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Berhanu D, Leal Rato M, Canhoto AI, Vieira da Cunha J, Geraldes R. Online information search by people with Multiple Sclerosis: A systematic review. Mult Scler Relat Disord 2023; 79:105032. [PMID: 37801957 DOI: 10.1016/j.msard.2023.105032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/15/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND People with Multiple Sclerosis (pwMS) search for information online about various aspects of living with their disease, but details about patterns of searching and outcomes are unclear. This means that opportunities to leverage online resources to support pwMS, and to enhance shared decision making, may be missed. We aimed to do a systematic review of the literature on digital information searching by pwMS. METHODS We performed a systematic search for studies assessing online information seeking of pwMS in MEDLINE and JSTOR databases. Studies were screened and selected by two investigators. All study designs were included, risk of bias was assessed using the Critical Appraisal Skills Programme qualitative checklist. Reports were assessed for the proportion of patients searching information online about MS, type of information sought, online tools used by patients, perceived quality of the information acquired, and impact of online searching in pwMS. RESULTS We identified 5 studies, including 10,090 patients. Most pwMS search for information online (53.8-82 %), which they rarely discuss with physicians. The most common topics are treatment, general disease information, symptoms, lifestyle recommendations, prognosis, and coping strategies. Patients that are younger, have a shorter disease duration, primary progressive MS, and during periods of disease worsening, are more likely to use online resources. Online information is perceived as low quality by pwMS. CONCLUSIONS Online information search is prevalent among pwMS. Despite concerns with the quality of the available information, only a minority of pwMS will discuss the information found with their physician. These findings highlight the importance of developing and providing quality online information resources for pwMS.
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Affiliation(s)
- David Berhanu
- Multiple Sclerosis Clinical Trials Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Universidade Católica Portuguesa, Portugal; Serviço de Imagiologia Neurológica, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - Miguel Leal Rato
- Multiple Sclerosis Clinical Trials Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal; Serviço de Neurologia, Departamento de Neurociências e Saúde Mental, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | | | | | - Ruth Geraldes
- Multiple Sclerosis Clinical Trials Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Department of Neurology, Frimley Health NHS Foundation Trust, Frimley, Surrey, UK; Department of Clinical Neurology, Oxford University Hospitals Trust, John Radcliffe Hospital, Oxford, Oxfordshire, UK.
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Bahmani B, Mehraban S, Carnero Contentti E, Azkhosh M, Khanjani M, Azimian M. Relationship of coping strategies with mood symptoms, disease related characteristics and demographic variables in patients with multiple sclerosis: A systematic review study. Mult Scler Relat Disord 2022; 67:104163. [PMID: 36126537 DOI: 10.1016/j.msard.2022.104163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 08/13/2022] [Accepted: 09/05/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE the aim of this systematic review was to summarize the coping strategies utilized by people with multiple sclerosis (pwMS) and the association of these strategies with mood symptoms, quality of life, fatigue and disability in pwMS. METHODS search in the literature was performed across electronic databases of PubMed, Web of Science, and Scopus. No time constraint was applied for searching across the databases. Manual search was also performed on the list of references of the retrieved papers. Two authors independently evaluated the retrieved citations based on predetermined inclusion criteria in two screening stages. This systematic review followed Joanna Briggs Institute (JBI) guidelines for cross-sectional research. The findings related to the coping patterns against MS as well as the relationship between the patterns and MS symptoms were extracted and synthesized. FINDINGS A total of 2390 records were identified. After removing duplicates and based on screening, 39 papers met the eligibility criteria for qualitative synthesis, and they were evaluated in terms of quality of study. When comparing genders, women used more religious coping, social support seeking, and positive coping compared to men. Depression and anxiety were associated with maladaptive and emotion-oriented coping strategies. The patients who used positive and problem solving oriented coping strategies had a better score of quality of life. Disability and fatigue were associated with applying avoidance and maladaptive coping strategies. CONCLUSION the findings of this review suggest that understanding the relationship between coping strategies and quality of life as well as the symptoms related to the disease is important to understand development of psychological interventions adopted by specialists to support these patients.
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Affiliation(s)
- Bahman Bahmani
- Department of counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Shafigh Mehraban
- Department of counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | | | - Manouchehr Azkhosh
- Department of counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammadsaeed Khanjani
- Department of counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mojtaba Azimian
- Department of Clinical Science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Moodley A, Van Aswegen A, Smit L. Are interpersonal communication skills adequately taught at postgraduate specialist level in South Africa? The neurology experience. S Afr Fam Pract (2004) 2021; 63:e1-e9. [PMID: 34212749 PMCID: PMC8378163 DOI: 10.4102/safp.v63i1.5275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/26/2021] [Accepted: 04/30/2021] [Indexed: 11/20/2022] Open
Abstract
Background Interpersonal communication skills by clinicians with patients, carers, fellow health professionals and legal professionals carry many unique challenges in practice. Whilst undergraduate training in communication helps with generic information receiving and information giving, uncomfortable and demanding speciality-specific issues in the various medical specialities are not covered during under- and postgraduate training. Methods The aim of this study was to determine the self-perceived competence of neurology registrars and neurologists in interpersonal communication and the need for such assessment in college exit exams. We undertook a quantitative, descriptive, cross-sectional survey by using self-administered printed questionnaires and the EvaSYS online system. Neurology registrars in training from the seven training centres in South Africa and neurologists based at the training centres and in the private sector were recruited. Results We received a 62.9% response rate. One hundred and twenty-nine participants were recruited comprising 42 neurology registrars and 87 neurologists. Registrars were more commonly female, more likely to be multilingual and less likely to use translators. Undergraduate training in communication was considered insufficient, 42.9% and 39.1% for registrars and specialists respectively, and was also considered not relevant to address speciality-specific issues encountered in practice. Most training received has been by observation of others and on-the-job training. Both groups felt strongly that postgraduate training in interpersonal communication was important (registrars 95.2%, specialists 91.9%), especially when dealing with issues of death and dying, disclosing medical errors and dealing with the legal profession. Conclusion Postgraduate training of interpersonal communication as required of neurology registrars and neurologists was considered insufficient. Most training has been by observation of others or experiential by trial and error. Assessment of interpersonal communication at board exit exams will drive postgraduate training and importantly will embrace the AfriMEDS framework developed to produce the holistic doctor in South Africa.
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Affiliation(s)
- Anand Moodley
- Department of Neurology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa; and, Department of Neurology, Universitas Hospital, Bloemfontein.
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Altunan B, Unal A, Bingöl A, Dilek F, Girgin D. Coping with stress during the first wave of the COVID-19 pandemic by Turkish people with Multiple Sclerosis: The relationship between perceived stress and quality of life. Mult Scler Relat Disord 2021; 53:103039. [PMID: 34087686 DOI: 10.1016/j.msard.2021.103039] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/09/2021] [Accepted: 05/16/2021] [Indexed: 12/26/2022]
Abstract
Background Multiple sclerosis (MS) is a chronic inflammatory disease and acute exacerbations are also a part of the clinical course. The presence of the disease and relapses cause stress in people with MS (pwMS). For this reason, stress coping strategies of the patients are important in reducing perceived stress. Our aim in this study is to evaluate which strategies pwMS use during the COVID-19 pandemic, the effect of the strategies on perceived stress, their relationship with relapses and their role on quality of life (QoL). Methods An online form including Perceived Stress Scale (PSS; 10 items), Coping with Experienced Problems Scale (Brief-COPE; 28 items) and SF-12 were sent to 340 pwMS under our follow-up. Results During the COVID-19 pandemic, we found that the patients used the strategies of turn to religion, planning and acceptance at a high rate. PSS score was high in 23 (11.2%) of the patients. The patients with low perceived stress used the acceptance strategy more (P=0.008). We found a negative correlation between physical component summary (PCS) of SF-12 and denial (r=-0.2, p<0.001) and distraction (r =-0.1, p=0.04). A negative correlation was found between mental component summary (MCS) of SF-12 and behavioral disconnection (r=-0.2, p=0.006). There was a positive correlation between MCS and humor (r=0.1, p=0.04), use of instrumental support (r=0.2, p=0.009), planning (r=0.1, p=0.04), and positive reframing (r=0.2, p=0.002). Conclusion PwMS have been successful in coping with stress in the first half of the pandemic with the combination of emotional and problem-focused strategies. Acceptance strategy was highly adopted by patients with low PSS, and the tendency to use the active coping strategy together with the acceptance strategy was high in patients without relapses. Adoption to emotional strategies may have prevented the severe deterioration in QoL in this study group in the early period of Covid-19 pandemic.
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Carnero Contentti E, López PA, Alonso R, Eizaguirre B, Pettinicchi JP, Tizio S, Tkachuk V, Caride A. Coping strategies used by patients with relapsing multiple sclerosis from Argentina: correlation with quality of life and clinical features. Neurol Res 2020; 43:126-132. [PMID: 33040711 DOI: 10.1080/01616412.2020.1831304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic neurodegenerative and inflammatory disease. The adaptation to MS depends on the effectiveness of coping, which moderates the process of adaptation and psychological well-being. OBJECTIVES We aimed to analyze the coping strategies of an Argentinean population of patients with MS (PwMS) and their association with clinical variables and health-related quality of life (QoL). METHODS A nationwide cross-sectional study. Screening instruments: Demographics and clinical data, coping strategies (Brief Coping Orientation to Problems Experienced, [COPE-28]), health-related QoL (MS Impact Scale, [MSIS-29]), Fatigue Severity Scale, and physical disability (self-administrated Expanded Disability Status Scale, [EDSS]). RESULTS We included 249 PwMS. Most responders were female (74.7%) with a mean age at survey of 38.6 (±10.7) and had a MS duration of 7.3 years (range: 1-43 years) and a mean EDSS of 1.9 (±1.8). Younger age (r = -0.17), active MS (r = 0.25), higher fatigue (r = 0.22), MSIS-29 total (r = 0.34), MSIS-physical (r = 0.26), MSIS-psychological scores (r = 0.44), higher scores for perception of both severity of MS (r = 0.12) and wheelchair-dependency (r = 0.14) correlated significantly with the use of maladaptive coping strategies. However, active MS (β2.10, p = 0.01), MSIS-psychological score (β0.28, p < 0.0001), high education level (β - 1.15, p = 0.04), and EDSS (β - 0.84, p = 0.0001) were independent predictors of the utilization of maladaptive coping strategies after having applied multivariate analysis via linear regression. CONCLUSIONS Maladaptive coping strategies used by PwMS are associated with relevant clinical aspects of the disease and with worse health-related QoL scores.
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Affiliation(s)
| | - Pablo A López
- Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán , Buenos Aires, Argentina
| | - Ricardo Alonso
- Universitary Center of Multiple Sclerosis, Neurology Department, Hospital J.M. Ramos Mejía, Faculty of Medicine, University of Buenos Aires , Buenos Aires, Argentina.,Neurology Department, Universitary Hospital Sanatorio Guemes, Faculty of Medicine, University of Buenos Aires , Buenos Aires, Argentina
| | - Barbara Eizaguirre
- Universitary Center of Multiple Sclerosis, Neurology Department, Hospital J.M. Ramos Mejía, Faculty of Medicine, University of Buenos Aires , Buenos Aires, Argentina
| | - Juan Pablo Pettinicchi
- Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán , Buenos Aires, Argentina
| | - Santiago Tizio
- Neuroimmunology Section, Neurology Department, Hospital De Clínicas 'José De San Martín', University of Buenos Aires , Buenos Aires, Argentina
| | - Verónica Tkachuk
- Neurology Department, Hospital Italiano Y Español De La Plata , La Plata, Argentina
| | - Alejandro Caride
- Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán , Buenos Aires, Argentina
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Anestis E, Eccles F, Fletcher I, French M, Simpson J. Giving and receiving a diagnosis of a progressive neurological condition: A scoping review of doctors' and patients' perspectives. Patient Educ Couns 2020; 103:1709-1723. [PMID: 32299642 DOI: 10.1016/j.pec.2020.03.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/04/2020] [Accepted: 03/26/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Delivering a life changing diagnosis can be a distressing experience for patients and a challenging task for professionals. Diagnosis delivery can be especially difficult for individuals with neurodegenerative diseases such as motor neurone disease (MND), multiple sclerosis (MS) and Parkinson's disease (PD). This review aims to scope the literature on doctors' and patients' perspectives on diagnosis delivery for these conditions in order to enhance our understanding in this area and identify potential research gaps. METHODS A scoping review methodology was used, and data were summarised using content analysis. RESULTS 47 studies fulfilled the inclusion criteria. Studies showed that although patients were generally satisfied with diagnosis delivery, a considerable proportion was still dissatisfied with aspects of the consultation, especially the information and time provided and the doctor's approach. Only six studies addressed doctors' perspectives, which focused more on doctors' practice. CONCLUSION There was a significant research gap in professionals' perspectives. The review also found that although basic standards of good practice were being met, a significant proportion of patients were dissatisfied with diagnosis communication. PRACTICE IMPLICATIONS Professionals delivering such diagnoses need to assess and respond to patients' information needs, provide time for questions and maintain an empathic attitude.
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Affiliation(s)
| | - Fiona Eccles
- Division of Health Research, Lancaster University, Lancaster, LA1, UK
| | - Ian Fletcher
- Division of Health Research, Lancaster University, Lancaster, LA1, UK
| | - Maddy French
- Division of Health Research, Lancaster University, Lancaster, LA1, UK
| | - Jane Simpson
- Division of Health Research, Lancaster University, Lancaster, LA1, UK
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Bužgová R, Kozáková R, Škutová M. Factors Influencing Health-Related Quality of Life of Patients with Multiple Sclerosis and Their Caregivers. Eur Neurol 2020; 83:380-388. [DOI: 10.1159/000508949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/26/2020] [Indexed: 11/19/2022]
Abstract
Background: Only a few studies have been done focusing on the quality of life (QoL) of patients with multiple sclerosis (MS) as well as their family members. The aim of our research was to determine the factors that influence the QoL of MS patients in advanced stage of disease and their caregivers. Methods: The sample of the cross-sectional study included 153 patients with MS and 74 caregivers. QoL was measured using the PNDQoL questionnaire (Progressive Neurological Diseases Quality of Life), and the severity of illness was assessed through the following scales: EDSS (Expanded Disability Status scale), PPS (Palliative Performance Scale), and ADL (Activity Daily Living). Results: The following predictors of the global QoL of the MS patients were identified – age, EDSS, symptom burden, daily care, emotional functioning, and spiritual_nonreligion functioning (R2 = 0.569; F = 32.900; p < 0.001). The following predictors of the global QoL of caregivers were identified – age, emotional functioning, spiritual_nonreligion functioning, patient’s QoL, and feeling of care (R2 = 0.431; F = 18.690; p < 0.001). Conclusion: Appropriate intervention should be directed particularly at older patients and caregivers who have faced the disease for longer time and at patients without any partner. Supporting the emotional and social well-being and mitigating the burden caused by symptoms of the patients as well as caregivers can improve the QoL of both groups.
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Andersen AH, Assing Hvidt E, Hvidt NC, Roessler KK. 'Maybe we are losing sight of the human dimension' - physicians' approaches to existential, spiritual, and religious needs among patients with chronic pain or multiple sclerosis. A qualitative interview-study. Health Psychol Behav Med 2020; 8:248-269. [PMID: 34040871 PMCID: PMC8114351 DOI: 10.1080/21642850.2020.1792308] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective Research suggests that existential, spiritual, and religious issues are important for patient’s psychological adjustment when living with chronic pain and multiple sclerosis. However, there is a paucity of studies investigating how physicians experience and approach these patients’ needs. Design Physicians’ experiences with and approaches to existential, spiritual, and religious needs when treating chronic pain or multiple sclerosis were studied in eight semi-structured interviews and analysed using interpretative phenomenological analysis (IPA). Results Physicians found that only few patients had spiritual and religious needs; however, they experienced that every patient were struggling with existential challenges related to the illness and rooted in a changed identity and approaching death. How the physicians approached these needs appeared to be influenced by six conditions: Their medical culture, training, role, experiences of time pressure, their personal interests, and interpersonal approach. Conclusion Physicians’ training seems better suited to meet biomedical objectives and their patients’ concrete needs than patients’ wish for a relational meeting focused on their subjective lifeworld. This challenge is discussed in relation to modern patient-centeredness, doctor-patient relationship, culturally constructed experiences of privacy, and future clinical practice and research needs.
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Affiliation(s)
- Aida Hougaard Andersen
- Department of Psychology, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Elisabeth Assing Hvidt
- Research Unit of General Practice, University of Southern Denmark, Odense, Denmark.,Department for the Study of Culture, University of Southern Denmark, Odense, Denmark
| | - Niels Christian Hvidt
- Research Unit of General Practice, University of Southern Denmark, Odense, Denmark.,Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
| | - Kirsten K Roessler
- Department of Psychology, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
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Kasser SL, Zia A. Mediating Role of Resilience on Quality of Life in Individuals With Multiple Sclerosis: A Structural Equation Modeling Approach. Arch Phys Med Rehabil 2020; 101:1152-1161. [DOI: 10.1016/j.apmr.2020.02.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 02/07/2023]
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Bužgová R, Kozáková R, Bar M, Škutová M, Ressner P, Bártová P. The Attitudes of Progressive Neurological Disease Patients and Their Family Members to End of Life Care: A Cross-Sectional Study. Omega (Westport) 2020; 85:4-22. [PMID: 32571138 DOI: 10.1177/0030222820936922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The objective was to identify the attitudes of progressive neurological disease (PND) patients and their family members regarding end-of-life care, and their worries about dying. The sample included 327 participants. The Attitudes of Patients with PND to End-of-Life Care questionnaire was used to collect the data. Statistically significant differences in the assessment of attitudes towards end-of-life care between patients and family members were identified (p < 0.001). Family members more frequently favored patients being kept alive at any cost; patients more commonly wished to have their end of life under control. Respondents most frequently deferred to doctors when it came to decisions on treatment to keep patients alive. However, both patients and family members wanted patients to be able to decide on their treatment by leaving a written record of their previously stated wishes. The demands of patients and their families regarding end-of-life care should be documented in individual care plans.
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Affiliation(s)
- Radka Bužgová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Radka Kozáková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Michal Bar
- Neurology Clinic, University Hospital Ostrava, Ostrava, Czech Republic
| | - Monika Škutová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.,Neurology Clinic, University Hospital Ostrava, Ostrava, Czech Republic
| | - Pavel Ressner
- Neurology Clinic, University Hospital Ostrava, Ostrava, Czech Republic
| | - Petra Bártová
- Neurology Clinic, University Hospital Ostrava, Ostrava, Czech Republic
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Meehan M, Doody O. The role of the clinical nurse specialist multiple sclerosis, the patients' and families' and carers' perspective: An integrative review. Mult Scler Relat Disord 2020; 39:101918. [PMID: 31927154 DOI: 10.1016/j.msard.2019.101918] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 11/30/2019] [Accepted: 12/24/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND MS is a common, neurological disease and it's unpredictable, progressive disabling nature can have a devastating effect on patients, their families' and carers. It is therefore important that the MS Clinical Nurse Specialist develops appropriate skills, services and professional expertise to support individuals along the disease trajectory. DESIGN An integrative literature review. METHOD A systematic search of nine databases; Cinahl, Medline, Scopus, Embase, Ovid, AMED, Academic Search Complete, Web of Science, PsycINFO up to January 31, 2018. Hand searching and review of secondary references also undertaken. Reporting using the PRISMA guidelines, quality appraised (Crowe Critical Appraisal Tool) and thematic data analysis approach (Braun and Clarke 2006). RESULTS Findings from the 17 studies were extracted, synthesised and analysed thematically. Three themes emerged; the MS CNS as a longitudinal care co-ordinator, a bespoke care provider, and an expert resource. The findings suggest a strong desire for the MS CNS to be a leading health care professional to meet the needs of patient, family, and carer. CONCLUSION It can be argued that MS CNSs are best placed to meet the complex, variable needs individuals with MS, their families and carers. Further evidence is required to explore the variability of the disease and the progressive effect and impact of cognitive decline on MS patient, families' and carers' in order to meet their fluctuating and often complex needs. Findings from the review suggest a multifaceted role, and additionally, the needs of patients, families and carers are difficult to define as they vary over time as the disease progresses.
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Affiliation(s)
- Michelle Meehan
- University Hospital Coventry and Warwickshire, United Kingdom
| | - Owen Doody
- Health Research Institute, Department of Nursing and Midwifery, University of Limerick, Ireland.
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Bužgová R, Kozáková R. Informing patients with progressive neurological disease of their health status, and their adaptation to the disease. BMC Neurol 2019; 19:250. [PMID: 31653233 PMCID: PMC6815047 DOI: 10.1186/s12883-019-1488-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 10/02/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Progressive neurological diseases, such as multiple sclerosis, Parkinson's disease, Huntington's disease, significantly interfere with patients' lives, and those of their families. The aim of the research was to establish whether the extent of the information on patients' health conditions, and the way patients learn this information from doctors affect their adaptation to chronic and progressive diseases. METHODS Qualitative methodology was used for a total of 52 participants (patients with progressive neurological diseases, their family members, and health and social workers). Data were collected using individual, in-depth interviews and focus groups. Analysis of data for interpretation, conceptualization, and re-integration was performed by open, axial, and selective coding. RESULTS It was determined that adequate information about patients' health status, and the use of coping strategies are related to their adaptation to their disease, and consequently, to their quality of life. The participants often considered the extent of the information provided, and the way they were informed to be inadequate. Receiving the diagnosis, the progression of the disease, and the end of life were found to be the most burdensome. CONCLUSION Our results show that Czech neurologist should develop better communication skills, particularly for informing patients with progressive neurological diseases. Open communication, emotional support, and support in selecting effective coping strategies can help patients adapt more readily to their disease, and improve their quality of life.
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Affiliation(s)
- Radka Bužgová
- Department of Nursing and Midwifery Faculty of Medicine, University of Ostrava, Syllabova 19, 700 30, Ostrava, Czech Republic.
| | - Radka Kozáková
- Department of Nursing and Midwifery Faculty of Medicine, University of Ostrava, Syllabova 19, 700 30, Ostrava, Czech Republic
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Žiaková K, Čáp J, Miertová M, Gurková E. Dimensions of personal dignity of patients with multiple sclerosis: a qualitative narrative review. Cent Eur J Nurs Midw 2019. [DOI: 10.15452/cejnm.2019.10.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Potemkowski A, Brola W, Ratajczak A, Ratajczak M, Zaborski J, Jasińska E, Pokryszko-Dragan A, Gruszka E, Dubik-Jezierzańska M, Podlecka-Piętowska A, Nojszewska M, Gospodarczyk-Szot K, Stępień A, Gocyła-Dudar K, Maciągowska-Terela M, Wencel J, Kaźmierski R, Kułakowska A, Kapica-Topczewska K, Pawełczak W, Bartosik-Psujek H. Internet Usage by Polish Patients With Multiple Sclerosis: A Multicenter Questionnaire Study. Interact J Med Res 2019; 8:e11146. [PMID: 30707107 PMCID: PMC6376336 DOI: 10.2196/11146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 11/30/2022] Open
Abstract
Background The internet is a source of knowledge and medium widely used in services that facilitate access to information and networking. Multiple sclerosis (MS) patients find the possibility of acquiring information relating to their condition particularly rewarding. Objective We aimed to identify Polish MS patients’ preferences by analyzing a percentage of internet users and determining the most common search subjects and patients’ approach to information on the internet. Disability connected with the condition, its duration, and other factors that influence patients’ internet use were examined along with instances of relations established through the internet and their durability. Methods The study examined 1045 patients (731 women, 314 men) treated in 10 Polish MS centers, of whom 932 (89.19%) declared to be internet users. Their average age was 40.65 (SD 11.06) and average MS duration was 9.08 (SD 6.97) years. The study used a proprietary survey on information seeking, the range of searched subjects, and internet usage frequency. Results The majority of the patients (494/932, 53.0%) used the internet 6-7 times per week and 4.3% (40/932) declared they spent minimum 2 hours per day. The most commonly searched subjects were world news (604/932, 72.9% of patients using the internet); 60.8% (504/932) searched for information on their condition, particularly for new treatment methods (562/932, 67.8%) and the course of illness (520/932, 62.7%). One’s sex had no impact on internet usage (female vs male, odds ratio [OR] 1.13, 95% CI 0.72-1.77), although a patient’s age might, at varying degrees. We found several significant associations using a .05 significance level: a patient with higher education used the internet 9 times more often than one with primary education (OR 8.64, 95% CI 3.31-22.57); lasting relationships increased chances of internet usage by 10-fold compared to widowers (OR 0.12, 95% CI 0.05-0.31); living in a city with a population over 100,000 increased chances by nearly 6 times compared with the countryside (OR 5.59, 95% CI 2.72-11.48); the relapsing-remitting MS type saw a 2-fold increase compared with the primary progressive MS type (OR 0.47, 95% CI 0.29-0.75); and those needing assistance were 2 times less likely to use the internet than patients who could move independently (OR 0.53, 95% CI 0.31-0.89). More than half of the patients (489/932, 52.5%) did not discuss the information found on the internet with their neurologists; 15.9% (148/932) believed that relationships established through the internet can be stable. Conclusions The majority of Polish patients use the internet as a crucial information source on their condition and innovative treatment methods. The internet can be helpful in establishing new relationships, which are usually short-lived. Polish patients do not frequently discuss the information gathered on the internet with their doctors.
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Affiliation(s)
- Andrzej Potemkowski
- Department of Clinical Psychology and Psychoprophylaxis, University of Szczecin, Szczecin, Poland
| | - Waldemar Brola
- Institute of Physiotherapy, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | | | | | - Jacek Zaborski
- Department of Neurology, Specialist Hospital in Międzylesie, Warsaw, Poland
| | | | | | - Ewa Gruszka
- Department of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | | | | | - Monika Nojszewska
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | | | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
| | | | | | - Jacek Wencel
- Department of Neurology and Cerebrovascular Disorders, L Bierkowski Hospital, Poznan University of Medical Sciences, Poznan, Poland
| | - Radosław Kaźmierski
- Department of Neurology and Cerebrovascular Disorders, L Bierkowski Hospital, Poznan University of Medical Sciences, Poznan, Poland
| | - Alina Kułakowska
- Department of Neurology, Medical University of Białystok, Białystok, Poland
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Mazanderani F, Hughes N, Hardy C, Sillence E, Powell J. Health information work and the enactment of care in couples and families affected by Multiple Sclerosis. Sociol Health Illn 2019; 41:395-410. [PMID: 30677163 DOI: 10.1111/1467-9566.12842] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Given the considerable emphasis placed on informed choice, the management of health information has become an increasingly important part of living with chronic illness. This paper explores the intra-familial dynamics of managing health information in the context of chronic illness. Drawing on 77 interviews with people affected by Multiple Sclerosis in the UK (patients, partners, family members and close friends), we show how families develop their own idiosyncratic information practices, including the careful, at times strategic, seeking, sharing and withholding of information. We describe how one individual, most commonly either the patient or their partner, often takes primary responsibility for managing growing quantities of health information. Doing this is a complex task, yet its dynamics within the family unit remain invisible and unacknowledged. In this paper we: (a) stress the importance of understanding information management in chronic illness as a collective process across all those affected, patients as well as carers; (b) conceptualise the process of managing health information in this context as 'health information work'; and (c) analyse it as part of the wider care practices families engage in and as a form of care in its own right.
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Affiliation(s)
| | | | - Claire Hardy
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | | | - John Powell
- Department of Primary Health Care, University of Oxford, UK
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Schoor R, Bruce A, Bruce J, Goggin K, Schanfarber B, Bradley-Ewing A, Thelen J, Glusman M, Lynch SG, Strober L, Catley D. Reasons for nonadherence and response to treatment in an adherence intervention trial for relapsing-remitting multiple sclerosis patients. J Clin Psychol 2018; 75:380-391. [PMID: 30485422 DOI: 10.1002/jclp.22725] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 09/26/2018] [Accepted: 10/18/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To explore whether patients in an adherence trial who appeared not to take disease modifying therapy (DMT) for avoidance reasons could be reliably identified, by observational coding, for their main reason of not taking DMT. To determine whether reason groups could be distinguished by clinical and self-report psychological characteristics and intervention outcomes. METHOD Participants were multiple sclerosis patients (N = 78, 88.5% female, mean age 45.64) demotivated to take DMT. Audio recordings of the sessions were coded for the main reason of not taking DMT. Reason groups were compared based on patient characteristics and intervention outcomes. RESULTS Avoidance and three other reasons for not taking DMT (side effects, cost, and mild course) were reliably identified (κ = 0.88). Patient characteristics failed to distinguish participants in the Avoidance group, which also had poorer outcomes (X2 [2, n = 73] = 6.35, p = 0.036). CONCLUSIONS Patients not taking DMT for avoidance reasons may need novel methods to identify them and encourage (re-)initiation.
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Affiliation(s)
- Rachel Schoor
- Department of Psychology, University of Missouri, Kansas City, Missouri
| | - Amanda Bruce
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Missouri
| | - Jared Bruce
- Department of Psychology, University of Missouri, Kansas City, Missouri.,Department of Biomedical and Health Infomatics, University of Missouri, Kansas City, Missouri
| | - Kathy Goggin
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy and Hospital Clinics, Kansas City, Missouri
| | | | - Andrea Bradley-Ewing
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy and Hospital Clinics, Kansas City, Missouri
| | - Joanie Thelen
- Department of Psychology, University of Missouri, Kansas City, Missouri
| | - Morgan Glusman
- Department of Psychology, University of Missouri, Kansas City, Missouri
| | - Sharon G Lynch
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, Missouri
| | - Lauren Strober
- Neuropsychology and Neuroscience Laboratory, Kessler Foundation, West Orange, New Jersey
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy and Hospital Clinics, Kansas City, Missouri
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Holland DP, Schlüter DK, Young CA, Mills RJ, Rog DJ, Ford HL, Orchard K; TONiC study group. Use of coping strategies in multiple sclerosis: Association with demographic and disease-related characteristics ✰. Mult Scler Relat Disord 2019; 27:214-22. [PMID: 30412819 DOI: 10.1016/j.msard.2018.10.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 09/22/2018] [Accepted: 10/21/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Coping positively and negatively influences psychosocial and other outcomes in multiple sclerosis (MS), but there is conflicting evidence about the use of different coping strategies and their associations with demographic and disease characteristics. Our aims were to examine which coping strategies are used by a large sample of people with MS, then to identify any associations between demographic and disease related factors with use of individual coping strategies. METHODS Participants in the Trajectories of Outcomes in Neurological Conditions (TONiC) study completed the Coping Orientations to Problems Experienced (COPE60) questionnaire. Relationships between demographic and clinical characteristics and coping strategies were examined by multiple ordinal logistic regression to assess the effect of each potential predictor after adjustment for other possible covariates. RESULTS From 722 patients, the most commonly used strategy was Acceptance, followed by Active Coping, Planning and Positive Reinterpretation and Growth. All but two strategies showed significant associations with demographic and clinical characteristics. The most marked effects were found for Restraint, with people in employment 2.1 times as likely to utilise this strategy compared to those unemployed, and Seeking of Emotional Social Support and Focus on and Venting of Emotions, which were utilised twice as much by women compared to men. Behavioural and Mental Disengagement were highly associated with greater disability and not being in employment. CONCLUSION Clinicians should be aware of several disease and demographic characteristics that are associated with use of potentially maladaptive coping strategies.
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Bužgová R, Kozáková R, Juríčková L. The Unmet Needs of Patients With Progressive Neurological Diseases in the Czech Republic: A Qualitative Study. J Palliat Care 2018; 34:38-46. [DOI: 10.1177/0825859718800489] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Aim: The aim of our research was to explore the unfulfilled needs of patients with a progressive neurological disease in advanced stage of the illness within the current system of health and social care in the Czech Republic. Design and Setting: Qualitative research (grounded theory) was used to conceptualize the patterns of unmet palliative care needs in Czech Republic. Methods: The data collection method comprised individual, in-depth interviews (n = 19) and focus groups (n = 4) where a total of 52 respondents participated (patients with progressive neurological diseases [PNDs], family members, and professionals). Results: Two main categories of unfulfilled needs were determined (life with the disease, professional help), and they were described in the context of the 3 crucial themes identified in the study—the symptoms of the advanced stage of the disease resulted in substantial reduction of physical self-sufficiency, loss of autonomy, and social isolation; the level of dependence on the support and help of others increased; the patients also highlighted several problems related to health-care services. Conclusion: The unmet needs should be taken into consideration when creating the concept of the neuropalliative and rehabilitation care, including the mental health support plan, because of the emotional, behavioral, and cognitive disorders that frequently occur in the lives of a substantial amount of patients with PND.
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Affiliation(s)
- Radka Bužgová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Radka Kozáková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Lubica Juríčková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
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Dehghani A, Keshavarzi A, Jahromi MF, Shahsavari isfahani S, Keshavarzi S. Concept analysis of coping with multiple sclerosis. Int J Nurs Sci 2018; 5:168-173. [PMID: 31406820 PMCID: PMC6626294 DOI: 10.1016/j.ijnss.2018.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 11/21/2017] [Accepted: 04/09/2018] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The concept of coping with disease appears frequently in the literature; however, there is no precise definition of coping. The aim of this study is to clarify coping concept, and to identify its attributes, antecedents, and consequences in patients with multiple sclerosis. METHODS Rodgers' evolutionary method of concept analysis was used to clarify the concept of coping. A literature review was conducted with key terms 'multiple sclerosis', 'coping', 'adjustment', and 'deal with'. After searching databases, 1370 papers were found for the period 1995-2017. Finally, 55 articles and texts were selected for analysis. Data analysis was carried out using thematic analysis. An independent researcher checked the process to ensure credibility and reduce personal bias. RESULTS Coping with multiple sclerosis is a multidimensional concept with three main attributes: maintenance of emotional balance, acceptance of the disease, and self-regulation. Social support, awareness toward the disease, attitude toward the disease, and religious-spiritual beliefs were found as antecedents. Health promotion, adherence to treatment regimen, independence in personal life and social relationships, and improvement of family relationships were found as consequences of these attributes. CONCLUSION These findings not only add to the body of knowledge in health science, but also serve as an important motivation for further theory development and research in this context. Nurses and health professions can also benefit from a deeper understanding of coping concept in providing and planning healthcare for these patients.
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Affiliation(s)
- Ali Dehghani
- School of Nursing and Paramedical, Jahrom University of Medical Science, Jahrom, Iran
- Research Center for Noncommunicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Abdolkhalegh Keshavarzi
- Department of General Surgery, School of Medicine, Member of Shiraz Burn Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Soheila Keshavarzi
- Department of Counseling, Faculty of Psychology and Educational Sciences, Islamic Azad University, Marvdasht Branch, Marvdasht, Iran
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Affiliation(s)
- Maryam Keramat Kar
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
- Faculty of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Lisa Whitehead
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
- School of Nursing & Midwifery, Edith Cowan University, Perth, Australia
| | - Catherine M. Smith
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Calandri E, Graziano F, Borghi M, Bonino S. Coping strategies and adjustment to multiple sclerosis among recently diagnosed patients: the mediating role of sense of coherence. Clin Rehabil 2017; 31:1386-1395. [DOI: 10.1177/0269215517695374] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: To examine the relationship between coping strategies (problem solving, emotional release, and avoidance) and adjustment (health-related quality of life, depression, and affective well-being) in a group of recently diagnosed multiple sclerosis patients (up to three years since diagnosis), and to explore the mediating role of sense of coherence between coping strategies and adjustment. Design: Cross-sectional. Setting: Multiple Sclerosis Clinic Centre. Subjects: A total of 102 patients (61.8% women; age (years): M = 35.8, SD = 11.9; 95% with a relapsing–remitting form of multiple sclerosis; Expanded Disability Status Scale score, between 1 and 4). Interventions: Not applicable. Main measures: Coping with multiple sclerosis (problem solving, emotional release, and avoidance), sense of coherence, health-related quality of life (SF-12), depression (CES-D), and affective well-being (PANAS). Results: Problem solving was linked to higher mental health ( β = 0.28) and higher affective well-being ( β = 0.36), emotional release was related to lower depression ( β = −0.22); avoidance was associated to higher mental health ( β = 0.25), higher affective well-being ( β = 0.24), and lower depression ( β = −0.29 ) (all betas were significant at p < 0.05). Sense of coherence mediated the relationship between emotional release and depression (Sobel z-value = −2.00; p < 0.05) and the relationship between avoidance and all the indicators of adjustment (mental health: Sobel z-value = 1.97; depression: Sobel z-value = −2.02; affective well-being: Sobel z-value= 2.05; p < 0.05). Conclusions: Emotional and avoidant coping strategies seem to be adaptive among recently diagnosed multiple sclerosis patients. A mediating role between coping strategies and adjustment is played by sense of coherence.
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Affiliation(s)
| | | | - Martina Borghi
- Cosso Foundation, Torino, Italy
- Neurology 2 – CRESM, San Luigi Gonzaga Hospital, Torino, Italy
| | - Silvia Bonino
- Department of Psychology, University of Torino, Torino, Italy
- Cosso Foundation, Torino, Italy
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Grytten N, Skår AB, Aarseth JH, Assmus J, Farbu E, Lode K, Nyland HI, Smedal T, Myhr KM. The influence of coping styles on long-term employment in multiple sclerosis: A prospective study. Mult Scler 2016; 23:1008-1017. [PMID: 27600114 DOI: 10.1177/1352458516667240] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The aim was to investigate predictive values of coping styles, clinical and demographic factors on time to unemployment in patients diagnosed with multiple sclerosis (MS) during 1998-2002 in Norway. METHOD All patients ( N = 108) diagnosed with MS 1998-2002 in Hordaland and Rogaland counties, Western Norway, were invited to participate in the long-term follow-up study in 2002. Baseline recordings included disability scoring (Expanded Disability Status Scale (EDSS)), fatigue (Fatigue Severity Scale (FSS)), depression (Beck Depression Inventory (BDI)), and questionnaire assessing coping (the Dispositional Coping Styles Scale (COPE)). Logistic regression analysis was used to identify factors associated with unemployed at baseline, and Cox regression analysis to identify factors at baseline associated with time to unemployment during follow-up. RESULTS In all, 41 (44%) were employed at baseline. After 13 years follow-up in 2015, mean disease duration of 22 years, 16 (17%) were still employed. Median time from baseline to unemployment was 6 years (±5). Older age at diagnosis, female gender, and depression were associated with patients being unemployed at baseline. Female gender, long disease duration, and denial as avoidant coping strategy at baseline predicted shorter time to unemployment. CONCLUSION Avoidant coping style, female gender, and longer disease duration were associated with shorter time to unemployment. These factors should be considered when advising patients on MS and future employment.
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Affiliation(s)
- Nina Grytten
- KG Jebsen MS Research Centre, Institute of Clinical Medicine, University of Bergen, Bergen, Norway/Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Anne Br Skår
- Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Jan Harald Aarseth
- Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Jorg Assmus
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Elisabeth Farbu
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway/Neuroscience Research Group, Stavanger University Hospital, Stavanger, Norway/Institute of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Kirsten Lode
- Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - Harald I Nyland
- Institute of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Tori Smedal
- Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway/Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway
| | - Kjell Morten Myhr
- KG Jebsen MS Research Centre, Institute of Clinical Medicine, University of Bergen, Bergen, Norway/Norwegian Multiple Sclerosis Registry and Biobank, Department of Neurology, Haukeland University Hospital, Bergen, Norway
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Parkerson HA, Kehler MD, Sharpe D, Hadjistavropoulos HD. Coping with Multiple Sclerosis Scale: Reconsideration of the Factorial Structure. Int J MS Care 2016; 18:192-200. [PMID: 27551244 DOI: 10.7224/1537-2073.2015-031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Coping with Multiple Sclerosis Scale (CMSS) was developed to assess coping strategies specific to multiple sclerosis (MS). Despite its wide application in MS research, psychometric support for the CMSS remains limited to the initial factor analytic investigation by Pakenham in 2001. METHODS The current investigation assessed the factor structure and construct validity of the CMSS. Participants with MS (N = 453) completed the CMSS, as well as measures of disability related to MS (Multiple Sclerosis Impact Scale), quality of life (World Health Organization Quality of Life Brief Scale), and anxiety and depression (Hospital Anxiety and Depression Scale). RESULTS The original factor structure reported by Pakenham was a poor fit to the data. An alternate seven-factor structure was identified using exploratory factor analysis. Although there were some similarities with the existing CMSS subscales, differences in factor content and item loadings were found. Relationships between the revised CMSS subscales and additional measures were assessed, and the findings were consistent with previous research. CONCLUSIONS Refinement of the CMSS is suggested, especially for subscales related to acceptance and avoidance strategies. Until further research is conducted on the revised CMSS, it is recommended that the original CMSS continue to be administered. Clinicians and researchers should be mindful of lack of support for the acceptance and avoidance subscales and should seek additional scales to assess these areas.
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Mikula P, Nagyova I, Krokavcova M, Vitkova M, Rosenberger J, Szilasiova J, Gdovinova Z, Groothoff JW, van Dijk JP. Do coping strategies mediate the association between Type D personality and quality of life among people with multiple sclerosis? J Health Psychol 2016; 23:1557-1565. [PMID: 27458108 DOI: 10.1177/1359105316660180] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study is to explore whether different coping strategies are able to mediate the association between Type D personality and quality of life. We collected information from 156 consecutive patients (response rate: 72.9%; 75.0% women; median age: 40 ± 3 years). Patients completed the Type D Scale-14, the Coping Self-Efficacy Scale and the Short-Form Health Survey for measuring physical and mental quality of life. The mediating effect of coping was analysed using correlations, linear regressions and the Sobel z-test. In the mental quality of life, all three studied coping strategies mediated the association between Type D personality and quality of life.
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Affiliation(s)
- Pavol Mikula
- 1 Pavol Jozef Safarik University in Kosice, Slovakia
| | - Iveta Nagyova
- 1 Pavol Jozef Safarik University in Kosice, Slovakia
| | | | | | | | | | | | | | - Jitse P van Dijk
- 1 Pavol Jozef Safarik University in Kosice, Slovakia.,2 University of Groningen, The Netherlands
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Melnikov M, Belousova O, Murugin V, Pashenkov М, Boyко A. The role of dopamine in modulation of Th-17 immune response in multiple sclerosis. J Neuroimmunol 2016; 292:97-101. [PMID: 26943966 DOI: 10.1016/j.jneuroim.2016.01.020] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 01/27/2016] [Accepted: 01/29/2016] [Indexed: 12/25/2022]
Abstract
Neuromediators may modulate neuroinflammation, particularly in multiple sclerosis (MS). We investigated the effects of dopamine (DA) on the pro-inflammatory Th17-branch of immunity in 43 patients with relapsing-remitting MS and 20 healthy subjects. Serum DA was lower in MS relapse, whereas percentages of blood CD4(+)CD26(+)CD161(+)CD196(+) Th17-cells and production of interleukin-17 (IL-17) and interferon-gamma by anti-CD3/anti-CD28-stimulated peripheral blood mononuclear cells (PBMC) were higher in MS relapse than in remission or healthy subjects. DA suppressed IL-17 production by PBMC from MS patients and healthy subjects. The suppressive effect of DA was abolished in the presence of an antagonist of D2-like receptors (sulpiride). These data suggest an anti-inflammatory role for DA in MS.
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Affiliation(s)
- Mikhail Melnikov
- Pirogov Russian National Research Medical University, Moscow, Russia.
| | - Olga Belousova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - Vladimir Murugin
- Laboratory of Clinical Immunology, Institute of Immunology, Moscow, Russia
| | - Мikhail Pashenkov
- Laboratory of Clinical Immunology, Institute of Immunology, Moscow, Russia
| | - Alexey Boyко
- Pirogov Russian National Research Medical University, Moscow, Russia
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Soundy A, Roskell C, Elder T, Collett J, Dawes H. The Psychological Processes of Adaptation and Hope in Patients with Multiple Sclerosis: A Thematic Synthesis. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ojtr.2016.41003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Soundy A, Roskell C, Adams R, Elder T, Dawes H. Understanding Health Care Professional-Patient Interactions in Multiple Sclerosis: A Systematic Review and Thematic Synthesis. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ojtr.2016.44018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Abstract
Unpleasant, unpredictable symptoms, difficult treatment regimes, and uncertainty about the future of Multiple Sclerosis require the patients to adapt to new life changes and restrictions. This study aimed to explore patients' experiences of adapting to Multiple Sclerosis. A qualitative content analysis method was used to conduct this study. The study participants were 25 patients with Multiple Sclerosis, chosen through purposeful sampling. Data were analyzed by using content analysis. The analysis resulted in the emergence of seven themes and eighteen subthemes. The main themes were: religiosity, information seeking, seeking support, hope rearing, emotional reactions, concealing the disease, fighting the disease and disability. These themes can represent the perceived characteristics and difficulties of adaptation to Multiple Sclerosis by patients. These findings can help nurses and families to aid patients in increasing their abilities to adapt to the disease and enhance their quality of life.
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Mackay AM, Buckingham R, Schwartz RS, Hodgkinson S, Beran RG, Cordato DJ. The Effect of Biofeedback as a Psychological Intervention in Multiple Sclerosis: A Randomized Controlled Study. Int J MS Care 2015; 17:101-8. [PMID: 26052255 PMCID: PMC4455862 DOI: 10.7224/1537-2073.2014-006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Relaxation, mindfulness, social support, and education (RMSSE) have been shown to improve emotional symptoms, coping, and fatigue in multiple sclerosis (MS). Biofeedback was trialed as a psychological intervention, designed to improve self-control, in two groups of patients with MS. Both groups received RMSSE, and one group additionally received biofeedback. METHODS Forty people with relapsing-remitting MS were recruited from three sites in Sydney, Australia. The mean disability score (Expanded Disability Status Scale; EDSS) was 2.41 ± 1.46 (95% confidence interval [CI], 1.46-3.36); the mean age in years was 45.9 ± 12.42 (95% CI, 41.92-49.87). Participants were randomly assigned to two active treatment groups (n = 20 per group). All participants received one 1-hour session per week for 3 weeks of RMSSE, while biofeedback equipment measured breathing rate and muscle tension. Members of one group used biofeedback screens to regulate physiological response. RESULTS Whole-group pre- and post-treatment scores demonstrated a reduction of 38% for anxiety and 39% for depression scores (P = .007 and P = .009, respectively). A post-treatment comparison failed to demonstrate any significant difference between the two active treatment groups in anxiety and depression scores. The biofeedback group showed significant pre- to post-treatment improvement or trends toward improvement in anxiety, fatigue, and stress (P = .05, .02, and .03, respectively). Comparison of pre-post treatment results between groups showed improvements for the biofeedback group in breathing rate and muscle tension (P = .06 and .09). CONCLUSIONS For relapsing-remitting MS patients receiving biofeedback in addition to RMSSE, there was a demonstrable reduction in anxiety, fatigue, and stress. There was also a trend toward significant reduction of breathing rate and muscle tension in favor of biofeedback.
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Affiliation(s)
- Alison M. Mackay
- Correspondence: Alison M. Mackay, BSocSci (Psych)(Hons), Suite 1, 561 Kingsway, Miranda, NSW 2228, Australia; e-mail:
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Hagen KB, Aas T, Lode K, Gjerde J, Lien E, Kvaløy JT, Lash TL, Søiland H, Lind R. Illness uncertainty in breast cancer patients: Validation of the 5-item short form of the Mishel Uncertainty in Illness Scale. Eur J Oncol Nurs 2015; 19:113-9. [DOI: 10.1016/j.ejon.2014.10.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 10/11/2014] [Accepted: 10/24/2014] [Indexed: 10/24/2022]
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Bianchi V, De Giglio L, Prosperini L, Mancinelli C, De Angelis F, Barletta V, Pozzilli C. Mood and coping in clinically isolated syndrome and multiple sclerosis. Acta Neurol Scand 2014; 129:374-81. [PMID: 24172013 DOI: 10.1111/ane.12194] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Few studies have examined behavioural changes in the early phase of multiple sclerosis (MS). The aim of the study is to investigate mood alterations and to explore coping strategies regarding patients with clinically isolated syndrome (CIS) and relapsing-remitting MS (RRMS). MATERIALS AND METHODS The communication of diagnosis was made by one neurologist using a standardized approach. Depression, anxiety and coping questionnaires were filled in within 1 month from the diagnosis and at 3, 6, 12, 18 and 24 months subsequently. RESULTS Thirty-nine patients were examined (11 CIS, 28 RRMS), also 39 healthy controls. At entry, patients showed a lower degree of hostile behaviour and a higher level of depression than the controls. At follow-up, a reduction in depression, anxiety and a better coping adjustment was observed. A higher reliance on 'Accepting responsibilities' coping score was seen in patients with higher levels of depression and anxiety. No significant differences were revealed by group comparisons between CIS and RRMS. CONCLUSIONS This study highlights transient mood alterations and an improving of adaptive coping over a period of time in patients with CIS and RRMS. Similar emotional reactions and coping in clinical subgroups suggest that these factors are independent from the type of information provided during the communication of the diagnosis.
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Affiliation(s)
- V. Bianchi
- MS Centre; S. Andrea Hospital; Neurological Sciences; La Sapienza University; Rome Italy
| | - L. De Giglio
- MS Centre; S. Andrea Hospital; Neurological Sciences; La Sapienza University; Rome Italy
- Department of Psychology; Sapienza University; Rome Italy
| | - L. Prosperini
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
| | - C. Mancinelli
- MS Centre; S. Andrea Hospital; Neurological Sciences; La Sapienza University; Rome Italy
| | - F. De Angelis
- MS Centre; S. Andrea Hospital; Neurological Sciences; La Sapienza University; Rome Italy
| | - V. Barletta
- MS Centre; S. Andrea Hospital; Neurological Sciences; La Sapienza University; Rome Italy
| | - C. Pozzilli
- Department of Neurology and Psychiatry; Sapienza University; Rome Italy
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Abstract
Background: Multiple Sclerosis (MS) is a debilitating and degenerative lifelong neurological disease that seems to be growing increasingly more prevalent in South Africa.Objectives: The aim of this qualitative study was to explore the personal experiences of individuals with MS in the South African context. The focus of this study was on the challenges faced by individuals with MS, as well as the resources that help them to cope with this debilitating, neurological condition.Method: Thematic analysis was used to explore the semi-structured interviews that were conducted with ten individuals with MS.Results: Several themes emerged that related to the participants’ experiences of living with MS. These themes included several challenges faced by the participants on a daily basis, such as the process of being diagnosed, daily life, invisible illness and medical aid schemes. Numerous resources that help these individuals to cope with MS also emerged from the data analysis and consisted of social support, mobility aids, religion and knowledge about MS.Conclusion: It is evident from the findings of this study that although individuals living with MS, which is a debilitating neurological condition, face several challenges on a daily basis, they often have several resources that help them to cope effectively with this condition. The findings of this study regarding knowledge of the challenges faced and the resources utilised by individuals with MS will hopefully create awareness of the disease and contribute to and inform the design and implementation of interventions for such individuals. Agtergrond: Veelvuldige Sklerose (VS) is ‘n aftakelende en degerenatiewe lewenslange neurologiese toestand wat blyk of dit toenemend meer algemeen in Suid-Afrika voorkom.Objektief: Die doel van hierdie kwalitatiewe studie was om die persoonlike ervarings van individue met VS binne die Suid-Afrikaanse konteks te ondersoek.Die fokus van hierdie studie was op die uitdagings wat individue met VS in die gesig staar, sowel as die hulpbronne wat hulle help met die hantering van hierdie ernstige neurologiese toestand.Metode: Tematiese analise is gebruik om die semi-gestruktureerde onderhoude te ondersoek, wat gevoer is met tien individue met VS.Resultate: Verskeie temas wat verband hou met die deelnemers se ervarings van ‘n lewe met VS het na vore gekom. Hierdie temas het verskeie uitdagingsingesluit wat die deelnemers op ‘n daaglikse basis in die gesig staar, soos die proses om korrek gediagnoseer te word, daaglikse lewe, onsigbare siekte en mediese fonds skemas. ‘n Aantal hulpbronne wat hierdie individue help om VS te hanteer het ook na vore gekom en bestaan uit sosiale ondersteuning, mobiliteit hulpmiddels, geloof en kennis oor VS.Gevolgtrekking: Dit is duidelik uit die bevindinge dat alhoewel individue wat lewe met VS, wat ‘n ernstige neurologiese toestand is, verskeie uitdaging op ‘n daaglikse basis in die gesig staar, hulle beskik oor verskeie hulpbronne wat hulle help om hierdie toestand effektief te hanteer. Die bevindinge van hierdiestudie rakende kennis van die uitdagings wat hierdie individue in die gesig staar en die hulpbronne wat individue met VS gebruik sal hopelik ‘n bewustheid skep en bydra tot die ontwerp en implimentering van intervensies vir sulke individue.
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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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Klevan G, Jacobsen CO, Aarseth JH, Myhr KM, Nyland H, Glad S, Lode K, Figved N, Larsen JP, Farbu E. Health related quality of life in patients recently diagnosed with multiple sclerosis. Acta Neurol Scand 2014; 129:21-6. [PMID: 23772958 DOI: 10.1111/ane.12142] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2013] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To describe a representative population of patients recently diagnosed with MS in terms of both motor and non-motor disability. In particular we wanted to examine the HRQoL in this population to get a better understanding of what impact various clinical features have on the patients' experience of distress in the early phase of the disease. METHODS Ninety three patients diagnosed with MS in Hordaland and Rogaland county in 1998-2000 and 96 healthy controls were examined through questionnaires on HRQoL (SF-36), depression (Beck's depression inventory), fatigue (fatigue severity scale) and apathy (Starkstein's apathy scale). The patients also underwent neurological examination including the expanded disability status scale and the Multiple Sclerosis Functional Composite, as well as the symbol digit memory test and the selective reminder test. RESULTS Patients with MS reported a lower HRQoL than the controls with a mean physical health summary score of 57.3 compared to 84.5 (P < 0.001), and a mental health summary score of 66.4 vs 79.2 (P < 0.001). The controls scored significantly higher on all SF-36 sub scores except for bodily pain. The incidence of fatigue was 71% in patients compared to 27% in controls (P < 0.001), whereas 46% of patients vs 18% of controls reported depression (P < 0.001). The mean score for apathy was significantly higher among patients. CONCLUSIONS Patients with recently diagnosed MS reported significantly lower on both physical and mental aspects of HRQoL compared with controls. Depression, fatigue and apathy were more common and more severe in MS. We found no correlation between cognitive decline and HRQoL scores.
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Affiliation(s)
- G. Klevan
- Department of Neurology; Stavanger University Hospital; Stavanger Norway
- Norwegian Centre of Movement Disorders; Stavanger University Hospital; Stavanger Norway
| | - C. O. Jacobsen
- Department of Neurology; Stavanger University Hospital; Stavanger Norway
- Norwegian Centre of Movement Disorders; Stavanger University Hospital; Stavanger Norway
| | - J. H. Aarseth
- Department of Neurology Norwegian; Multiple Sclerosis Competence Centre; Haukeland University Hospital; Bergen Norway
| | - K.-M. Myhr
- Department of Neurology Norwegian; Multiple Sclerosis Competence Centre; Haukeland University Hospital; Bergen Norway
- Department of Clinical Medicine; KG Jebsen MS-research Centre; Haukeland University Hospital; Bergen Norway
- Clinical Institute 1; University of Bergen; Bergen Norway
| | - H. Nyland
- Department of Neurology Norwegian; Multiple Sclerosis Competence Centre; Haukeland University Hospital; Bergen Norway
- Department of Clinical Medicine; KG Jebsen MS-research Centre; Haukeland University Hospital; Bergen Norway
- Clinical Institute 1; University of Bergen; Bergen Norway
| | - S. Glad
- Department of Neurology Norwegian; Multiple Sclerosis Competence Centre; Haukeland University Hospital; Bergen Norway
| | - K. Lode
- Norwegian Centre of Movement Disorders; Stavanger University Hospital; Stavanger Norway
| | - N. Figved
- Department of Geriatric Psychiatry; Stavanger University Hospital; Stavanger Norway
| | - J. P. Larsen
- Norwegian Centre of Movement Disorders; Stavanger University Hospital; Stavanger Norway
- Clinical Institute 1; University of Bergen; Bergen Norway
| | - E. Farbu
- Department of Neurology; Stavanger University Hospital; Stavanger Norway
- Norwegian Centre of Movement Disorders; Stavanger University Hospital; Stavanger Norway
- Clinical Institute 1; University of Bergen; Bergen Norway
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Herman A, Taylor S, Noll J. Coping strategies and support networks for Sjögren's syndrome patients. Oral Maxillofac Surg Clin North Am 2013; 26:111-5. [PMID: 24287199 DOI: 10.1016/j.coms.2013.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sjögren's syndrome is a chronic systemic autoimmune disease that can affect any organ system in the body. The most common symptoms are dryness of the mouth and eyes resulting from chronic inflammation and a progressive loss of secretory function. As with most individuals managing a chronic condition, patients with Sjögren's are on a multipronged path to disease and symptom management. Various coping strategies are presented in this article and the advantages and disadvantages discussed. Additionally, how a support group functions and practical guidance for the initiation of a Sjögren's support group are discussed.
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Affiliation(s)
- Andrea Herman
- Department of Oral Medicine, Carolinas Center for Oral Health, 1601 Abbey Place, Suite 220, Charlotte, NC 28209, USA.
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Haase R, Schultheiss T, Kempcke R, Thomas K, Ziemssen T. Use and acceptance of electronic communication by patients with multiple sclerosis: a multicenter questionnaire study. J Med Internet Res 2012; 14:e135. [PMID: 23069209 PMCID: PMC3510727 DOI: 10.2196/jmir.2133] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 06/18/2012] [Accepted: 08/08/2012] [Indexed: 01/01/2023] Open
Abstract
Background The number of multiple sclerosis (MS) information websites, online communities, and Web-based health education programs has been increasing. However, MS patients’ willingness to use new ways of communication, such as websites, mobile phone application, short message service, or email with their physician, remains unknown. Objectives We designed a questionnaire to evaluate the a priori use of electronic communication methods by MS patients and to assess their acceptance of such tools for communication with their health care providers. Methods We received complete data from 586 MS patients aged between 17 and 73 years. Respondents were surveyed in outpatient clinics across Germany using a novel paper-and-pencil questionnaire. In addition to demographics, the survey items queried frequency of use of, familiarity with, and comfort with using computers, websites, email, and mobile phones. Results About 90% of all MS patients used a personal computer (534/586) and the Internet (527/586) at least once a week, 87.0% (510/586) communicated by email, and 85.6% (488/570) communicated by mobile phone. When asked about their comfort with using electronic communication methods for communication with health care providers, 20.5% (120/586) accepted communication by mobile Internet application or short message service via mobile phone, 41.0% (240/586) by websites, 54.3% (318/586) by email service, and 67.8% (397/586) by at least one type of electronic communication. The level of a priori use was the best predictor for the acceptance of electronic communication with health care providers. Patients who reported already searching online for health information (odds ratio 2.4, P < .001) and who had already communicated with a physician through a website (odds ratio 3.3, P = .03) reported higher acceptance for Web-based communication. Patients who already scheduled appointments with their mobile phones (odds ratio 2.1, P = .002) were more likely to accept the use of mobile phone applications or short message service for communicating with their physician. Conclusions The majority of MS patients seen at specialist centers already use modern communication technology regularly. New forms of electronic communication appear to have high levels of acceptance for exchanging information about MS between patients and health care providers. Such methods should be integrated into eHealth services such as electronic health records and patient relationship management systems.
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Affiliation(s)
- Rocco Haase
- Multiple Sclerosis Centre Dresden, Department of Neurology, University of Technology Dresden, Dresden, Germany.
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Costa DC, Sá MJ, Calheiros JM. The effect of social support on the quality of life of patients with multiple sclerosis. Arq Neuropsiquiatr 2012; 70:108-13. [PMID: 22311214 DOI: 10.1590/s0004-282x2012000200007] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 10/11/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the predictive value of social support on health related quality of life (HRQoL) in multiple sclerosis (MS) patients. METHODS The sample is composed by 150 MS consecutive patients. We used the Medical Outcomes Study Social Support Survey to assess social support and the Health Status Questionnaire to assess HRQoL. For inferential analysis, we used the Multiple Linear Regression with stepwise selection of variables. RESULTS The age, basic education, psychological support and disability explains 41.6% of the variance in physical function, 29.4% in physical performance and 30.6% in emotional performance. Age and psychological support explains 23.1% of the variance in physical function and 29.4% in vitality. CONCLUSION This study demonstrated that social support is a predictor with a significant effect on HRQoL in MS.
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Normann B, Sørgaard KW, Salvesen R, Moe S. Contextualized perceptions of movement as a source of expanded insight: People with multiple sclerosis' experience with physiotherapy. Physiother Theory Pract 2012; 29:19-30. [DOI: 10.3109/09593985.2012.698717] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Boland P, Levack WMM, Hudson S, Bell EM. Coping with multiple sclerosis as a couple: 'peaks and troughs' - an interpretative phenomenological exploration. Disabil Rehabil 2012; 34:1367-75. [PMID: 22256892 DOI: 10.3109/09638288.2011.645115] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Multiple Sclerosis (MS) is a chronic degenerative condition where illness uncertainty is a key difficulty that people with MS and their significant others have to cope with. Clinicians acknowledge that people with MS need to be seen in the context of their families, however there is little knowledge on what to expect about how people cope as a couple, which this study set out to explore. METHOD Interpretative Phenomenological Analysis (IPA) exploring, through semi-structured interviews, how seven couples, where one had MS, experienced coping with their situation. RESULTS Two overarching themes pertaining to coping as a couple emerged from the data: Coping Together: "Peaks and Troughs" and Coping Over the Long Haul, with each overarching theme relating to sub-themes. Two integrative themes emerged also, which were called Faith in Self and Faith in Each Other. CONCLUSIONS These results will assist clinicians better comprehend how those with MS and their spouses cope in an interconnected way and this in turn affects their experience of rehabilitation. Results from this research indicated that clinicians need to be sensitive to the individual coping strategies of both members of a couple where one has MS, and address the changing needs of their relationship.
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Affiliation(s)
- Pauline Boland
- Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand.
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Pozzilli C, Schweikert B, Ecari U, Oentrich W. Supportive strategies to improve adherence to IFN beta-1b in Multiple Sclerosis — Results of the BetaPlus observational cohort study. J Neurol Sci 2011; 307:120-6. [PMID: 21636099 DOI: 10.1016/j.jns.2011.04.026] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Accepted: 04/25/2011] [Indexed: 11/24/2022]
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Salamonsen A, Launsø L, Kruse TE, Eriksen SH. Understanding unexpected courses of multiple sclerosis among patients using complementary and alternative medicine: A travel from recipient to explorer. Int J Qual Stud Health Well-being 2010; 5:10.3402/qhw.v5i2.5032. [PMID: 20616888 PMCID: PMC2900149 DOI: 10.3402/qhw.v5i2.5032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2010] [Indexed: 12/31/2022] Open
Abstract
Complementary and alternative medicine (CAM) is frequently used by patients with multiple sclerosis (MS). Some MS patients experience unexpected improvements of symptoms, which they relate to their use of CAM. The aim of this study was to obtain knowledge and develop understandings of such self-defined unexpected improvement of MS symptoms. Two cases were constructed based on documents and 12 qualitative interviews. Our aim was not to make generalisations from the cases, but to transfer knowledge as working hypotheses. We identified four health-related change processes: the process of losing bodily competence; the process of developing responsibility; the process of taking control; and the process of choosing CAM. The patients explained unexpected improvements in their MS symptoms as results of their own efforts including their choice and use of CAM. In our theoretical interpretations, we found the patients' redefinition of history, the concept of treatment and the importance of conventional health care to be essential, and leading to a change of patients' position towards conventional health care from recipients to explorers. The explorers can be perceived as boundary walkers reflecting limitations within the conventional health care system and as initiators regarding what MS patients find useful in CAM.
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Affiliation(s)
- Anita Salamonsen
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, University of Tromsø, Tromsø, Norway
- Department of Sociology, Political Science and Community Planning, University of Tromsø, Tromsø, Norway
| | - Laila Launsø
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Tove E. Kruse
- Department of Culture and Identity, Roskilde University, Roskilde, Denmark
| | - Sissel H. Eriksen
- Department of Sociology, Political Science and Community Planning, University of Tromsø, Tromsø, Norway
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Lejbkowicz I, Paperna T, Stein N, Dishon S, Miller A. Internet usage by patients with multiple sclerosis: implications to participatory medicine and personalized healthcare. Mult Scler Int 2010; 2010:640749. [PMID: 22096625 DOI: 10.1155/2010/640749] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2010] [Revised: 05/18/2010] [Accepted: 05/26/2010] [Indexed: 11/30/2022] Open
Abstract
Online health information and services for patients were suggested to improve symptom management and treatment adherence, thereby contributing to healthcare optimization. This paper aimed to characterize multiple sclerosis (MS) patients Internet usage. Information regarding browsing habits, Internet reliability, and the medical team's attitude to information collected online was obtained by questionnaires from MS patients. Data was compared between nonbrowsers, browsers on MS topics, and browsers on non-MS topics only. From the 96 patients recruited, 61 (63.5%) performed MS-related searches. The most viewed topics were “understanding the disease” and “treatments”. Patients reported that the information helped coping with MS and assured them of the appropriateness of their therapy. Shorter disease duration was correlated with higher Internet activity. Disabled patients were more interested in online interaction with specialists and support groups. This paper suggests that MS patients benefit from online information, and it emphasizes the importance of resources tailored to patients needs.
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Montel S, Bungener C. [Validation of CHIP (a coping questionnaire) in French patients with neurological disorders]. Rev Neurol (Paris) 2009; 166:54-60. [PMID: 19515394 DOI: 10.1016/j.neurol.2009.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2008] [Revised: 04/13/2009] [Accepted: 05/11/2009] [Indexed: 11/16/2022]
Abstract
INTRODUCTION While conceived in the 1960's by Lazarus, the concept of coping was a long time coming in the field of neurological diseases. So far, no valid instrument has been available in French for assessing the style of coping of patients with neurological diseases. METHODS We used Coping with Health Injuries and Problems (CHIP), which was conceived for patients with chronic diseases. We proceeded to a factorial analysis in a population of 307 patients with multiple sclerosis (MS) or Parkinson's disease (PD) in order to identify the factors observed in this population. RESULTS We finally retained a model with six factors, which saturated on 24 items and explained 48% of the total variance. Factors we found included palliative coping and distraction, both known for the original instrument, and four new factors: emotional regulation, seeking of well-being/self-preservation, seeking of information and cognitive avoidance. DISCUSSION Tools for assessing coping in a setting of chronic diseases must be adapted to specific diseases. In this new validation, CHIP appeared to be well adapted to the specific features of neurological disorders. This instrument would be useful for the neurologist to better understand the specific ways by which patients cope with their disease. Such knowledge would certainly have a positive effect on the patient-neurologist relationship. Moreover, a better understanding of patients' coping strategies in neurological diseases could pave the way for specific preventive interventions focusing on using coping strategies to promote better adaptation.
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Affiliation(s)
- S Montel
- Laboratoire de psychopathologie et neuropsychologie clinique, université Paris Descartes, institut de psychologie, 71, avenue E.-Vaillant, 92774 Boulogne-Billancourt cedex, France.
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Abstract
Background Multiple sclerosis (MS) is a chronic disease with unclear etiology, unpredictable clinical course, and no cure. Patients’ ability to cope with MS moderates the adaptation to the disease. Objectives To compare coping in patients recently diagnosed with MS and healthy controls and to study the association between depressive symptoms and patients' coping styles. Methods A sample of 86 recently diagnosed patients with definite or probable MS and 93 healthy population controls completed questionnaires assessing coping styles and depressive symptoms. Results Compared with healthy controls, patients with MS used significantly less the problem focused strategies including planning, restraint coping, and seeking social support for instrumental reasons, and they used less the emotion-focused strategies seeking social support for emotional reasons, focusing on and venting of emotions, and positive reinterpretation and growth. The mean Beck Depressive symptoms Inventory scores were 10.8 and 4.7 in patients and controls, respectively. In stress situations connected to MS, depressive symptoms in these patients were related to the problem-focused strategies of restraint coping and planning, the emotion-focused strategy of focusing on and venting of emotions, and the avoidance strategies of behavioral- and mental disengagements, and denial.
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Affiliation(s)
- K Lode
- The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway
| | - E Bru
- Centre of Behavioral Research, University of Stavanger, Stavanger, Norway
| | - G Klevan
- Department of Neurology, Stavanger University Hospital, Stavanger, Norway
| | - KM Myhr
- The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Section of Neurology, University of Bergen, Bergen, Norway
| | - H Nyland
- The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Section of Neurology, University of Bergen, Bergen, Norway
| | - JP Larsen
- The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway; Department of Neurology, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine, Section of Neurology, University of Bergen, Bergen, Norway
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Affiliation(s)
- S Hartley
- Neurology Team, North Tees and Hartlepool NHS Foundation Trust, Hardwick Road, Stockton-on-Tees, Cleveland, TS19 8PE, UK
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