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Maalouly E, Yamazaki R, Nishio S, Nørskov M, Kamaga K, Komai S, Chiba K, Atsumi K, Akao KI. The effect of conversation on altruism: A comparative study with different media and generations. PLoS One 2024; 19:e0301769. [PMID: 38875175 PMCID: PMC11178171 DOI: 10.1371/journal.pone.0301769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 03/21/2024] [Indexed: 06/16/2024] Open
Abstract
Despite the overwhelming evidence of climate change and its effects on future generations, most individuals are still hesitant to make environmental changes that would especially benefit future generations. In this study, we investigate whether dialogue can influence people's altruistic behavior toward future generations of humans, and how it may be affected by participant age and the appearance of the conversation partner. We used a human, an android robot called Telenoid, and a speaker as representatives of future generations. Participants were split among an old age group and a young age group and were randomly assigned to converse with one of the aforementioned representatives. We asked the participants to play a round of the Dictator Game with the representative they were assigned, followed by an interactive conversation and another round of the Dictator Game in order to gauge their level of altruism. The results show that, on average, participants gave more money after having an interactive conversation, and that older adults tend to give more money than young adults. There were no significant differences between the three representatives. The results show that empathy might have been the most important factor in the increase in altruistic behavior for all participants.
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Affiliation(s)
- Elie Maalouly
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Ryuji Yamazaki
- Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Osaka, Japan
| | - Shuichi Nishio
- Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Osaka, Japan
| | - Marco Nørskov
- Department for Philosophy and the History of Ideas, Aarhus University, Aarhus, Denmark
| | - Kohei Kamaga
- Faculty of Economics, Sophia University, Tokyo, Japan
| | - Shoji Komai
- Faculty of Engineering, International Professional University of Technology in Tokyo, Tokyo, Japan
| | - Kiyoshi Chiba
- School of Social Sciences, Waseda University, Tokyo, Japan
| | | | - Ken-Ichi Akao
- School of Social Sciences, Waseda University, Tokyo, Japan
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Maalouly E, Yamazaki R, Nishio S, Nørskov M, Kamaga K, Komai S, Chiba K, Atsumi K, Akao KI. Assessing the effect of dialogue on altruism toward future generations: A preliminary study. FRONTIERS IN COMPUTER SCIENCE 2023. [DOI: 10.3389/fcomp.2023.1129340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
IntroductionDespite the abundance of evidence on climate change and its consequences on future generations, people, in general, are still reluctant to change their actions and behaviors toward the environment that would particularly benefit posterity. In this study, we took a preliminary step in a new research direction to explore humans' altruistic behavior toward future generations of people and whether it can be affected by dialogue.MethodsWe used an android robot called Telenoid as a representative of future generations by explaining that the robot is controlled by an Artificial Intelligence (AI) living in a simulation of our world in the future. To measure people's altruistic behavior toward it, we asked the participants to play a round of the Dictator Game with the Telenoid before having an interactive conversation with the Telenoid and then playing another round.ResultsOn average, participants gave more money to the Telenoid in the second round (after having an interactive conversation). The average amount of money increased from 20% in the first to about 30% in the second round.DiscussionThe results indicate that the conversation with the robot might have been responsible for the change in altruistic behavior toward the Telenoid. Contrary to our expectations, the personality of the participants did not appear to have an influence on their change of behavior, but other factors might have contributed. We finally discuss the influence of other possible factors such as empathy and the appearance of the robot. However, the preliminary nature of this study should deter us from making any definitive conclusions, but the results are promising for establishing the ground for future experiments.
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Liković M, Buljevac M. ‶You look really good, I don't know why you came here″: persons with multiple sclerosis´ perspectives on social support. Home Health Care Serv Q 2023:1-22. [PMID: 36913915 DOI: 10.1080/01621424.2023.2189645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
The aim of this qualitative study is to gain insight into the perspectives of persons with multiple sclerosis on social support. Semi-structured interviews were conducted with eleven persons with multiple sclerosis. The results on informal support for persons with multiple sclerosis reveal perceived support and the lack of support from different persons. The results on formal support for persons with multiple sclerosis show perceived support from healthcare professionals, professionals working outside healthcare and social care systems, and associations of persons with MS, but also inadequate support from healthcare professionals and social workers. Close emotional relationship, empathy, knowledge and understanding are the basis for provision of all types of support from informal support system, while perceived support from formal support system is based on professionals´ empathy, their professionalism and knowledge. Persons with multiple sclerosis need accurate and timely emotional, informational, practical and financial support.
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Affiliation(s)
- Maja Liković
- Department of Social Work, Faculty of Law, University of Zagreb, Zagreb, Croatia
| | - Marko Buljevac
- Department of Social Work, Faculty of Law, University of Zagreb, Zagreb, Croatia
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Aterman S, Ghahari S, Kessler D. Characteristics of peer-based interventions for individuals with neurological conditions: a scoping review. Disabil Rehabil 2023; 45:344-375. [PMID: 35085058 DOI: 10.1080/09638288.2022.2028911] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE Peer-based interventions are increasingly popular and cost-effective therapeutic opportunities to support others experiencing similar life circumstances. However, little is known about the similarities and differences among peer-based interventions and their outcomes for people with neurological conditions. This scoping review aims to describe and compare the characteristics of existing peer-based interventions for adults with common neurological conditions. MATERIALS AND METHODS We searched MEDLINE, CINAHL, PsychInfo, and Embase for research on peer-based interventions for individuals with brain injury, Parkinson's, multiple sclerosis, spinal cord injury, and stroke up to June 2019. The search was updated in March 2021. Fifty-three of 2472 articles found were included. RESULTS Characteristics of peer-based intervention for this population vary significantly. They include individual and group-based formats delivered in-person, by telephone, or online. Content varied from structured education to tailored approaches. Participant outcomes included improved health, confidence, and self-management skills; however, these varied based on the intervention model. CONCLUSION Various peer-based interventions exist, each with its own definition of what it means to be a peer. Research using rigorous methodology is needed to determine the most effective interventions. Clear definitions of each program component are needed to better understand the outcomes and mechanism of action within each intervention.IMPLICATIONS FOR REHABILITATIONRehabilitation services can draw on various peer support interventions to add experiential knowledge and support based on shared experience to enhance outcomes.Fulfilling the role of peer mentor may be beneficial and could be encouraged as part of the rehabilitation process for people with SCI, TBI, Stroke, PD, or MS.In planning peer-based interventions for TBI, Stroke, SCI, PD, and MS populations, it is important to clearly define intervention components and evaluate outcomes to measure the impact of the intervention.
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Affiliation(s)
- Sarah Aterman
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Setareh Ghahari
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Dorothy Kessler
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
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Elkhalii-Wilhelm S, Sippel A, Riemann-Lorenz K, Kofahl C, Scheiderbauer J, Arnade S, Kleiter I, Schmidt S, Heesen C. Experiences of persons with Multiple Sclerosis with lifestyle adjustment–A qualitative interview study. PLoS One 2022; 17:e0268988. [PMID: 35622783 PMCID: PMC9140290 DOI: 10.1371/journal.pone.0268988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 05/12/2022] [Indexed: 12/04/2022] Open
Abstract
Background Persons with Multiple Sclerosis (pwMS) follow individual strategies to cope with this highly heterogeneous disease. As surveys show, lifestyle habits play an important role in pwMS. However, little is known about individual experiences of pwMS with different lifestyle adjustment strategies. Objective This study aims to describe and understand individual experiences of pwMS with lifestyle adjustments. Methods Semi-structured interviews were conducted with 50 pwMS in Germany. Criteria for inclusion were age ≥ 18 years and a diagnosis of relapsing-remitting Multiple Sclerosis. Data were analyzed inductively and deductively according to a six-step thematic analysis. Results The three main themes for experience-based lifestyle adjustments were: 1) nutrition and supplements, 2) exercise and physical activity, and 3) stress management. Influencing factors on the decision-making process such as active disease management, information and advice, desire for mental health and social support, and the wish for self-determination were identified. Impacts of starting or maintaining lifestyle habits included, for example, MS-specific, general, and mental health benefits, the development of coping strategies, social support, and barriers that led to a termination of lifestyle adjustments. Conclusion This study provides a rich and nuanced amount of experiences of pwMS with lifestyle adjustments and leads to three important conclusions: 1) Further research is warranted to better describe the perceived effects of lifestyle habits on MS symptoms and progression, in particular with regard to nutrition and stress reduction; 2) patient education in MS should include the available evidence on lifestyle management and 3) patients need to be actively supported in changing their lifestyle behavior.
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Affiliation(s)
- Saskia Elkhalii-Wilhelm
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- * E-mail:
| | - Anna Sippel
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Karin Riemann-Lorenz
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Christopher Kofahl
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - Sigrid Arnade
- LEBENSNERV–Stiftung zur Förderung der Psychosomatischen MS-Forschung, Berlin, Germany
| | - Ingo Kleiter
- Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke GmbH, Berg, Germany
| | - Stephan Schmidt
- Neurologische Gemeinschaftspraxis, Gesundheitszentrum St. Johannes, Bonn, Germany
| | - Christoph Heesen
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Neurology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Bijani M, Niknam M, Karimi S, Naderi Z, Dehghan A. The effect of peer education based on Pender's health promotion model on quality of life, stress management and self-efficacy of patients with multiple sclerosis: a randomized controlled clinical trial. BMC Neurol 2022; 22:144. [PMID: 35436876 PMCID: PMC9014276 DOI: 10.1186/s12883-022-02671-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background As a chronic, disabling disease, multiple sclerosis (MS) has challenged healthcare systems in many ways. MS adversely affects patients’ quality of life and self-efficacy and results in psychological stress. The present study was conducted to investigate the effect of peer education based on Pender’s health promotion model on the quality of life, stress management, and self-efficacy of patients with MS in the south of Iran. Methods The present study was a randomized controlled clinical trial. A total of 90 patients were divided into group A intervention group 45 patients) and group B (control group 45 patients). The intervention was peer education based on Pender’s health promotion model. Data were collected using the MS Quality of Life Scale, the Self-efficacy Scale, and the Stress Management Scale. Data analyses were conducted using SPSS version 22. To analyze the data, we used descriptive statistics. Thus, inferential statistics applied included Chi-square, independent-samples t-test, and Repeated measures (ANOVA). The significance level was considered p < 0.05. Results The quality of life, self-efficacy, and stress management mean scores of the intervention group as measured immediately and 3 months after intervention were significant (p < 0.05). As for the control group, however, the difference was not significant. Conclusion Peer education based on Pender’s health promotion model improves patients’ quality of life, stress management, and self-efficacy with multiple sclerosis. Nursing managers and health system policymakers can use this educational approach for patients with other chronic diseases to enhance their quality of life and self-efficacy. Trial registration Iranian Registry of Clinical Trials: IRCT registration number: IRCT20190917044802N3.
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Affiliation(s)
- Mostafa Bijani
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran.
| | - Maryam Niknam
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Shanaz Karimi
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Zeinab Naderi
- Department of Nursing, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Azizallah Dehghan
- NonCommunicable Diseases Research Center (NCDRC), Fasa University of Medical Sciences, Fasa, Iran
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Dorstyn D, Oxlad M, Roberts R, Murphy G, Potter E, Kneebone I, Craig A. MS JobSeek: A pilot randomized controlled trial of an online peer discussion forum for job-seekers with multiple sclerosis. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-211174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Peer-facilitated interventions have been successfully used in chronic disease management. Less is known about their application in vocational rehabilitation. OBJECTIVE: To pilot-test an online peer discussion forum to improve exploration of employment options in job-seekers with long-term multiple sclerosis (MS). METHODS: Twenty-nine persons with relapsing/progressive MS (4–27 years since diagnosis) were recruited online and randomly assigned to an 8-week discussion forum led by peers and a moderator, MS JobSeek (n = 14), or an active control group (n = 15). Forum engagement and user satisfaction were examined, as were pre-post self-evaluations of job search behaviour, efficacy, and quality of life. RESULTS: A high (43%) attrition rate was noted, although intervention completers acknowledged and valued online mentors’ guidance and expertise. Group and time effects were not significant (p < 0.05), with both MS JobSeek and control participants reporting positive (e.g., increase in job search activities) and negative (e.g., lowered self-efficacy) change. CONCLUSIONS: The pilot findings suggest that online peer support is feasible, however more can be done to promote peer-to-peer communication. Recommendations for improving forum engagement and satisfaction in a future controlled trial, including strategies to better support mentees’ individualised needs, are offered.
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Affiliation(s)
- Diana Dorstyn
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Melissa Oxlad
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Rachel Roberts
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Gregory Murphy
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Elizabeth Potter
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Ian Kneebone
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, Australia
| | - Ashley Craig
- Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute of Medical Research, RNSH, St Leonards, Australia
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Hughes AJ, Botanov Y, Beier M. Dialectical Behavior Therapy Skills Training for Individuals with Multiple Sclerosis and their Support Partners: A Pilot Randomized Controlled Trial. Mult Scler Relat Disord 2022; 59:103481. [DOI: 10.1016/j.msard.2021.103481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/06/2021] [Accepted: 12/31/2021] [Indexed: 10/19/2022]
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Sales MC, Kasahara TM, Sacramento PM, Rossi ÁD, Cafasso MOS, Oyamada HA, Hygino J, Alvim F, Andrade RM, Cristina Vasconcelos C, Bento CA. Selective serotonin reuptake inhibitor attenuates the hyperresponsiveness of TLR2 + and TLR4 + Th17/Tc17-like cells in multiple sclerosis patients with major depression. Immunology 2021; 162:290-305. [PMID: 33112414 PMCID: PMC7884649 DOI: 10.1111/imm.13281] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 02/06/2023] Open
Abstract
Elevated frequency of Th17-like cells expressing Toll-like receptors (TLRs) has been recently associated with relapsing-remitting multiple sclerosis (MS) pathogenesis, a chronic inflammatory demyelinating autoimmune disease of the central nervous system. We aimed to investigate the impact of current major depressive disorder (MDD) on the behaviour of these cells following in vitro stimulation with TLR2, TLR4, TLR5 and TLR9 agonists. Here, the level of both cell proliferation and cytokine production related to Th17/Tc17 phenotypes in response to TLR2 (Pam3C) and TLR4 (LPS) ligands was significantly higher in CD4+ and CD8+ T-cell cultures from MS/MDD patients when compared to non-depressed patients. These cytokine levels were positively associated with neurological disabilities in patients. No difference for responsiveness to TLR5 (flagellin) and TLR9 (ODN) agonists was observed. LPS, but not Pam3C, induced significant IL-10 release, mainly in patients without MDD. Interestingly, more intense expression of TLR2 and TLR4 on these cells was observed in MDD patients. Finally, in vitro addition of serotonin and treatment of MDD patients with selective serotonin reuptake inhibitors (SSRIs) reduced the production of Th17/Tc17-related cytokines by CD4+ and CD8+ T cells in response to Pam3C and LPS. However, only SSRI therapy diminished the frequency and intensity of TLR2 and TLR4 expression on circulating CD4+ and CD8+ T cells. In summary, although preliminary, our findings suggest that adverse events that elevate circulating levels of TLR2 and TLR4 ligands can affect MS pathogenesis, particularly among depressed patients.
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Affiliation(s)
- Marisa C. Sales
- Department of Microbiology and ParasitologyFederal University of the State of Rio de JaneiroRio de JaneiroBrazil
- Post‐graduate Program in MicrobiologyUniversity of the State of Rio de JaneiroRio de JaneiroBrazil
| | - Taissa M. Kasahara
- Department of Microbiology and ParasitologyFederal University of the State of Rio de JaneiroRio de JaneiroBrazil
| | - Priscila M. Sacramento
- Department of Microbiology and ParasitologyFederal University of the State of Rio de JaneiroRio de JaneiroBrazil
- Post‐graduate Program in MicrobiologyUniversity of the State of Rio de JaneiroRio de JaneiroBrazil
| | - Átila D. Rossi
- Department of GeneticsFederal University of Rio de JaneiroRio de JaneiroBrazil
| | - Marcos Octávio S.D. Cafasso
- Department of Microbiology and ParasitologyFederal University of the State of Rio de JaneiroRio de JaneiroBrazil
| | - Hugo A.A. Oyamada
- Department of Microbiology and ParasitologyFederal University of the State of Rio de JaneiroRio de JaneiroBrazil
- Post‐graduate Program in MicrobiologyUniversity of the State of Rio de JaneiroRio de JaneiroBrazil
| | - Joana Hygino
- Department of Microbiology and ParasitologyFederal University of the State of Rio de JaneiroRio de JaneiroBrazil
- Post‐graduate Program in NeurologyFederal University of the State of Rio de JaneiroRio de JaneiroBrazil
| | - Fabianna Alvim
- Department of Microbiology and ParasitologyFederal University of the State of Rio de JaneiroRio de JaneiroBrazil
| | - Regis M. Andrade
- Department of General Medicine DepartmentFederal University of the State of Rio de JaneiroRio de JaneiroBrazil
| | | | - Cleonice A.M. Bento
- Department of Microbiology and ParasitologyFederal University of the State of Rio de JaneiroRio de JaneiroBrazil
- Post‐graduate Program in NeurologyFederal University of the State of Rio de JaneiroRio de JaneiroBrazil
- Department of General Medicine DepartmentFederal University of the State of Rio de JaneiroRio de JaneiroBrazil
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Levin SN, Riley CS, Dhand A, White CC, Venkatesh S, Boehm B, Nassif C, Socia L, Onomichi K, Leavitt VM, Levine L, Heyman R, Farber RS, Vargas WS, Xia Z, De Jager PL. Association of social network structure and physical function in patients with multiple sclerosis. Neurology 2020; 95:e1565-e1574. [PMID: 32769139 DOI: 10.1212/wnl.0000000000010460] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/18/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To test the association between physical function and the social environment in multiple sclerosis (MS), we quantified personal social networks. METHODS In this cross-sectional study, we analyzed data from 2 academic MS centers, with center 1 serving as a discovery group and center 2 as the extension group. We performed a meta-analysis of the centers to extend the analysis. We used responses from a questionnaire to map the structure and health habits of participants' social networks as well as the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) physical function scale (0-100, mean 50 for US general population) as the primary outcome. We applied multivariable models to test the association between network metrics and physical function. RESULTS The discovery cohort included 263 patients with MS: 81% were women, 96% non-Hispanic European, 78% had relapsing MS, average age was 50 (12.4) years, and mean disease duration was 17 (12.3) years. The extension group included 163 patients, who were younger, more racially diverse, and less physically disabled, and had shorter disease duration. In the meta-analysis, higher network constraint, a measure of tightly bound networks, was associated with worse physical function (β = -0.163 ± 0.047, p < 0.001), while larger network effective size, a measure of clustered groups in the network, correlated with better physical function (β = 0.134 ± 0.046, p = 0.003). CONCLUSIONS Our study highlights personal networks as an important environmental factor associated with physical function in MS. Patients with close-knit networks had worse function than those with more open networks. Longitudinal studies are warranted to evaluate a causal relationship between network structure and physical impairment.
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Affiliation(s)
- Seth N Levin
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Claire S Riley
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Amar Dhand
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Charles C White
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Shruthi Venkatesh
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Blake Boehm
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Caren Nassif
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Lauren Socia
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Kaho Onomichi
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Victoria M Leavitt
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Libby Levine
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Rock Heyman
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Rebecca S Farber
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Wendy S Vargas
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Zongqi Xia
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA
| | - Philip L De Jager
- From the Multiple Sclerosis Center and the Center for Translational & Computational Neuroimmunology, Department of Neurology (S.N.L., C.S.R., C.N., L.S., K.O., V.M.L., L.L., R.S.F., W.S.V., P.L.D.J.), and The Taub Institute for Alzheimer's Disease Research (P.L.D.J.), Columbia University Irving Medical Center, New York, NY; Department of Neurology (A.D.), Brigham and Women's Hospital, Harvard Medical School; Network Science Institute (A.D.), Northeastern University, Boston; Broad Institute (C.C.W., Z.X., P.L.D.J.), Cell Circuits Program, Cambridge, MA; and Department of Neurology (S.V., B.B., R.H., Z.X.), University of Pittsburgh, PA.
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11
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Landstad BJ, Hedlund M, Kendall E. Practicing in a person-centred environment - self-help groups in psycho-social rehabilitation. Disabil Rehabil 2020; 44:1067-1076. [PMID: 32673133 DOI: 10.1080/09638288.2020.1789897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM The increasing prevalence of chronic conditions and impairments in the population is putting new demands on health and rehabilitation services. Research on self-help groups suggest that participation in these groups might have a positive impact on people who are struggling with chronic illnesses or disabilities. In this study, we explore person-centred support in which participants in self-help groups are undergoing rehabilitation to develop their knowledge, skills and confidence necessary to handle life's challenges. METHOD The design is exploratory, analysing data from informant interviews and focus groups (a total of 32 participants) using a Grounded Theory inspired approach to analyse. The participants were rehabilitation clients aged between 20 and 60 years; eight were men and twenty-six were women. RESULTS Three main categories emerged as being important self-help processes that were likely to promote positive rehabilitation outcomes: (1) Learning and practicing safely, (2) A refuge from expectations, (3) Internal processes that accentuate the positives. CONCLUSION Peer support delivered through the structured self-help environment can facilitate the development of new self-awareness, promote acceptance and adjustment, facilitate the establishment of new skills and enable transfer of learning to new environments, including the workplace.IMPLICATIONS FOR REHABILITATIONSelf-help groups may support the process of rehabilitation.Participating in self-help groups provides an enabling context for individuals to address challenges and limitations.Peer support delivered through the structured self-help environment can facilitate the development of new self-awareness, promote adjustment, and facilitate the establishment of new skills.Participating in peer led self-help groups can assist with the transfer of learning to new environments, including development of potential work capacity.
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Affiliation(s)
- Bodil J Landstad
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden.,Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Marianne Hedlund
- Faculty of Health Science, Nord University, Levanger, Norway.,Department of Social Work and Health Science, Norwegian University of Technology and Science, Trondheim, Norway
| | - Elizabeth Kendall
- The Hopkins Centre, Disability, Rehabilitation & Resilience Program, Menzies Health Institute Qld, Griffith University, Logan Campus, Australia
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12
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Garabedian M, Perrone E, Pileggi C, Zimmerman V. Support Group Participation: Effect on Perceptions of Patients with Newly Diagnosed Multiple Sclerosis. Int J MS Care 2020; 22:115-121. [PMID: 32607073 DOI: 10.7224/1537-2073.2018-099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Patients newly diagnosed as having multiple sclerosis (MS) face an overwhelming number of questions about how it will affect their lives. Participation in a support group is one way to obtain information and receive support from others. However, existing support groups are often attended by patients with significant disability, resulting in newly diagnosed patients being hesitant to return. Methods This qualitative pilot study explored perceptions of patients with newly diagnosed MS before and after participation in two monthly meetings. A support group was conducted each month using nursing staff, a physician, and a social worker. Prior to the first meeting, participants were asked to complete a questionnaire with open-ended questions to share their thoughts about how MS may affect their lives. After the two meetings, they were asked to complete the same questionnaire again. Results Eight themes were identified: uncertain disease course; insecure future; physical, emotional, and cognitive impacts; effect on relationships with family and/or spouse/significant other; ability to develop future relationship with significant other; impact on career plans; impact on ability to achieve future goals; and impact on ability to care for self and family. Five of six participants who attended both meetings and one of four who attended only the first meeting expressed a change in their perception of how MS may affect their lives. Conclusions A support group dedicated exclusively to newly diagnosed patients may provide an opportunity for patients to experience a change in perceptions of MS.
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13
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Abstract
BACKGROUND Multiple sclerosis (MS) affects approximately 50 000 people in Spain, so it is essential to implement health interventions that respond to their needs and demands. Expert patient programs may facilitate health-related empowerment through peer learning, but their particular features need to be tailored to MS. METHODS Qualitative research was used to examine the needs and demands of people with MS in relation to the management of MS with the aim of designing a specific program to enable empowerment. Data gathered from focus group interviews were coded and grouped using thematic analysis with independent peer review. RESULTS The identified needs and demands focused on improving MS knowledge and acquiring the skills to promote self-management and autonomy. An MS expert patient program should address the impact of MS, its integrated treatment, and health promotion. The program's design should follow an open script with small groups and the support of healthcare professionals. Participants showing a need for help and an absence of comorbidities that prevent interaction should be included. Expert patients should have a positive outlook on their health, experience-based knowledge, and leadership and communication skills. The identified potential benefits were an improvement in knowledge, quality of life, and the normalization of the patient's health situation. CONCLUSION The needs and demands of people with MS focused on enhancing knowledge about all aspects of the disease and on acquiring skills to promote self-management, autonomy, and empowerment. Program design and content were identified enabling determination of the characteristics needed to resolve these issues and develop an expert patient program for people with MS in Spain.
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14
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Biglar Chopoghlou S, Hanifi N, Varjoshani NJ. A comparative study of uncertainty and coping strategies of patients with multiple sclerosis for members and nonmembers in peer groups. Health Care Women Int 2019; 41:354-367. [PMID: 31259667 DOI: 10.1080/07399332.2019.1621317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Patients with multiple sclerosis (MS) experience a high level of uncertainty and face serious difficulty in coping effectively with their conditions. We compared the rate of uncertainty and coping strategies of women patients in members and nonmembers of peer groups. Our results showed that uncertainty level for patients who are members in peer groups was less than that of the nonmember patients in peer groups. Moreover, we observed that people who are members in peer groups employed problem-oriented coping strategies more than the nonmember patients in the peer group.
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Affiliation(s)
| | - Nasrin Hanifi
- School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.,Zanjan Nursing and Midwifery School, Zanjan University of Medical Sciences (ZUMS), Zanjan, Iran
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15
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Ghasemi M, Hosseini H, Sabouhi F. Effect of Peer Group Education on the Quality of Life of Elderly Individuals with Diabetes: A Randomized Clinical Trial. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2019; 24:44-49. [PMID: 30622577 PMCID: PMC6298160 DOI: 10.4103/ijnmr.ijnmr_39_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background: Considering the important role of education and the benefits of peer education in increasing patients' independence in self-care, as well as the socio-economic benefit of using peer education, the present study was conducted to assess the effect of peer education on the quality of life (QOL) of elderly people with diabetes. Materials and Methods: This clinical trial was conducted with 44 diabetic people aged over 65 years in selected health centers of Isfahan, Iran, in 2014. After preparing the peer group, 8 educational sessions were held for the participants of the groups by their peers (intervention group) and by the researcher (control group). The Diabetes Quality-of-Life (DQOL) measure was used to assess their QOL before, immediately after, and 1 month after the intervention. Results: The difference between the groups in terms of the total quality of life score immediately after the intervention was significant (t = 8.63; p = 0.001). The results showed that the QOL score in the dimensions of worries about diabetes effects (t = 12.13, p = 0.042), impact of diabetes treatment, (t = 8.63, p = 0.001), and satisfaction with diabetes treatment (t = 11.33, p = 0.001) was significantly different in the groups immediately after the intervention. Conclusions: Peer education increased the QOL of patients with diabetes, with significantly better results than the researcher training group immediately after the training. Thus, this method can be used to improve the QOL of the aged population.
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Affiliation(s)
- Maryam Ghasemi
- Department of Health, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Habibolah Hosseini
- Department of Health, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fakhri Sabouhi
- Department of Health, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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16
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Boland P, Levack WMM, Hudson S, Bell E. A qualitative exploration of barriers and facilitators to coping experienced by couples when one has multiple sclerosis. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.5.240] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Pauline Boland
- Lecturer, Clinical Therapies, University of Limerick, Republic of Ireland
| | - William MM Levack
- Associate professor, Rehabilitation, Teaching and Research Unit and Associate Dean of Research, University of Otago, Wellington, New Zealand
| | - Sheena Hudson
- Associate researcher, Rehabilitation, Teaching and Research Unit, University of Otago, Wellington, New Zealand
| | - Elliot Bell
- Lecturer and clinical psychologist, Psychological Medicine and Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand
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17
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Alba Palé L, León Caballero J, Samsó Buxareu B, Salgado Serrano P, Pérez Solà V. Systematic review of depression in patients with multiple sclerosis and its relationship to interferonβ treatment. Mult Scler Relat Disord 2017; 17:138-143. [DOI: 10.1016/j.msard.2017.07.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/30/2017] [Accepted: 07/07/2017] [Indexed: 10/19/2022]
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18
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Turner AP, Alschuler KN, Hughes AJ, Beier M, Haselkorn JK, Sloan AP, Ehde DM. Mental Health Comorbidity in MS: Depression, Anxiety, and Bipolar Disorder. Curr Neurol Neurosci Rep 2017; 16:106. [PMID: 27848174 DOI: 10.1007/s11910-016-0706-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Among individuals with multiple sclerosis (MS), mental health comorbidities play a significant role in contributing to secondary disability and detracting from quality of life. This review examines current evidence surrounding three mental health issues of particular relevance to MS: depression, anxiety, and bipolar disorder. We review what is known of the prevalence, correlates, screening mechanisms, and current treatment of each issue and provide recommendations for future areas of research.
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Affiliation(s)
- Aaron P Turner
- Rehabilitation Care Service, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA. .,Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
| | - Kevin N Alschuler
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.,Department of Neurology, University of Washington, Seattle, WA, USA
| | - Abbey J Hughes
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
| | - Meghan Beier
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
| | - Jodie K Haselkorn
- Rehabilitation Care Service, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA.,Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Alicia P Sloan
- Rehabilitation Care Service, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98108, USA
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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19
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Malek Khahi A, Mohseny M, Soleimany F, Vejdani M, Keshvardoost A, Amiri P. Relationship between self-transcendence and physically-healthy patients under hemodialysis in participating in peer-support group; a randomized clinical trial. J Renal Inj Prev 2017. [DOI: 10.15171/jrip.2017.48] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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20
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Mohr DC, Burke H, Beckner V, Merluzzi N. A preliminary report on a skills-based telephone-administered peer support programme for patients with multiple sclerosis. Mult Scler 2016; 11:222-6. [PMID: 15795964 DOI: 10.1191/1352458505ms1150oa] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Peer-support interventions have shown no statistically significant or clinically meaningful effect on quality of life (QOL) or depressive symptoms for multiple sclerosis (MS) patients. Peer-support interventions for MS generally provide support but no skills training. The aim of this study was to evaluate a brief telephone-administered skills-training model of peer-support for patients with MS. Methods: Sixteen patients with MS showing signs of moderate distress received eight sessions of telephone-administered peer support (TAPS). TAPS is a manualized programme administered by peer-support counsellors diagnosed with MS. Using a workbook, peer-support counsellors teach skills to manage distress and MS symptoms. Subjective depression was assessed using the Center for Epidemiological Studies Depression Scale while objective depression was rated using the Hamilton Rating Scale for Depression. QOL was measured preand post-treatment using the SF-36. Results: The participants showed significant improvements on both the CESD (p=0.04) and the HRSD (p=0.01). Overall QOL improved significantly (p=0.045), however this was not reflected in either the Physical Health composite score or the Mental Health Composite Scale (p-0.17). Conclusions: These findings suggest that TAPS may prove to be an efficacious peer-support model for patients with MS.
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Affiliation(s)
- David C Mohr
- Department of Psychiatry, University of California, San Francisco, CA, USA.
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21
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JadidMilani M, Ashktorab T, AbedSaeedi Z, AlaviMajd H. The impact of self-transcendence on physical health status promotion in multiple sclerosis patients attending peer support groups. Int J Nurs Pract 2015; 21:725-32. [DOI: 10.1111/ijn.12186] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - Tahereh Ashktorab
- Faculty of Nursing and Midwifery; Shahid Beheshti University/Medical Sciences; Tehran Iran
| | - Zhila AbedSaeedi
- Faculty of Nursing and Midwifery; Shahid Beheshti University/Medical Sciences; Tehran Iran
| | - Hamid AlaviMajd
- Faculty of Paramedical Sciences; Shahid Beheshti University/Medical Sciences; Tehran Iran
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22
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Bryan AEB, Arkowitz H. Meta-analysis of the effects of peer-administered psychosocial interventions on symptoms of depression. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2015; 55:455-71. [PMID: 25861883 DOI: 10.1007/s10464-015-9718-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Many community mental health centers have implemented peer treatment models that employ recovered former clients as cost-efficient adjunct providers. The effectiveness of these and other peer-administered interventions (PAIs) for treating depression symptoms has not been well-established. The current study is a meta-analysis of PAIs' effects on depression symptoms. Twenty-three eligible studies were identified. Study characteristics were coded by multiple raters, random-effects models were used to compare mean effect sizes, and mixed-effects models were used to test for moderation. PAIs produced significant pre-post reductions in depression symptoms (d = .5043 [95 % CI .3675-.6412]). In direct comparisons, PAIs performed as well as non-peer-administered interventions (.0848 [-.1455-.3151]), and significantly better than no-treatment conditions (.2011 [.0104-.3918]). PAIs that involved a professional in a secondary treatment role were significantly less effective than those that were purely peer-administered, and educational/skills-based PAIs produced better outcomes than those that were mainly supportive. Follow-up data, when available, indicated that PAIs' benefits were maintained. PAIs reduce depression symptoms and warrant further study. The clinical significance of PAIs' benefits, and whether they are better suited as stand-alone or adjunct treatments, remain to be established. Implications for the roles of mental health professionals are discussed.
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Affiliation(s)
- Amanda E B Bryan
- Alcohol and Drug Abuse Institute, University of Washington, 1107 NE 45th St., Suite 120, Seattle, WA, 98105, USA,
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23
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Abstract
Patients with systemic sclerosis (SSc; also called scleroderma) have to cope with not only the physical impacts of the disease but also the emotional and social consequences of living with the condition. Because there is no cure for SSc, improving quality of life is a primary focus of treatment and an important clinical challenge. This article summarizes significant problems faced by patients with SSc, including depression, anxiety, fatigue, sleep disruption, pain, pruritus, body image dissatisfaction, and sexual dysfunction, and describes options to help patients cope with the consequences of the disease.
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24
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Upton D, Taylor C. What are the support needs of men with multiple sclerosis, and are they being met? Int J MS Care 2015; 17:9-12. [PMID: 25741222 PMCID: PMC4338643 DOI: 10.7224/1537-2073.2013-044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic, degenerative condition of the central nervous system that can lead to high levels of disability and a range of psychological and social problems. Although considerable research has been conducted on the experience of living with MS and the disease's psychosocial consequences, much of this has focused on women, with the male perspective seldom considered. It is possible, therefore, that men differ from women in how they experience MS and the type of support or interventions that meet their needs. METHODS A literature review was undertaken to identify the specific support needs of men with MS, describe current support available to men with MS, and evaluate the extent to which these needs are met by current service provision. RESULTS The literature reviewed suggests that the needs of men with MS are different from those of women in terms of psychological factors such as well-being and mental health and support. CONCLUSIONS If interventions are to be evidence based, health-care professionals need to take into account the needs, desires, and capabilities of men with MS in the development of services. Further qualitative and quantitative research is required to address the gaps in the evidence base of support needs for men with MS.
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Affiliation(s)
- Dominic Upton
- Institute of Health and Society, University of Worcester, Worcester, UK
| | - Charlotte Taylor
- Institute of Health and Society, University of Worcester, Worcester, UK
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25
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Steadman J, Pretorius C. The impact of an online Facebook support group for people with multiple sclerosis on non-active users. Afr J Disabil 2014; 3:132. [PMID: 28730005 PMCID: PMC5443048 DOI: 10.4102/ajod.v3i1.132] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 09/17/2014] [Indexed: 11/07/2022] Open
Abstract
Background Multiple sclerosis (MS) is a debilitating disease and there is little research on support networks for people with MS (PwMS). More specifically, most studies on online support groups focus on those who actively participate in the group, whereas the majority of those who utilise online support groups do so in a passive way. Objectives This study therefore aimed to explore the experiences of non-active users of an online Facebook support group for PwMS. Emphasis was placed on the facilitators and the barriers that were associated with membership to this group. Method An exploratory qualitative research design was implemented, whereby thematic analysis was utilised to examine the ten semi-structured interviews that were conducted. Results Several facilitators were acquired through the online support group; namely emotional support (constant source of support, exposure to negative aspects of the disease), informational support (group as a source of knowledge, quality of information) and social companionship (place of belonging). Some barriers were also identified; namely emotional support (emotions lost online, response to messages, exposure to negative aspects of the disease), informational support (information posted on the group, misuse of group) and social companionship (non-active status) Conclusion These findings demonstrate that the non-active members of the online support group for PwMS have valid reasons for their non-active membership status. More important, the findings suggest that the online Facebook support group provided the group members with an important support network in the form of emotional support, informational support and social companionship, despite their non-active membership status or the barriers that have been identified.
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Affiliation(s)
- Jacqui Steadman
- Department of Psychology, Stellenbosch University, South Africa
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26
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The social support model for people with chronic health conditions: A proposal for future research. SOCIAL THEORY & HEALTH 2014. [DOI: 10.1057/sth.2014.3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Salminen AL, Kanelisto KJ, Karhula ME. What components of rehabilitation are helpful from the perspective of individuals with multiple sclerosis? Disabil Rehabil 2014; 36:1983-9. [PMID: 24506664 DOI: 10.3109/09638288.2014.885092] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To investigate the helpful components of rehabilitation from the point of view of people with multiple sclerosis (MS). METHODS Sixteen focus groups were conducted for 68 adults with MS, who were 6 months through their 2-year multi-professional group-based out-patient rehabilitation programs in three regions of Finland. Data were analyzed using qualitative inductive content analysis combined with counts of the coded data. RESULTS Participants described 20 helpful components of rehabilitation that were clustered to themes of the rehabilitee himself/herself, structures of everyday life, information, activity, environmental interventions, social relationships and support. The most frequently described components of the seven main themes were peers, advice, physical exercise, assistive technology and home adaptations, and personal responsibility. CONCLUSIONS The helpful components of both in-patient and out-patient rehabilitation that are of particular importance to people with MS are diverse and show the relevance of ICF in rehabilitation and the need for a comprehensive view in rehabilitation. The importance of peers and peer support should be taken into account in rehabilitation planning and related recommendations. The findings show that helpful rehabilitation for people with MS is not a set of mechanistic interventions but requires good social relationships and support. Implications for Rehabilitation Helpful components of rehabilitation for people with MS are diverse and show the need for a comprehensive and individual view in rehabilitation. Professionally guided peer support should be offered as a part of rehabilitation. Interventions related to assistive technology and home adaptations should be an obvious part of rehabilitation. It is important to support people with MS to preserve identity as an active person and to take personal responsibility in their own rehabilitation.
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Abstract
The concept of resilience remains under-researched in the multiple sclerosis literature. Consequently, current understanding of the unique and joint contribution of disability-specific variables, cognitive-behavioural skills and social resources to this dynamic process is limited. A holistic model of resilience was therefore developed and tested. Results of an online survey completed by 196 adults with multiple sclerosis revealed both direct and indirect pathways to resilience, with positive affect and self-efficacy being the strongest predictors. The findings lend support to psychological interventions which focus on promoting the personal resources and assets needed to cope effectively with multiple sclerosis.
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Outcomes of a Peer Support Program in Multiple Sclerosis in an Australian Community Cohort: A Prospective Study. JOURNAL OF NEURODEGENERATIVE DISEASES 2013; 2013:429171. [PMID: 26316989 PMCID: PMC4437345 DOI: 10.1155/2013/429171] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 11/04/2013] [Indexed: 11/18/2022]
Abstract
Background/Objectives. This pilot study evaluated the impact of a peer support program on improving multiple sclerosis (MS) related psychological functions (depression, anxiety, and stress) and enhancing quality of life. Methodology. Participants (n = 33) were recruited prospectively and received an 8-week group face-to-face peer support program. Assessments were at baseline (T1), 6 weeks after program (T2), and 12 months after program (T3), using validated questionnaires: Depression Anxiety Stress Scale (DASS), McGill Quality of Life (MQOL), and Brief COPE. Results. Participants' mean age was 52; the majority were female (64%) and married (64%). Median time since MS diagnosis was 16 years. At T2, participants reported improved psychological functioning (DASS "depression," "anxiety," and "stress" subscales, z values -2.36, -2.22, and -2.54, moderate effect sizes (r) 0.29, 0.28, and 0.32, resp.) and quality of life (MQOL SIS z score -2.07, r = 0.26) and were less likely to use "self-blame" as a coping mechanism (Brief COPE z score -2.37, r = 0.29). At T3, the positive improvements in stress (DASS stress subscale z score -2.41, r = 0.31) and quality of life were maintained (MQOL SIS, z score -2.30, r = 0.29). There were no adverse effects reported.
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Gallagher S, O'Donnell AT, Minescu A, Muldoon OT. A commentary on 'The effects of identification with a support group on the mental health of people with multiple sclerosis'. J Psychosom Res 2013; 75:294. [PMID: 23972421 DOI: 10.1016/j.jpsychores.2013.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 07/06/2013] [Indexed: 11/16/2022]
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Sweet SN, Perrier MJ, Podzyhun C, Latimer-Cheung AE. Identifying physical activity information needs and preferred methods of delivery of people with multiple sclerosis. Disabil Rehabil 2013; 35:2056-63. [PMID: 23763468 DOI: 10.3109/09638288.2013.800915] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The purpose of this study was to examine the preferred sources and methods for acquiring physical activity information of individuals with multiple sclerosis (MS) using the Comprehensive Model of Information Seeking. A secondary objective was to explore the barriers and facilitators to physical activity information seeking. METHODS Twenty-one participants diagnosed with MS participated in focus groups or telephone interviews. RESULTS A direct content analysis of the transcripts revealed that individuals appeared to generally prefer receiving physical activity information during period of relapse and remission. Participants also had positive beliefs toward physical activity and a clear preference for a time when physical activity messages would be relevant. Receiving physical activity information from credible sources such as the MS Society of Canada, healthcare professionals and peers with MS was also deemed important. The Internet was a preferred source to receive information due to its accessibility, but it often was considered to lack credibility. The lack of physical activity information specific to MS is the greatest barrier for individuals with MS to learn about physical activity. CONCLUSIONS Healthcare professionals, National MS Societies, and peers should work together to deliver specific and relevant physical activity messages the MS population. IMPLICATIONS FOR REHABILITATION People with MS want more physical activity information from credible sources. Multiple vehicles of physical activity information delivery (i.e. healthcare providers, peers, MS Society) should be utilized. Physical activity information should be tailored to the individual with MS.
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Affiliation(s)
- Shane N Sweet
- School of Kinesiology and Health Studies, Queen's University , Kingston, Ontario , Canada
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Wakefield JRH, Bickley S, Sani F. The effects of identification with a support group on the mental health of people with multiple sclerosis. J Psychosom Res 2013; 74:420-6. [PMID: 23597330 DOI: 10.1016/j.jpsychores.2013.02.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 02/04/2013] [Accepted: 02/06/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Multiple sclerosis (MS) is associated with various psychological problems, including depression and anxiety. Whilst MS support groups are intended to improve mental health, this goal is not always achieved. Taking a social identity approach, we hypothesise that it is the level of subjective identification with a support group (rather than simply support group membership per se) that positively affects the mental health of people with MS. METHODS 152 individuals with MS were recruited via UK MS support groups and completed a questionnaire. This included measures of support group identification, depression, anxiety and satisfaction with life, as well as control variables (education level and age). RESULTS Analyses revealed that, as hypothesised, support group identification was significantly linked to depression, anxiety and satisfaction with life. Moreover, group identification explained a significant amount of variance in addition to that explained by education and age on each health outcome. Repeating the analysis to compare each of the three main sub-types of MS revealed these effects to be present for individuals with relapsing-remitting (RR) and Primary Progressive (PP) MS, but not for those with secondary progressive (SP) MS. CONCLUSIONS We suggest that identifying highly with an MS support group has important positive outcomes for MS patients' mental health. This has implications for practicing clinicians: people with MS (particularly RRMS and PPMS) should be encouraged to engage with support groups, but more must be done to ensure they subjectively identify with these groups, rather than merely attend them.
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Affiliation(s)
- Kathleen Dracup
- From the Department of Physiological Nursing, University of California, San Francisco, CA
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34
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Heesen C, Köpke S, Kasper J, Poettgen J, Tallner A, Mohr DC, Gold SM. Behavioral interventions in multiple sclerosis: a biopsychosocial perspective. Expert Rev Neurother 2013; 12:1089-100. [PMID: 23039388 DOI: 10.1586/ern.12.103] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Managing uncertainty is a major challenge associated with the diagnosis of multiple sclerosis (MS). In addition to physical symptoms, neuropsychiatric symptoms are highly prevalent in this disease. Depression in particular is more common in MS than in other chronic diseases. While substantial achievements have been made in the therapy of MS and an increasing number of immunomodulatory treatments are now available, the long-term benefits of these are still a matter of debate. Importantly, while the approved therapies show good efficacy on inflammatory lesions and relapse rate, and may slow certain aspects of disease progression, improvements in function have rarely been reported. On the other hand, behavioral interventions have recently been shown to significantly improve fatigue and depression as well as motor function. In addition, recent evidence suggests that group education or face-to-face behavioral interventions may decrease inflammatory disease activity (such as relapse rate or lesion formation measured by MRI). Therefore, behavioral interventions not only ameliorate symptoms but may have the potential to modify the disease process itself.
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Affiliation(s)
- C Heesen
- University Medical Center Hamburg-Eppendorf, Institute for Neuroimmunology and Clinical MS Research and Department of Neurology, Hamburg, Germany.
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Holmes JM, Ford E, Yuill F, Drummond AER, Lincoln NB. Attendance at a psychological support group for people with multiple sclerosis and low mood. Disabil Rehabil 2011; 34:1323-7. [PMID: 22201291 DOI: 10.3109/09638288.2011.642927] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE A cognitive behavioural group promoting psychological adjustment for people with multiple sclerosis (MS) was found to reduce psychological distress. Not all those offered treatment attended the group sessions. The aims were to examine the rates of attendance and to evaluate feedback from participants. METHOD Participants with MS and low mood were recruited to a randomized trial comparing attendance at a psychological support group with a usual care control group. The attendance at each session was determined and those who attended were compared with those who failed to attend using a Mann-Whitney U-test or chi-squared. A sample of participants completed a telephone feedback questionnaire to determine their views of the group. RESULTS The 44 participants who attended four or more sessions were not significantly different from the 28 who attended fewer than four sessions on demographic variables, disability, self-efficacy or quality of life, but significantly fewer men attended than women (p = 0.03). Participants' feedback from the group was mainly positive, and no factors were identified associated with non-attendance. CONCLUSIONS Men were less likely to attend group treatment sessions than women, but no other variables were associated with non-attendance. Attendance rates influence the effectiveness of interventions and reasons for non-attendance need to be determined.
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Affiliation(s)
- Jessica M Holmes
- School of Community Health Sciences, University of Nottingham, UK
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Ng L, Talman P, Khan F. Neuropsychological sequelae in motor neurone disease: outcomes of a peer support programme. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2011. [DOI: 10.12968/ijtr.2011.18.8.429] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Louisa Ng
- Department of Rehabilitation Medicine, Royal Melbourne Hospital, and Honorary Clinical Senior Lecturer, Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria
| | - Paul Talman
- Barwon Health, The Geelong Hospital, Victoria
| | - Fary Khan
- Department of Rehabilitation Medicine, Royal Melbourne Hospital and Principal Fellow, Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
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Finlayson ML, Cho CC. A profile of support group use and need among middle-aged and older adults with multiple sclerosis. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2011; 54:475-493. [PMID: 21714616 DOI: 10.1080/01634372.2011.575446] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study compared middle-aged and older adults with multiple sclerosis (MS, N = 1,275) according to their use of support groups and identified factors associated with perceived need. Over 64.6% (n = 824) of participants had attended a MS support group meeting at least once. Individuals who had never attended a group were more likely to reside in urban or suburban communities, report lower symptom interference, and fewer activity limitations. Women, individuals without a helper, and people with greater symptom interference were more likely to perceive a need for a support group. Findings raise questions for professionals involved in developing and implementing multiple sclerosis support groups.
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Affiliation(s)
- Marcia L Finlayson
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
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38
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Abstract
The treatment of multiple sclerosis (MS) has advanced greatly since the introduction of disease-modifying therapies (DMTs) in the early 1990s. Although the DMTs have exhibited significant efficacy in relapsing-remitting MS and other forms of the disease, the degree of benefit depends heavily on patient adherence to recommended regimens. This article addresses some of the most pressing areas of unmet need in educating advanced-practice nurses, neurologists, patients, and support care partners regarding strategies that can overcome obstacles to adherence. The observations presented here are based on clinical experience with real-life cognitive, psychosocial, and cultural impediments to adherence. The article also explores the ways in which adherence may be affected by emerging therapies for MS (such as oral agents) as well as the educational needs that will arise with the further evolution of MS care.
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Jaracz K, Pawlak M, Górna K, Kołcz B, Wołoszyn D, Kozubski W. Quality of life and social support in patients with multiple sclerosis. Neurol Neurochir Pol 2010; 44:358-65. [PMID: 20827609 DOI: 10.1016/s0028-3843(14)60295-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND PURPOSE The aim of the study was to evaluate quality of life (QoL) in multiple sclerosis (MS) patients and to assess the relationship between QoL and social support taking into account key clinical factors and other sociodemographic variables. MATERIAL AND METHODS Two hundred and ten MS patients (150 women and 60 men) aged between 21 and 59 years were evaluated; the MS group was compared with 108 healthy controls. QoL (MSQOL-54), disease severity (Expanded Disability Status State, EDSS), social support (Social Provisions Scale, SPS), mood (Beck Depression Inventory, BDI) and basic clinical and demographic data were assessed. RESULTS Disease severity was mild (EDSS < 4) in 85% of patients, and depressive symptoms (BDI > 13) were present in 41% of patients. Mean physical health composite of MSQOL-54 was 53.6 ± 20.7 and mean mental health composite was 60.0 ± 19.8. MS patients scored significantly lower than healthy subjects. Mean SPS was 78.2 ± 10.9 (range, 6-96) which indicated high social support. In bivariate analysis, social support correlated significantly with the majority of MSQOL domains; in multivariate analysis, however, this relationship was not significant. Emotional well-being was the main predictor of QoL, in both physical and mental domains. CONCLUSIONS MS influences QoL but to a greater extent in the physical than the psychological domain. The role of social support in QoL is generally positive but its protective function may be weakened when interacting with other factors. Depression is the main predictor of QoL when adjusted for other factors. Thus, treatment of mood disturbances might significantly improve QoL in MS patients.
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Affiliation(s)
- Krystyna Jaracz
- Zakład Pielêgniarstwa Neurologicznego i Psychiatrycznego, Uniwersytet Medyczny im. Karola Marcinkowskiego,ul. Smoluchowskiego 11, 60-179 Poznań.
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Gold SM, Irwin MR. Depression and immunity: inflammation and depressive symptoms in multiple sclerosis. Immunol Allergy Clin North Am 2009; 29:309-20. [PMID: 19389584 PMCID: PMC3625861 DOI: 10.1016/j.iac.2009.02.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
An increasing body of evidence suggests that patients who have major depressive disorder show alterations in immunologic markers including increases in proinflammatory cytokine activity and inflammation. Inflammation of the central nervous system is a pathologic hallmark of multiple sclerosis (MS). Patients affected by this disease also show a high incidence of depression. Accumulating evidence from animal studies suggests that some aspects of depression and fatigue in MS may be linked to inflammatory markers. This article reviews the current knowledge in the field and illustrates how the sickness behavior model may be applied to investigate depressive symptoms in inflammatory neurologic diseases.
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Affiliation(s)
- Stefan M. Gold
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
- Multiple Sclerosis Program, Department of Neurology, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Michael R. Irwin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
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41
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Walker ID, Gonzalez EW. Review of intervention studies on depression in persons with multiple sclerosis. Issues Ment Health Nurs 2007; 28:511-31. [PMID: 17613150 DOI: 10.1080/01612840701344480] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Depression is prevalent among persons with multiple sclerosis (MS), an acquired neurologic disability that affects predominantly women. The purpose of this article is to review intervention studies on depression in persons with MS. An integrative review of eight intervention studies published from 2000 to 2005 has revealed that various interventions could potentially alleviate depression. Although no definite conclusions can be made from this review, there is reasonable evidence that cognitive behavioral approaches are beneficial in the treatment of depression and in helping people adjust to, and cope with, having MS.
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Affiliation(s)
- I Diane Walker
- John Dystel Nurse Fellow of the National MS Society, Griswold Special Care, Erdenheim, PA, USA.
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42
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Twork S, Schwermer KH, Kugler J. [Coping training for patients with multiple sclerosis. Evaluation from a neurologic standpoint]. DER NERVENARZT 2007; 78:429-36. [PMID: 17375276 DOI: 10.1007/s00115-006-2253-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a challenging disease for patients, the social environment, and therapists. We analysed how coping training and compliance of MS patients are assessed by neurologists in private practice. METHOD One thousand five hundred and seventy-five neurologists in private practice were asked to fill in short, standardised, anonymous questionnaires concerning number of MS patients treated per year, experience with coping training methods, assessments of requirements, aims, location, and suitable trainer, financial aspects of coping training, assessment of patient compliance concerning immunomodulating therapies, and possibilities of increasing compliance. RESULTS The response rate was 25.7% (404 questionnaires). Of these, 344 (21.8%) could be included in the analysis. Many neurologists had no experience with coping training methods but saw a reasonable demand, especially for newly diagnosed MS patients, those with psychological problems, and for their relatives. Most of them would like to provide such training themselves in their own locations. Useful aims of coping training included reduction of anxiety, uncertainty, and depression and increased patient compliance and well-being. They proposed that coping training should mainly be financed by health care insurers and patients. Neurologists assessed the compliance of MS patients concerning immunomodulating therapies as being moderate to high. Increased compliance was understood as better doctor-patient conversations, involvement of MS nurses, and support from self-help groups. CONCLUSION There is a reasonable need of coping training for MS patients that is also seen by privately practicing neurologists, the main therapists for MS patients. The selection of adequate and scientifically reliable training should be improved. Thus coping with the disease, compliance, and well-being can all be improved.
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Affiliation(s)
- S Twork
- Lehrstuhl Gesundheitswissenschaften/Public Health, Medizinische Fakultät TU Dresden, Fetscherstrasse 74, 01307 Dresden.
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Malcomson KS, Dunwoody L, Lowe-Strong AS. Psychosocial interventions in people with multiple sclerosis: a review. J Neurol 2007; 254:1-13. [PMID: 17508135 DOI: 10.1007/s00415-006-0349-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2006] [Accepted: 08/21/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Upon diagnosis individuals with Multiple Sclerosis (MS) must cope with both day to day and disease-related stressors in addition to unpredictable, fluctuating and confusing symptoms. Furthermore, disease progression may interfere with employment, family life, relationships and social activities. Psychosocial interventions aim to help individuals manage these psychological, social and emotional challenges. However, there are no specific guidelines available regarding the most effective intervention content, format or delivery. Therefore, a review of the research that has utilised these interventions, specifically those which, by definition, aimed to improve quality of life (QoL) and/or well-being in people with MS, was considered essential in order to identify which aspects of these interventions may help alleviate the psychosocial challenges associated with MS. OBJECTIVES To identify all randomised controlled trials (RCTs), quasi-experimental, cohort, case control and case series studies that have investigated psychosocial interventions in people with MS which aimed to improve QoL and/or well-being, to establish the methodological quality of such studies, and to determine the effectiveness of the interventions. SEARCH STRATEGY Searches were carried out using computerised databases with predefined search terms; this was supplemented by manual searches of reference lists of all retrieved articles. Relevant journals were also hand searched. SELECTION CRITERIA Studies written in English and published before January 2006, investigating the effectiveness of psychosocial interventions on QoL and/or well-being in people with MS, were eligible for inclusion. DATA COLLECTION AND ANALYSIS Methodological quality was independently assessed by two reviewers using the Downs and Black quality scoring checklist. The qualitative and quantitative characteristics of studies were extracted using a data extraction sheet. MAIN RESULTS Thirty-three studies fulfilled the inclusion criteria; however, interventions varied widely in content, delivery and duration. Furthermore, failure to report full methodological details, as well as weaknesses in study design, reduced the strength of inferences that could be drawn from these studies. These notwithstanding, there were three studies of sufficient quality to provide some evidence regarding the value of education/information, goal setting, homework assignments, exercise, discussion forums and multidisciplinary team support. Thus, this review has identified the potential benefit of the aforementioned activities in the psychosocial management of this population. However, further well designed clinical trials are warranted to determine, definitively, the effectiveness, or otherwise, of these components.
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Affiliation(s)
- K S Malcomson
- Health and Rehabilitation Sciences, Research Institute, University of Ulster, Shore Road, Newtownabbey, BT37 0QB, Northern Ireland
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Gold SM, Irwin MR. Depression and immunity: inflammation and depressive symptoms in multiple sclerosis. Neurol Clin 2007; 24:507-19. [PMID: 16877121 DOI: 10.1016/j.ncl.2006.03.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
There is strong evidence that depression involves alterations in multiple aspects of immunity that may contribute to the development or exacerbation of a number of medical disorders and also may play a role in the pathophysiology of depressive symptoms. Accordingly, aggressive management of depressive disorders in medically ill populations or individuals at risk for disease may improve disease outcome or prevent disease development. On the other hand, in light of data suggesting that immune processes may interact with the pathophysiologic pathways known to contribute to depression, novel approaches to the treatment of depression may target relevant aspects of the immune response. Taken together, the data provide compelling evidence that a psychoimmunologic frame of reference may have profound implications regarding the consequences and treatment of depression. In addition, this approach may be used to investigate the possibility that peripheral and central production of cytokines may account for neuropsychiatric symptoms in inflammatory diseases. This article summarizes evidence for a cytokine-mediated pathogenesis of depression and fatigue in MS. The effects of central inflammatory processes may account for some of the behavioral symptoms seen in patients who have MS that cannot be explained by psychosocial factors or CNS damage. This immune-mediated hypothesis is supported by indirect evidence from experimental and clinical studies of the effect of cytokines on behavior, which have found that both peripheral and central cytokines may cause depressive symptoms. Emerging clinical data from patients who have MS support an association of central inflammation (as measured by MRI) and inflammatory markers with depressive symptoms and fatigue. Based on the literature reviewed in this article, subtypes of MS fatigue and depression may exist that are caused by different pathogenetic mechanisms, including inflammation and CNS damage as well as psychosocial factors or predisposition. The existence of these subtypes could have important clinical implications. For example, an inflammatory depression may require different therapeutic approaches than a reactive depression in MS. Future research should aim to characterize these subtypes better with the goal of optimizing treatment.
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Affiliation(s)
- Stefan M Gold
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience, 300 Medical Plaza, Suite 3109, Los Angeles, CA 90095, USA.
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Montel S, Bungener C. Les troubles de l’humeur et des émotions dans la sclérose en plaques : une revue de la littérature. Rev Neurol (Paris) 2007; 163:27-37. [PMID: 17304170 DOI: 10.1016/s0035-3787(07)90352-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Even though mood and emotion are closely related concepts, they differ in some ways. This article aims to review the main mood and emotional disorders most often found in Multiple Sclerosis (MS). STATE OF ART Studies related to four fields are presented and discussed: assessment tools and methodological problems; prevalence, etiology and symptoms of mood as well as emotional disorders in MS; relationship between cognition and emotion. Beside these main subjects, we tackle some interesting questions which concern patients as well as clinicians, such as the risk of depression and protective factors, the relationship between depression and fatigue and the impact of beta-interferon on depression. PROSPECTIVES We focus on a new promising trend aiming to link neuroimaging data to psychological variables. CONCLUSIONS These four fields cover a large portion of the questions about mood and emotional disorders in MS. Due to their frequency as well as to their impact on quality of life, specific attention should be given to these disorders.
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Affiliation(s)
- S Montel
- Laboratoire de Psychopathologie et Neuropsychologie Cliniques, Université Paris Descartes et Centre d'Investigation Clinique de l'Hôpital La Pitié-Salpêtrière.
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Grytten N, Måseide P. 'When I am together with them I feel more ill.' The stigma of multiple sclerosis experienced in social relationships. Chronic Illn 2006; 2:195-208. [PMID: 17007696 DOI: 10.1177/17423953060020030101] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES We explored the stigma that people with multiple sclerosis (MS) experienced in social relationships. Informed by the symbolic integrationist paradigm, this sociological study focuses on the creation of personal identity through interaction with others. The symbolic interactionist account of stigma examines the meaning and reality being negotiated in communication with others. METHODS Fourteen people with MS and their relatives were interviewed. The unstructured interviews were tape-recorded, transcribed and coded in accordance with the procedure of grounded theory. RESULTS Informants reported being ignored or, in contrast, having people overemphasize MS in interpersonal encounters. Although people tried to act tactfully, these acts were experienced as crucial stigmatizing. Informants were coping to counteract stigmatizing experiences in social relationships. DISCUSSION People with MS perceive that their bodily performance and impression management is being judged in interpersonal encounters. Being ignored or perceiving that MS is overemphasized indicates the dilemma of managing stigma in social networks. Consequently, during interaction and in social relationships, people with MS experience a sense of 'feeling more ill'. This paper describes strategies of networking to affirm self and identity.
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Affiliation(s)
- Nina Grytten
- Institute of Clinical Medicine, Department of Neurology, University of Bergen, N-5021 Bergen, Norway.
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Sobel RM, Lotkowski S, Mandel S. Update on depression in neurologic illness: stroke, epilepsy, and multiple sclerosis. Curr Psychiatry Rep 2005; 7:396-403. [PMID: 16216161 DOI: 10.1007/s11920-005-0043-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The risk of depression is increased in chronic neurologic illness and can adversely affect the course of disease. Recent literature is reviewed for depression in stroke, epilepsy, and multiple sclerosis. Depression can share pathophysiologic aspects of the comorbid illness, such as neurotransmitter pathway disturbances, hypothalamus-pituitary-adrenal pathway disturbances, and changes in immunologic function. Depression also can be a psychologic reaction to the burden of the neurologic condition. Risk factors for development of depression are reviewed. Depression and other medical conditions can have shared symptoms (eg, fatigue, psychomotor retardation) that can complicate the diagnosis of depression in neurologic illness. Proper selection of antidepressant treatment is necessary to avoid worsening the neurologic disorder.
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Affiliation(s)
- Richard M Sobel
- Department of Psychiatry, Jefferson Medical College, 1518 Walnut Street, Suite 1110, Philadelphia, PA 19102, USA.
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Bombardier CH, Wadhwani R, LaRotonda C. Health Promotion in People with Multiple Sclerosis. Phys Med Rehabil Clin N Am 2005; 16:557-70. [PMID: 15893686 DOI: 10.1016/j.pmr.2005.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Chronic diseases like MS present unique challenges and opportunities for patients and the medical care system. Patients are challenged because they are under tremendous pressure to actively engage themselves in multiple prevention, treatment, and health maintenance behaviors, often before they feel ready. Health care providers are challenged because health-promotion activities require more time, counseling skills, and organizational resources than traditional, acute medical care. Patients, clinicians, and researchers face the challenge of determining which health-promotion activities are not only supported by the evidence but also appropriate for a given patient. New models of health promotion are being developed that integrate self-help and professional help. These approaches have been applied in other chronic diseases and should be adapted and studied among people with MS.
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Affiliation(s)
- Charles H Bombardier
- Multiple Sclerosis Rehabilitation Research and Training Center, Department of Rehabilitation Medicine, Box 359740, University of Washington School of Medicine, Harborview Medical Center, Seattle, WA 98195-6490, USA.
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Abstract
Several studies have reported high rates of depression in multiple sclerosis (MS) with a lifetime prevalence of approximately 50% and an annual prevalence of 20% not uncommon. Concern about the potential of new drug treatments to exacerbate or precipitate depression in MS has led to increased interest in the relation between MS and depression. This review on MS and depression identifies the following key issues: How common is depression in people with MS? Is depression in MS associated with lesions in specific regions of the central nervous system? Is there an increased risk of suicide in MS? Is there a higher than expected incidence of anxiety disorders in MS? Are fatigue and depressed mood related in MS? Is there a relation between depression and cognitive impairment in MS? Which psychosocial variables affect the development of depression in MS? Does treatment with interferon increase the risk of depression? How effective are treatments for MS patients with depression? Each of these issues is briefly reviewed with critical commentary, and some priorities for future research are suggested.
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Affiliation(s)
- R J Siegert
- Rehabilitation Teaching and Research Unit, Department of Medicine, Wellington School of Medicine, University of Otago, PO Box 7343, Wellington South, New Zealand.
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