either face to face, by telephone or email to accommodate for varying levels of disability. PARTICIPANTS 25 people with MND and 10 caregivers took part. Participants were purposively sampled based on their MND diagnosis, symptoms and time since diagnosis. DATA ANALYSIS Data were analysed using inductive reflexive thematic analysis. RESULTS Eight broad themes were generated (20 subthemes). Participants described the emotional distress of losing physical function and having a threatened future because of poor prognosis. Keeping up with constant changes in symptoms and feeling unsupported by the healthcare system added to emotional distress. Finding hope and positivity, exerting some control, being kinder to oneself and experiencing support from others were helpful strategies for emotional well-being. CONCLUSION The study provides a broad understanding of what impacts emotional distress and well-being and discusses implications for psychological interventions for people with MND and caregivers. Any communication and support provided for people with MND and their caregivers, needs to pay attention to concepts of hope, control and compassion.
Collapse
Affiliation(s)
- Cathryn Pinto
- Department of Psychology, University of Southampton, Southampton, UK
| | - Adam W A Geraghty
- Primary Care and Population Sciences, University of Southampton, Southampton, Hampshire, UK
| | - Lucy Yardley
- Department of Psychology, University of Southampton, Southampton, UK
- School of Health Sciences, University of Bristol, Bristol, UK
| | - Laura Dennison
- Department of Psychology, University of Southampton, Southampton, UK
| |
Collapse
|
9
|
Leandro GS, Dourado Júnior MET, Santana GC, Dantas LSX. Coping strategies among amyotrophic lateral sclerosis (ALS) patients: an integrative review. J Neurol 2021; 269:693-702. [PMID: 33783642 DOI: 10.1007/s00415-021-10472-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify coping strategies used by amyotrophic lateral sclerosis (ALS) patients. METHODS Integrative literature review using the Virtual Health Library, MEDLINE, and ScienceDirect databases. RESULTS Eighteen studies were included. "Seeking social support" was the main coping strategy, while "Confrontive coping" and "Distancing" were the least mentioned. CONCLUSION The coping strategies used by ALS patients do not seem to focus on emotions or stress-triggering problems. Age and gender did not modify the chosen strategy.
Collapse
|
10
|
Oh J, An J, Park K. Coping in people with amyotrophic lateral sclerosis and motor neuron disease: Systematic review. J Clin Nurs 2021; 30:1838-1853. [PMID: 33555628 DOI: 10.1111/jocn.15692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To systematically review previous studies on the variables associated with coping strategies in people with amyotrophic lateral sclerosis and motor neuron disease (ALS/MND), such as demographics, clinical features and patient-reported outcomes. BACKGROUND Coping strategies are important factors for adjustment and quality of life (QOL) in patients with long-term conditions, and this topic in people with ALS/MND has not yet been the subject of a systematic review. DESIGN A systematic review was performed based on the PRISMA checklist. METHODS Electronic databases, including CINAHL, MEDLINE and EMBASE, were systemically searched from their inception to December 2019 for articles meeting the following inclusion criteria: (1) written in English, (2) published in peer-reviewed journals, (3) included subjects with ALS/MND and (4) used quantitative measurements of coping strategies in people with ALS/MND. RESULTS Twenty-one articles were included. Significant relationships between participants' demographics (age and sex) and any coping strategy aspect were shown in six studies. Eight studies found significant relationships between clinical characteristics (disease duration and physical functional status) and coping strategies, and ten studies reported coping strategies that were associated with patients' QOL and mental health outcomes. CONCLUSION Younger people used relatively more problem-focused, emotion-focused and social support coping strategies, and women used relatively more social support coping strategies. Problem-focused coping was generally related to better QOL and mental health, and emotion-focused coping was generally related to less depression. RELEVANCE TO CLINICAL PRACTICE As the pattern of coping strategies is related to demographic and clinical characteristics, this study could be used to inform the provision of patient-centred nursing in clinical care. Coping patterns are related to mental health and QOL; thus, in clinical care, it is recommended that people with ALS be encouraged to develop skills that enable them to cope more effectively and that their coping strategies be assessed.
Collapse
Affiliation(s)
- Juyeon Oh
- College of Nursing, Dankook University, Cheonan-si, South Korea
| | - Jiwon An
- Department of Nursing, Far East University, Eumseong-gun, South Korea
| | - Kyongok Park
- Department of Nursing, Gangneung-Wonju National University, Wonju-si, South Korea
| |
Collapse
|
11
|
Medical Dance/Movement Therapy in the Infusion Room: A Model for Individual Sessions with Adults in Active Treatment. AMERICAN JOURNAL OF DANCE THERAPY 2020. [DOI: 10.1007/s10465-020-09323-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
12
|
Peña-Bautista C, Casas-Fernández E, Vento M, Baquero M, Cháfer-Pericás C. Stress and neurodegeneration. Clin Chim Acta 2020; 503:163-168. [PMID: 31987795 DOI: 10.1016/j.cca.2020.01.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 12/13/2022]
Abstract
Neurodegenerative diseases are a great concern because of aging worldwide population. Despite substantial effort to advance our understanding of the etiology and potential treatment of neurodegeneration, there remains a paucity of information with respect to this complex disease process. Interestingly, stress has been implicated among the potential mechanisms implicated in neurodegenerative pathology. Given the increase in chronic stress in modern society, this premise warrants further investigation. The aim of this review is to evaluate the influence of stress on neurodegeneration, the effect of neurodegenerative diseases diagnosis on stress, and therapeutic strategies for neurodegenerative diseases with a special focus on stress reduction. Neurodegenerative disorders such as Alzheimer's, Parkinson's and Huntington's Disease showed an acceleration in disease progression and a worsening of symptoms under stress. Some therapies (e.g., yoga, meditation) focused on reducing stress showed beneficial effects against neurodegeneration. Nevertheless, more studies are necessary in order to completely understand the implications of stress in neurodegeneration and the usefulness of stress reduction in the treatment thereof.
Collapse
Affiliation(s)
| | | | - Máximo Vento
- Health Research Institute La Fe, Valencia, Spain
| | - Miguel Baquero
- Division of Neurology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | |
Collapse
|
13
|
Benbrika S, Desgranges B, Eustache F, Viader F. Cognitive, Emotional and Psychological Manifestations in Amyotrophic Lateral Sclerosis at Baseline and Overtime: A Review. Front Neurosci 2019; 13:951. [PMID: 31551700 PMCID: PMC6746914 DOI: 10.3389/fnins.2019.00951] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/22/2019] [Indexed: 12/11/2022] Open
Abstract
It is now well recognized that, in addition to motor impairment, amyotrophic lateral sclerosis (ALS) may cause extra-motor clinical signs and symptoms. These can include the alteration of certain cognitive functions, impaired social cognition, and changes in the perception and processing of emotions. Where these extra-motor manifestations occur in ALS, they usually do so from disease onset. In about 10% of cases, the cognitive and behavioral changes meet the diagnostic criteria for frontotemporal dementia. The timecourse of behavioral and cognitive involvement in ALS is unclear. Whereas longitudinal studies have failed to show cognitive decline over time, some cross-sectional studies have demonstrated poorer cognitive performances in the advanced stages of the disease. Neuroimaging studies show that in ALS, extra-motor signs and symptoms are associated with specific brain lesions, but little is known about how they change over time. Finally, patients with ALS appear less depressed than might be expected, given the prognosis. Moreover, many patients achieve satisfactory psychosocial adjustment throughout the course of the disease, regardless of their degree of motor disability. There are scant longitudinal data on extra-motor impairment in ALS, and to our knowledge, no systematic review on this subject has yet been published. Even so, a better understanding of patients' clinical trajectory is essential if they are to be provided with tailored care and given the best possible support. We therefore undertook to review the evidence for extra-motor changes and their time course in ALS, in both the cognitive, emotional and psychological domains, with a view to identifying mechanisms that may help these patients cope with their disease.
Collapse
Affiliation(s)
| | - Béatrice Desgranges
- Neuropsychology and Imaging of Human Memory, Normandy University-PSL Research University-EPHE-INSERM U1077, Caen University Hospital, Caen, France
| | | | | |
Collapse
|
14
|
Ando H, Cousins R, Young CA. Exploring and Addressing 'Concerns' for Significant Others to Extend the Understanding of Quality of Life With Amyotrophic Lateral Sclerosis: A Qualitative Study. J Cent Nerv Syst Dis 2019; 11:1179573519859360. [PMID: 31312086 PMCID: PMC6614934 DOI: 10.1177/1179573519859360] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 05/25/2019] [Indexed: 12/11/2022] Open
Abstract
Background The absence of curative medication for amyotrophic lateral sclerosis (ALS) makes palliative care and understanding quality of life (QoL) in ALS a clinical priority. Previous qualitative research has explored the concept of QoL in terms of illness impact on life perspectives and sense of self. Objective In this research, we explored 'concerns' - one of the four aspects in the World Health Organisation's conceptualisation of QoL - towards adding to the literature. Methods In-depth interviews with 26 individuals with ALS were subjected to thematic analysis involving both inductive and deductive approaches to explore participant's concerns, and to evaluate the relevance of their concerns for understanding QoL in ALS. Findings The analysis showed that concerns for significant others contribute to participant's QoL because of their existential value. It was important for participants to minimise the impact of limitations and burdens associated with ALS on significant others, even at a cost to self. Discussion The current study supports a holistic approach in service provision, ensuring the inclusion of relevant significant others. It is further suggested that clinicians explore the specifics of burdens perceived by patients in order to support them in minimising the burdens for their significant others.
Collapse
Affiliation(s)
- Hikari Ando
- Respiratory Laboratory, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - Rosanna Cousins
- Department of Psychology, Liverpool Hope University, Liverpool, UK
| | | |
Collapse
|
15
|
Sandstedt P, Littorin S, Johansson S, Gottberg K, Ytterberg C, Kierkegaard M. Disability and Contextual Factors in Patients with Amyotrophic Lateral Sclerosis - A Three-Year Observational Study. J Neuromuscul Dis 2019; 5:439-449. [PMID: 30282373 PMCID: PMC6218138 DOI: 10.3233/jnd-180322] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by muscle weakness and wasting. Observational natural history studies can give information on body function/structure impairments, activity limitations and participation restrictions, i.e. disability. Information needed to plan and develop care and support. Objective: To describe and explore disease severity and impairments, activity limitations, participation restrictions and contextual factors over time. In specific, to explore concurrent presence of cognitive impairment, fatigue, anxiety, depression and pain, and whether these impairments were related to disease severity. Methods: In this three-year observational study, 60 patients with ALS were included at baseline. Follow-ups were performed every 6 months unless participants had deceased or declined participation. Data was collected from medical records, and by study-specific and standardized questionnaires administrated during home visits. Results: Regardless of disease severity; fatigue, anxiety, depression and pain were present in patients with ALS at each data collection. Approximately one-third experienced two or more of these impairments concurrently, i.e. at the same time point. Cognitive impairment could not be assessed in many patients due to their physical impairments. Disease severity was not associated with fatigue, anxiety, depression or pain. Conclusions: Patients with ALS need, throughout the course of the disease, to be regularly screened for commonly present impairments, activity limitations and participation restrictions so that person-centered interventions can be applied at the right time.
Collapse
Affiliation(s)
- Petter Sandstedt
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Function Area Ageing Health and Functioning, Karolinska University Hospital, Stockholm, Sweden
| | - Susanne Littorin
- Function Area Ageing Health and Functioning, Karolinska University Hospital, Stockholm, Sweden
| | - Sverker Johansson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Gottberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Ytterberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Marie Kierkegaard
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
16
|
Jakobsson Larsson B, Ozanne AG, Nordin K, Nygren I. A prospective study of quality of life in amyotrophic lateral sclerosis patients. Acta Neurol Scand 2017; 136:631-638. [PMID: 28523721 DOI: 10.1111/ane.12774] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2017] [Indexed: 11/28/2022]
Abstract
OBJECTS The aim of this prospective and longitudinal study was to describe individual quality of life in patients with amyotrophic lateral sclerosis (ALS) and its correlations with physical function and emotional well-being from diagnosis and over time. MATERIALS AND METHODS Thirty-six patients were included in the study. Individual quality of life was measured with the Schedule of Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), illness severity was assessed using the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALS FRS-R), and emotional distress was measured using the Hospital Anxiety and Depression Scale (HADS). Data were collected from diagnosis and thereafter, every six months for a period of two years. Twelve patients completed the 24-month follow-up. RESULTS Family, friends and own physical health were important for overall quality of life, from diagnosis and during the disease progression. Most patients had good quality of life, which remained stable, despite changed physical functions. Several patients scored above the cut-off score for doubtful and clinical anxiety and depression early on after diagnosis, and there was a significant decrease in anxiety over time. Soon after diagnosis, there was a correlation between depression and quality of life. CONCLUSION The family, social relations and own physical health are important for overall quality of life in patients with ALS. Thus, supporting the family and facilitating so that patients can continue to stay in contact with friends are important aspects during the disease. Conducting an early screening for depression can be important for preventing decreased quality of life.
Collapse
Affiliation(s)
- B. Jakobsson Larsson
- Department of Neuroscience; Neurology; Uppsala University Hospital; Uppsala Sweden
| | - A. G. Ozanne
- Neurology; Clinical Neuroscience; Sahlgrenska Universitetssjukhus; Göteborg Sweden
| | - K. Nordin
- Department of Global Health and Primary Care; Uppsala University; Uppsala Sweden
| | - I. Nygren
- Department of Neuroscience; Neurology; Uppsala University Hospital; Uppsala Sweden
| |
Collapse
|
17
|
Dachez J, Ndobo A. Coping Strategies of Adults with High-Functioning Autism: A Qualitative Analysis. JOURNAL OF ADULT DEVELOPMENT 2017. [DOI: 10.1007/s10804-017-9278-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
18
|
|
19
|
Predictors of health-related quality of life in people with amyotrophic lateral sclerosis. J Neurol Sci 2016; 370:269-273. [PMID: 27772773 DOI: 10.1016/j.jns.2016.09.034] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 09/05/2016] [Accepted: 09/20/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Knowledge of factors influencing health-related quality of life (HRQL) in people with amyotrophic lateral sclerosis (ALS) is important because some factors might be amenable to intervention. OBJECTIVES The aim was to describe and explore the effects of disease severity, fatigue, anxiety, depression, frequency of social and lifestyle activities, coping capacity and mechanical ventilator use on HRQL in people with ALS. METHODS Sixty people with ALS were enrolled in this cross-sectional study. Data were collected with questionnaires during home visits. The Sickness Impact Profile and the EuroQol Visual Analogue Scale were used to assess HRQL. Multivariate regression analyses explored associations between HRQL and independent factors. RESULTS Low frequency of social and lifestyle activities, and severe disease, were associated with worse HRQL, explaining 57% of total variance in the Sickness Impact Profile physical score. Severe disease, weak coping capacity and anxiety and/or depression were associated with worse HRQL, explaining 33% of total variance in Sickness Impact Profile psychosocial score. Fatigue and mechanical ventilator use were associated with worse HRQL, explaining 17% of variance in the EuroQol Visual Analogue Scale. CONCLUSION Knowledge and understanding of how frequency of social and lifestyle activities, disease severity, coping capacity, anxiety and/or depression, fatigue and ventilator use contribute to and predict self-rated HRQL can optimize person-centred care and support.
Collapse
|