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Cardwell KL, Hume TA, McKenna OJ, Pilutti LA, Fakolade A. Symptom Management Among Multiple Sclerosis Care Partners in Canada. Int J MS Care 2023; 25:281-287. [PMID: 37969913 PMCID: PMC10634598 DOI: 10.7224/1537-2073.2022-113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
BACKGROUND Managing the heterogeneity and unpredictability of multiple sclerosis (MS) symptoms can be difficult for MS care partners. This study aimed to characterize the symptoms managed by MS care partners, recognize relationships between symptom management difficulty and other aspects of the caregiving role, and identify supplemental sources of care-giving support used by care partners. METHODS A Canadian cohort of MS care partners completed an online survey capturing care-partner characteristics, care-recipient symptoms, care-partner difficulty with managing symptoms, and sources of caregiving assistance. Descriptive analysis, analysis of variance, and χ2 tests were used to compare differences in care-partner characteristics by symptom management difficulty groups, defined as low (<4 symptoms), medium (5-7 symptoms), and high difficulty (>7 symptoms). RESULTS Care partners to individuals with MS (N = 475) reported a median of 8 symptoms (IQR = 4) experienced by their care-recipients. The most frequent symptoms reported were fatigue (89.1%), weakness (87.2%), and depression (81.9%). Care partners reported a median of 6 (IQR = 5) symptoms being somewhat or very difficult to manage. Balance or mobility impairments (20.3%), depression (14.3%), and vision difficulties (13.1%) were most frequently reported as very difficult to manage. Assisting with activities of daily living (P < .001) and time spent caregiving (P = .035) varied significantly between symptom management difficulty groups. Additional help available was reported by 77.5%, 17.8%, and 41.6% of care partners reporting low, medium, and high symptom management difficulty, respectively (P < .001). CONCLUSIONS Care partners of individuals with MS report difficulty in managing multiple, variable symptoms and often have no additional help. These findings suggest that MS care partners experience difficulty managing many diverse symptoms and may benefit from additional support.
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Affiliation(s)
- Katherine L. Cardwell
- From the Interdisciplinary School of Health Sciences (KLC, TAH, LAP), the Faculty of Medicine (OJMK), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Taylor A. Hume
- From the Interdisciplinary School of Health Sciences (KLC, TAH, LAP), the Faculty of Medicine (OJMK), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Odessa J. McKenna
- From the Interdisciplinary School of Health Sciences (KLC, TAH, LAP), the Faculty of Medicine (OJMK), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Lara A. Pilutti
- From the Interdisciplinary School of Health Sciences (KLC, TAH, LAP), the Faculty of Medicine (OJMK), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Afolasade Fakolade
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada (AF)
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Chen PY, Tsan YT, Yang CT, Lee YM, Chen LL, Ho WC, Lu SH. Prediction of risk of ischemic heart disease in first-diagnosed systemic lupus erythematosus patients in taiwan: is air pollution exposure a risk factor? BMC Rheumatol 2023; 7:14. [PMID: 37287067 DOI: 10.1186/s41927-023-00337-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 05/04/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Air pollution is a key public health factor with the capacity to induce diseases. The risk of ischemia heart disease (IHD) in those suffering from systemic lupus erythematosus (SLE) from air pollution exposure is ambiguous. This study aimed to: (1) determine the hazard ratio (HR) of IHD after the first-diagnosed SLE and (2) examine the effects of air pollution exposure on IHD in SLE for 12 years. METHODS This is a retrospective cohort study. Taiwan's National Health Insurance Research Database and Taiwan Air Quality Monitoring data were used in the study. Cases first diagnosed with SLE in 2006 cases without IHD were recruited as the SLE group. We randomly selected an additional sex-matched non-SLE cohort, four times the size of the SLE cohort, as the control group. Air pollution indices by residence city per period were calculated as the exposure. Life tables and Cox proportional risk models of time-dependent covariance were used in the research. RESULTS This study identified patients for the SLE group (n = 4,842) and the control group (n = 19,368) in 2006. By the end of 2018, the risk of IHD was significantly higher in the SLE group than in the control group, and risks peaked between the 6th and 9th year. The HR of incidence IHD in the SLE group was 2.42 times that of the control group. Significant correlations with risk of developing IHD were noted for sex, age, CO, NO2, PM10, and PM2.5, of which PM10 exposure had the highest risk of IHD incidence. CONCLUSIONS Subjects with SLE were at a higher risk of IHD, especially those in the 6th to 9th year after SLE diagnosis. The advanced cardiac health examinations and health education plan should be recommended for SLE patients before the 6th year after SLE diagnosed.
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Affiliation(s)
- Pei-Yun Chen
- Departmant of public Health, China Medical University, Taichung, Taiwan
- Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
| | - Yu-Tse Tsan
- Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Occupational Safety and Health Office, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chao-Tung Yang
- Department of Computer Science, Tunghai University, Taichung, Taiwan
| | - Yun-Mei Lee
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, New Taipei City, Taiwan
| | - Li-Li Chen
- School of Nursing, China Medical University, Taichung, Taiwan
- Department of Nursing, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Chao Ho
- Departmant of public Health, China Medical University, Taichung, Taiwan.
| | - Shu-Hua Lu
- School of Nursing, China Medical University, Taichung, Taiwan.
- Department of Nursing, China Medical University Hospital, Taichung, Taiwan.
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Gil-González I, Pérez-San-Gregorio MÁ, Funuyet-Salas J, Conrad R, Martín-Rodríguez A. Significance of Post-Traumatic Growth and Mental Health for Coping in Multiple Sclerosis Caregivers. Healthcare (Basel) 2023; 11:healthcare11101390. [PMID: 37239676 DOI: 10.3390/healthcare11101390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/21/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
We investigated the influence of post-traumatic growth (PTG) and mental health (MH) on multiple sclerosis (MS) caregivers' uses of coping strategies and identified biopsychosocial predictors of proactive or reactive coping. The Short Form Health Survey (SF-12), General Health Questionnaire (GHQ-28), Post-Traumatic Growth Inventory (PGI-21), Brief COPE Questionnaire (COPE-28), and Multidimensional Scale of Perceived Social Support (MSPSS) were used to evaluate 209 caregivers. Higher PTG was related to greater use of emotional support, positive reframing, religion, active coping, instrumental support, planning, denial, self-distraction, self-blaming, and venting. Better MH was associated with greater use of acceptance, while behavioral disengagement and self-distraction were associated with poorer MH. The PTG dimensions relating to others and new possibilities, SF-12 dimensions of physical and emotional roles as well as partnership, not living with the patient, and significant others' social support were predictors of proactive coping. Reactive coping was positively predicted by the PTG dimension relating to others, depression, vitality, other than partner relation, and physical role, and negatively predicted by mental health level and emotional role. In summary, higher MH was associated with proactive coping strategies, whereas post-traumatic growth was related to the use of a wide range of proactive coping as well as reactive coping strategies.
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Affiliation(s)
- Irene Gil-González
- Department of Personality, Assessment, and Psychological Treatment, University of Seville, 41018 Seville, Spain
| | | | - Jesús Funuyet-Salas
- Department of Personality, Assessment, and Psychological Treatment, University of Seville, 41018 Seville, Spain
| | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Muenster, 48149 Muenster, Germany
| | - Agustín Martín-Rodríguez
- Department of Personality, Assessment, and Psychological Treatment, University of Seville, 41018 Seville, Spain
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Rajachandrakumar R, Finlayson M. Multiple sclerosis caregiving: A systematic scoping review to map current state of knowledge. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e874-e897. [PMID: 34935217 DOI: 10.1111/hsc.13687] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/07/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
Unpaid caregivers, typically family and friends, provide significant amounts of support to people with multiple sclerosis (MS). Understanding their experiences, needs and challenges is necessary to ensure that caregivers receive the support that they require to continue in their role. Our aim was to map the current state of knowledge about unpaid caregivers of people with MS and identify gaps in knowledge to guide future research and practice. We used scoping review methodology with three major health-related databases (MEDLINE, CINAHL, APA Psychinfo), searching in September 2019, April and October 2020 and October 2021. We selected peer-reviewed scientific articles reporting on primary studies of unpaid caregivers of people with MS, regardless of topic or research design. We extracted information on study aim, participant characteristics, measures used and key findings to generate major themes and identify knowledge gaps. We identified 108 published studies between 1992 and 2021 that met our criteria. Studies of spousal caregivers were most common. Studies focused primarily on measurement of caregiver burden or other negative consequences of caregiving. Thirteen studies addressed positive consequences of caregiving. Sixteen studies reported actual tasks performed by caregivers and seven reported outcomes of caregiver support interventions. Attention to diversity issues that may influence caregiving experiences and outcomes was rare. Overall, knowledge of MS caregiving is limited, particularly with respect to tasks performed by caregivers that may contribute to negative outcomes, diversity issues and effective approaches to remediate caregiver burden. Without this knowledge, finding ways to better support MS caregivers will be difficult.
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Affiliation(s)
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
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Özen Ş, Karataş T, Polat Ü. Perceived social support, mental health, and marital satisfaction in multiple sclerosis patients. Perspect Psychiatr Care 2021; 57:1862-1875. [PMID: 33728706 DOI: 10.1111/ppc.12760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE This study aimed to examine the patients' perceived social support, mental health, and marital satisfaction. DESIGN AND METHODS Data were collected via Patient Information Form, Barthel Index of Activities of Daily Living, Marital Life Scale, Multidimensional Scale of Perceived Social Support, and General Health Questionnaire for 72 patients. FINDINGS Multiple sclerosis (MS) patients had a moderate level of marital satisfaction. The perceived social support showed positive correlation with marital satisfaction and negative correlation with mental health disorders in MS. PRACTICE IMPLICATIONS These results will facilitate the perception of mental problems, marital satisfaction, and social support in MS patients by the nurses.
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Affiliation(s)
- Şükrü Özen
- Department of Nursing, Faculty of Health Sciences, Bingöl University, Bingöl, Turkey
| | - Tuğba Karataş
- Department of Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ülkü Polat
- Department of Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Gil-González I, Pérez-San-Gregorio MÁ, Conrad R, Martín-Rodríguez A. Predicting improvement of quality of life and mental health over 18-months in multiple sclerosis patients. Mult Scler Relat Disord 2021; 53:103093. [PMID: 34175814 DOI: 10.1016/j.msard.2021.103093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/27/2021] [Accepted: 06/13/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic neurodegenerative disease that can negatively affect functioning across a wide spectrum of domains. This study aims to investigate the development of mental health and quality of life in MS patients over 18-months and to identify predictive factors. METHOD 314 MS outpatients of Virgen Macarena University Hospital in Sevilla/Spain (mean age 45 years, 67.8% women, on average 12.1 years since diagnosis) participated in the study. Health-related quality of life (HRQOL) and mental health were assessed by the 12-Item Short Form Health Survey (SF-12) and the General Health Questionnaire-28 (GHQ-28) twice over an 18-months follow up period. RESULTS HRQOL and mental health significantly improved in almost all domains, except for a worsening of vitality. Mental and physical HRQOL improved by a large effect size. Binomial logistic regression models showed that disability status (Expanded Disability Status Scale) predicted both components of HRQOL and age the physical component of HRQOL. Sex, educational level, and disease duration predicted mental health. CONCLUSIONS Our findings confirm the possibility of a significant large-sized improvement of HRQOL in the course of 18-months even 12 years after MS diagnosis on average. The study showed the importance of sociodemographic as well as clinical variables to predict HRQOL and mental health. Further longitudinal research is needed to better understand their impact on patients' outcomes.
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Affiliation(s)
- Irene Gil-González
- Department of Personality, Assessment, and Psychological Treatment, University of Seville, Camilo José Cela Street, Seville 41018, Spain.
| | - María Ángeles Pérez-San-Gregorio
- Department of Personality, Assessment, and Psychological Treatment, University of Seville, Camilo José Cela Street, Seville 41018, Spain
| | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Agustín Martín-Rodríguez
- Department of Personality, Assessment, and Psychological Treatment, University of Seville, Camilo José Cela Street, Seville 41018, Spain
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Abdulla FA, Albagmi FM, Al-Khamis FA. Factors that influence quality of life in patients with multiple sclerosis in Saudi Arabia. Disabil Rehabil 2021; 44:4775-4783. [PMID: 33966564 DOI: 10.1080/09638288.2021.1919929] [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] [Indexed: 10/21/2022]
Abstract
PURPOSE To study the factors which may contribute to quality of life (QOL) in patients with multiple sclerosis (pwMS) in Saudi Arabia. METHODS 175 pwMS and 71 age-, gender-, and BMI-matched healthy subjects participated in this cross-sectional study. QOL was studied by the multiple sclerosis quality of life-54 (MSQOL-54) while depression, disability, and fatigue were measured by the beck depression inventory-II (BDI-II), the expanded disability status scale (EDSS), and the modified fatigue impact scale (MFIS), respectively. The effects of demographic and clinical characteristics on MSQOL-54 were studied. RESULTS QOL was worse in pwMS. A better QOL in pwMS was linked to being male, having relapsing-remitting MS, having lower BMI, being employed, having a low disability, having no or minimal depression, and not fatigued. Age, disease duration, marital status, living status, and level of education did not affect the QOL. QOL showed a moderate to strong correlation with depression and fatigue and a weak correlation with EDSS. Depression and fatigue were the strongest predictors of QOL. Other predictors included gender and BMI but not EDSS. CONCLUSIONS Many of the factors which seem to influence QOL in pwMS are modifiable. Evaluation and management of such factors may improve QOL in pwMS.Implications for rehabilitationAssessment of QOL (using a proper tool) should be part of every pwMS evaluation.Depression and fatigue are the main predictors of QOL in pwMs, therefore, attention should be paid for their evaluation and management.Sexual dysfunction and pain should be assessed and managed early in the course of the disease.
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Affiliation(s)
- Fuad A Abdulla
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.,Department of Neuroscience, Institute for Research and Medical Consultation, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal M Albagmi
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.,Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fahd A Al-Khamis
- Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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