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Pourhaji F, Peyman N, Taraghdar MM, Jamali J, Tehrani H. Explaining the burden of psychosocial factors on the worsening symptoms of MS: a qualitative study of patients' experiences. BMC Neurol 2023; 23:98. [PMID: 36879228 PMCID: PMC9987086 DOI: 10.1186/s12883-023-03148-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND This study was conducted with the aim of identifying the burden of psychosocial factors on the worsening symptoms of multiple sclerosis. METHODS This as conducted with a qualitative approach and conventional content analysis among patients with Multiple sclerosis in Mashhad. Data were collected through semi-structured interviews with patients with Multiple sclerosis. Twenty-one patients with Multiple sclerosis were selected through purposive sampling and snowball sampling. The data were analyzed using Graneheim and Lundman method. Guba and Lincoln's criteria were used for evaluating research transferability. The data collection and management was performed by using the MAXQADA 10 software. RESULTS In explanation of the psychosocial factors of patients with Multiple sclerosis, one category (psychosocial tensions) and three subcategories of stress (physical symptoms, emotional symptoms, and behavioral symptoms), agitation (family disorder, treatment-related concerns, and social relationship concerns), and stigmatization (social stigma and internalized stigma) were extracted. CONCLUSION The results of this study show that patients with Multiple sclerosis are faced with concerns such as stress, agitation, and fear of stigma, and need support and understanding from the family and community to overcome these concerns. Society must base its health policies on addressing the challenges faced by patients. Accordingly, the authors argue that health policies, and consequently, healthcare systems, need to address patients' ongoing challenges as a priority in caring for patients with Multiple sclerosis.
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Affiliation(s)
- Fahimeh Pourhaji
- Department of Health Education and Health Promotion, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Peyman
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.,Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mousa Mahdizadeh Taraghdar
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jamshid Jamali
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran. .,Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Mehraban S, Bahmani B, Boukani SA, Toosi M, Karami M, Carnero Contentti E. Patients experiences when receiving diagnosis of multiple sclerosis: A qualitative systematic review. Mult Scler Relat Disord 2023; 69:104473. [PMID: 36549103 DOI: 10.1016/j.msard.2022.104473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/13/2022] [Accepted: 12/17/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a neurological disease in which the myelin lining the central nervous system is damaged. The complex and unpredictable nature of MS disease makes the diagnosis process more difficult for the patient. The aim of this study was to review the lived experiences of patients with multiple sclerosis when receiving the diagnosis. METHODS We followed the guidelines of the Preferred Reporting Items for Systematic Reviews (PRISMA) statement. A systematic search was performed using four databases including PubMed, Scopus, Web of Science, and psych info on April 2022. RESULTS We found 537 articles. After Applying relevant exclusion criteria removing duplicate and irrelevant articles, 13 studies were included in our systematic review after the abstract and full-text screening. Our findings collected data from 10 sub-themes in the following 3 themes to capture patients' experiences after receiving the diagnosis. These included: Emotional reactions to receiving the diagnosis; Communication with health professionals and knowledge about MS and Fear of being different. CONCLUSION It is important to understand patients' experiences with the disease and identifying problems to help and support families, patients, and health care personnel's. Therefore, it is necessary to design or implement therapeutic interventions for patients at the time of receiving the diagnosis to reduce psychological problems.
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Affiliation(s)
- Shafigh Mehraban
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Bahman Bahmani
- Department of Counselling, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Soliman Ahmad Boukani
- Department of Counseling, Faculty of Education and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Maryam Toosi
- Department of Psychology, Buinzahra Branch, Islamic Azad University, Qazvin, Iran
| | - Mina Karami
- Department of Clinical Psychology, Medical Science Branch, Islamic Azad University, Tehran, Iran
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3
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Kassie SA, Alia J, Hyland L. Biopsychosocial implications of living with multiple sclerosis: a qualitative study using interpretative phenomenological analysis. BMJ Open 2021; 11:e049041. [PMID: 34404710 PMCID: PMC8372815 DOI: 10.1136/bmjopen-2021-049041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is estimated to affect 2.8 million people worldwide, with increasing prevalence in all world regions (Walton et al). While there is no cure for MS, medication and lifestyle modifications can slow disease progression and enhance patients' quality of life. The biopsychosocial model of health recognises important interactions among biological, psychological and social factors in illness, including those relating to illness management, which contribute to the experience of those diagnosed with MS. OBJECTIVE This qualitative, idiographic study aimed to explore the lived experiences of patients in the United Arab Emirates (UAE) diagnosed with S. METHODS Semistructured interviews were conducted with a purposive sample of eight patients with MS ranging in age from 25 to 56 years. All participants were residing in the UAE at the time of data collection. Interpretative phenomenological analysis was used to analyse the data. RESULTS Three superordinate themes were identified from patients' candid accounts of their lives with MS, highlighting issues of illness management, acceptance and gratitude, and adaptive coping. These themes broadly illustrate biological, psychological and social aspects of patients' MS experiences. CONCLUSION The study emphasised the importance of adopting the biopsychosocial model to treat and manage MS. Additionally, it highlights the need for routine assessment and early, multidimensional approach with multidisciplinary team efforts to improve patients' quality of life.
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Affiliation(s)
- Seada A Kassie
- Shared Clinical Services, American Center for Psychiatry and Neurology, Abu Dhabi, UAE
- Psychology, Middlesex University Dubai, Dubai, UAE
| | - Jannat Alia
- Department of Neurology, American Center for Psychiatry and Neurology, Abu Dhabi, UAE
| | - Lynda Hyland
- Psychology, Middlesex University Dubai, Dubai, UAE
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Power M, Arafa N, Wenz A, Foley G. Perceptions of fatigue and fatigue management interventions among people with multiple sclerosis: a systematic literature review and narrative synthesis. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2020.0144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background/Aims Fatigue is the most common symptom of multiple sclerosis. Evidence supports the effectiveness of fatigue management interventions for people with multiple sclerosis. This review aimed to identify how people with multiple sclerosis experience fatigue and to examine their perceptions of fatigue management interventions. Methods The review was conducted systematically, searching the following electronic databases: AMED, CINAHL Complete, eBook Nursing Collection, ERIC, Health Source: Nursing/Academic Edition, MEDLINE, APA PsycArticles, and APA PsycInfo for original peer-reviewed empirical research published in English between January 2000 and June 2020. Qualitative and mixed-methods studies that captured the perspectives of people with multiple sclerosis on their fatigue and/or their perceptions of fatigue management interventions were included. A narrative synthesis was used to synthesise the findings. Results A total of 23 qualitative and eight mixed-methods studies were extracted comprising a total of 662 people with multiple sclerosis (relapsing remitting n=293; secondary progressive n=129; primary progressive n=73; relapsing progressive n=3; benign n=2; fulminant n=1; type of multiple sclerosis not reported n=161). Fatigue was perceived by people with multiple sclerosis as a debilitating symptom of the condition and which they felt impacted adversely on their lives. A lack of understanding from others about multiple sclerosis fatigue was challenging for people with multiple sclerosis. People with multiple sclerosis valued the physical and psychosocial-based content of fatigue management interventions and felt fatigue management interventions enabled them to legitimise their fatigue and feel more in control of their fatigue. Conclusions From the perspective of people with multiple sclerosis, fatigue is a central and debilitating feature of the everyday experience of living with multiple sclerosis. Research on the potential of fatigue management interventions to foster control for people with multiple sclerosis to help them manage their fatigue is warranted. Healthcare professionals should consider how they can empower people with multiple sclerosis to educate others about their fatigue. Some evidence being generated for practice might not be sufficiently contextualised to different forms of multiple sclerosis.
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Affiliation(s)
- Míde Power
- Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Ireland
| | - Nora Arafa
- Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Ireland
| | - Anke Wenz
- Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Ireland
| | - Geraldine Foley
- Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Ireland
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Aburub AS, Khalil H, Al-Sharman A, El-Salem K. Measuring quality of life and identifying what is important to Jordanian living with multiple sclerosis using the Arabic version of the patient-generated index. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2021; 26:e1893. [PMID: 33448540 DOI: 10.1002/pri.1893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 11/30/2020] [Accepted: 12/25/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Patient-generated index (PGI) is one of the individualized measures used to measure the quality of life (QOL) in people with different chronic conditions including multiple sclerosis (MS). However, the psychometric properties of the Arabic version of the PGI have not been fully established in Jordanian living with MS. Therefore, the objective of this study is to identify what matters to Jordanian living with MS and to contribute evidence toward the psychometric properties of the Arabic version of the PGI. METHODS A total of 75 participants with MS completed three QOL measures; PGI, the patient determined disease steps (PDDS), and EQ-5D. Generalized estimating equations were used to compare the total score of three QOL measures. Bland-Altman plot and Spearman's correlation coefficient were used to study the relationships and differences between the PGI and the other study measures (PDDS and EQ-5D). RESULTS Only 66 (88%) of the participants were able to complete the PGI. Overall, 36 areas of QOL concern were nominated by the participants using the PGI with the top three areas were emotional function (47%), involuntary movement reaction functions (45.5%), and walking (44 %). The average global score of the PGI was lower (34 ± 22) than the global score of the EQ-5D (69 ± 23), and the PDDS (68 ± 24). PGI had a moderate correlation with EQ-5D and PPDS. CONCLUSION The Arabic version of the PGI is a feasible, acceptable, and valid measure among Jordanians with MS. PGI also captures more important areas that contribute to QOL than EQ-5D and PDDS. PGI could improve the decision making and guide healthcare professionals to provide appropriate intervention programs to reduce the burdens from MS disease and improve QOL.
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Affiliation(s)
- Ala' S Aburub
- Physical Therapy, Faculty of Allied Medical Sciences, Isra University, Amman, Jordan
| | - Hanan Khalil
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Alham Al-Sharman
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid El-Salem
- Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Desborough J, Brunoro C, Parkinson A, Chisholm K, Elisha M, Drew J, Fanning V, Lueck C, Bruestle A, Cook M, Suominen H, Tricoli A, Henschke A, Phillips C. 'It struck at the heart of who I thought I was': A meta-synthesis of the qualitative literature examining the experiences of people with multiple sclerosis. Health Expect 2020; 23:1007-1027. [PMID: 32578287 PMCID: PMC7696124 DOI: 10.1111/hex.13093] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/20/2020] [Accepted: 06/02/2020] [Indexed: 02/03/2023] Open
Abstract
Background People with multiple sclerosis (MS) have varied experiences and approaches to self‐management. This review aimed to explore the experiences of people with MS, and consider the implications of these experiences for clinical practice and research. Methods A meta‐synthesis of the qualitative literature examining experiences of people with MS was conducted using systematic searches of ProQuest, PubMed, CINAHL and PsycINFO. We incorporated feedback from team members with MS as expert patient knowledge‐users to capture the complex subjectivities of persons with lived experience responding to research on lived experience of the same disease. Results Of 1680 unique articles, 77 met the inclusion criteria. We identified five experiential themes: (a) the quest for knowledge, expertise and understanding, (b) uncertain trajectories (c) loss of valued roles and activities, and the threat of a changing identity, (d) managing fatigue and its impacts on life and relationships, and (f) adapting to life with MS. These themes were distributed across three domains related to disease (symptoms; diagnosis; progression and relapse) and two contexts (the health‐care sector; and work, social and family life). Conclusion The majority of people in the studies included in this review expressed a determination to adapt to MS, indicating a strong motivation for people with MS and clinicians to collaborate in the quest for knowledge. Clinicians caring for people with MS need to consider the experiential and social outcomes of this disease such as fatigue and the preservation of valued social roles, and incorporate this into case management and clinical planning.
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Affiliation(s)
- Jane Desborough
- Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Crystal Brunoro
- Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Anne Parkinson
- Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Katrina Chisholm
- Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Mark Elisha
- Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Janet Drew
- Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Vanessa Fanning
- Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Christian Lueck
- Australian National University Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Anne Bruestle
- John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Matthew Cook
- Australian National University Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.,John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Hanna Suominen
- School of Computer Science, College of Engineering and Computer Science, Australian National University, Canberra, ACT, Australia
| | - Antonio Tricoli
- Research School of Electrical Energy & Materials Engineering, College of Engineering and Computer Science, Australian National University, Canberra, ACT, Australia
| | - Adam Henschke
- National Security College, College of Asia and the Pacific, Australian National University, Canberra, ACT, Australia
| | - Christine Phillips
- Australian National University Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
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Jaime-Lara RB, Koons BC, Matura LA, Hodgson NA, Riegel B. A Qualitative Metasynthesis of the Experience of Fatigue Across Five Chronic Conditions. J Pain Symptom Manage 2020; 59:1320-1343. [PMID: 31866485 PMCID: PMC7239763 DOI: 10.1016/j.jpainsymman.2019.12.358] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/06/2019] [Accepted: 12/09/2019] [Indexed: 01/18/2023]
Abstract
CONTEXT Fatigue is a symptom reported by patients with a variety of chronic conditions. However, it is unclear whether fatigue is similar across conditions. Better understanding its nature could provide important clues regarding the mechanisms underlying fatigue and aid in developing more effective therapeutic interventions to decrease fatigue and improve quality of life. OBJECTIVES To better understand the nature of fatigue, we performed a qualitative metasynthesis exploring patients' experiences of fatigue across five chronic noninfectious conditions: heart failure, multiple sclerosis, rheumatoid arthritis, chronic kidney disease, and chronic obstructive pulmonary disease. METHODS We identified 34 qualitative studies written in the last 10 years describing fatigue in patients with one of the aforementioned conditions using three databases (Embase, PubMed, and CINAHL). Studies with patient quotes describing fatigue were synthesized, integrated, and interpreted. RESULTS Across conditions, patients consistently described fatigue as persistent overwhelming tiredness, severe lack of energy, and physical weakness that worsened over time. Four common themes emerged: running out of batteries, a bad life, associated symptoms (e.g., sleep disturbance, impaired cognition, and depression), and feeling misunderstood by others, with a fear of not being believed or being perceived negatively. CONCLUSION In adults with heart failure, multiple sclerosis, rheumatoid arthritis, chronic kidney disease, and chronic obstructive pulmonary disease, we found that fatigue was characterized by severe energy depletion, which had negative impacts on patients' lives and caused associated symptoms that exacerbated fatigue. Yet, fatigue is commonly misunderstood and inadequately acknowledged.
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Affiliation(s)
| | - Brittany C Koons
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lea Ann Matura
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nancy A Hodgson
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Maggio MG, Maresca G, De Luca R, Stagnitti MC, Porcari B, Ferrera MC, Galletti F, Casella C, Manuli A, Calabrò RS. The Growing Use of Virtual Reality in Cognitive Rehabilitation: Fact, Fake or Vision? A Scoping Review. J Natl Med Assoc 2019; 111:457-463. [PMID: 30739728 DOI: 10.1016/j.jnma.2019.01.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This review aims to evaluate the role of Virtual Reality (VR) in cognitive rehabilitation of different neurological diseases, and the accessibility to healthcare systems providing this type of treatment. METHOD OF RESEARCH Studies performed between 2003 and 2017 and fulfilling the selected criteria were found on PubMed, Scopus, Cochrane and Web of Sciences databases. The search combined the terms VR rehabilitation with different neurological disease. RESULTS Our findings showed that neurological patients performed significant improvement in many cognitive domains (executive and visual-spatial abilities; speech, attention and memory skills) following the use of VR training. CONCLUSIONS This review supports the idea that rehabilitation through new VR tools could positively affect neurological patients' outcomes, by boosting motivation and participation so to get a better response to treatment. In particular, VR can be used to enhance the effects of conventional therapies, promoting longer training sessions and a reduction in overall hospitalization time.
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Affiliation(s)
| | | | | | | | - Bruno Porcari
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
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Health Related Quality of Life Among Patients With Multiple Sclerosis: The Role of Psychosocial Adjustment to Illness. Arch Psychiatr Nurs 2019; 33:11-16. [PMID: 30663613 DOI: 10.1016/j.apnu.2018.08.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/21/2018] [Accepted: 08/04/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) is associated with poor quality of life (QOL). Individuals suffering from MS must make multiple adjustments as their condition changes. To date, little is known about the role of psychosocial adjustment in improving QOL of patients with MS. PURPOSE The purpose of this study is to identify the relationship between psychosocial adjustment and HRQOL controlling for demographic variables among patients with MS. METHODS This study used a descriptive-correlational design. A sample of 160 patients from two hospitals participated in the study. Self-reported data were collected using the demographic survey, Multiple Sclerosis Quality of Life (MSQoL-54) tool and Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR). RESULTS Participants reported poor QOL and difficulty with psychosocial adjustment. The QOL and psychosocial adjustment were correlated with various demographic variables. After controlling for demographic variables, psychosocial adjustment explained a large variance in the mental health composite of QOL (r square change = 44%) and the physical health composite of QOL = (r square change = 38%). CONCLUSION Psychosocial care could play a vital role in improving quality of life among MS patients.
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