Activities of daily living and self-care agency in patients with multiple sclerosis for the first 10 years

The effectiveness of nontraditional or home-based programing on ADL performance of individuals living with multiple sclerosis: A systematic review

PURPOSE

To examine evidence-based nontraditional and home-based interventions and their efficacy for use in individuals with MS to improve performance in their daily activities.

MATERIALS AND METHODS

A search of five databases including PubMed, CINAHL, Cochrane Library, OT Seeker, and Ovid Medline produced 924 research articles. Thirty-two articles were selected for full-text review, of which 15 were included in this systematic review.

INCLUSION CRITERIA

Articles were level 2B or higher evidence, had a minimum of 19 participants with MS, addressed ADLs or body functions supporting ADL performance, and were published since 2010.

EXCLUSION CRITERIA

Articles not written in English and not identified as nontraditional or home-based programming.

RESULTS

The review uncovered strong evidence for the use of the nontraditional interventions of vestibular rehabilitation, self-management, yoga, musical production, and ELEVIDA to improve ADL performance in individuals with MS. Strong evidence supported the use of home-based programs that included cognitive behavioral therapy, cooling suits, manual dexterity, strengthening, vestibular rehabilitation, and physical activity.

CONCLUSIONS

High levels of evidence support the use of nontraditional or home-based interventions to improve ADL performance in clients with MS. Innovation and technology continue to expand the occupational therapist's toolbox of interventions.

The Relationship Between Adaptation to Disease and Self-care Agency Levels in Patients With Multiple Sclerosis

ABSTRACT

BACKGROUND: Multiple sclerosis (MS) is an inflammatory and demyelinating disorder of the central nervous system. The patients with MS have some difficulties in physical, social, and psychological functions. This study was carried out to determine the relationship between the adaptation levels of patients with MS to the disease and their self-care agency levels. METHODS: This study used a descriptive design and was carried out in a university hospital's neurology clinic and outpatient clinic between July 2019 and March 2020. The sample size was determined as 258 using the known universe sampling method. Data were collected using the "Adaptation to Chronic Illness Scale," the "Self-Care Agency Scale," and a "Patient Identification Form." Spearmen correlation analysis was used to evaluate the data. RESULTS: The mean age of the patients participating in the study was 41.36 (0.74) years, 74% of them had MS for more than 3 years, 58% had their last attack more than a year ago, and 27% had balance problems. The adaptation levels of patients to the disease (76.79 [0.57]) and their self-care agency (88.42 [1.34]) were slightly higher than the moderate level. A moderate-level, significant, and positive correlation was found between the adaptation level of the patients to the chronic illness and their self-care agency levels (r = 0.310, P = .000). CONCLUSION: It was concluded that there was a moderate-level, significant, and positive correlation between the patients' level of adaptation to MS disease and the level of their self-care agency. We recommend the provision of supportive professional training to patients with MS on their disease.

Self-care appraisal in nursing assistant students: Adaptation, validation and psychometric properties of the Spanish ASAS

The core implication of nursing professionals’ labor is promoting self-care and foster well-being among healthcare service users. The beginning of the healing process starts with the provider, and self-care habits are needed to positively impact on patients’ care outcomes at different spheres. Overall, current literature supports the idea that nurses’ personal self-care should be a necessary skill to be expected in their professional role. In this regard, the Appraisal of Self-care Agency Scale (ASAS) is a worldwide known instrument aimed at assessing the ability to engage in self-care. However, it has never been tested in the Spanish context before, and much less in nursing practitioners or apprentices. The aim of this study was to translate, adapt and validate the ASAS for Spanish nursing apprentices, assessing its dimensionality, psychometric properties and convergent validity by means of the Sense of Coherence (SOC-13) questionnaire. Methods: Data were collected from a random sample of 921 Certificated Nursing Assistant (CNA) Spanish students and was analyzed trough confirmatory factor analyses via structural equation models. The core ASAS construct and its subscales were correlated with the SOC-13 scores. Results: Fair psychometric properties for the questionnaire were set. Also, SEM models endorse the validity and reliability of the four-factor dimensionality of the Spanish adaptation of the ASAS, whose associations to SOC scores were coherent and significant. Conclusion: This study allowed to establish that the Spanish version of the ASAS might be a useful tool for addressing self-care-related issues among nursing apprentices, a key population for promoting both their own and patients’ health and welfare through healthy and care-related behaviors.

Changes in Activity Participation After Multiple Sclerosis Diagnosis

BACKGROUND

Multiple sclerosis (MS) results in impairments in cognitive and motor skills, which may reduce the level of activity participation in people with MS. This study compares past and current levels of activity participation in adults with MS and controls. The relationship between retained activity participation (since diagnosis) and cognitive, motor, functional status, and depression symptoms of persons with MS was examined.

METHODS

Twenty-seven individuals with MS living in the community and 21 controls completed cognitive and motor tests and rated their activity participation (using the Activity Card Sort), depression symptoms, and functional status.

RESULTS

The MS group reported significantly lower current activity participation than the control group. Percentage of retained activity participation (from prediagnosis to current) in the MS group correlated with time since diagnosis, executive function and motor skill ability, depression symptoms, and current functional status.

CONCLUSIONS

Persons with MS report negative changes in activity participation in most aspects of life after diagnosis. These findings call attention to changes in activity participation in people with MS that are directly related to disease symptoms. Therefore, using a quantitative measure of activity participation-the Activity Card Sort-can provide important information to aid the clinician in developing individualized treatment goals for people with MS.

Functional and self-care capacity of people with multiple sclerosis

Objective:

describe the self-care and functionality levels of patients with multiple sclerosis and determine whether sociodemographic, clinical and functional variables interfere with self-care and/or functionality.

Method:

correlational, cross-sectional study with a quantitative approach performed with individuals in outpatient follow-up. We collected sociodemographic and clinical data and applied the Appraisal of Self-care Agency Scale, the Barthel index, the Lawtton and Brody Scale, and the instrument to investigate the performance in Advanced Activities of Daily Living. We performed descriptive and inferential analysis.

Results:

most patients were classified as “having self-care” (82.14%); with moderate dependence (51.19%) for the basic activities of daily living, partial dependence for the instrumental activities of daily living (55.95%), and more active for the advanced activities of daily living (85.71%). Patients with longer disease duration had a higher number of disabilities and, in those with better socioeconomic and educational profile, the functionality was better.

Conclusion:

disease duration was strongly correlated with a higher number of disabilities and better socioeconomic and educational profiles showed to be protective factors for functionality. Care planning should consider the needs observed by the multidisciplinary team, stimulating the development of self-care, functionality and sociability.

THE EFFECT OF EDUCATIONAL INTERVENTION ON KNOWLEDGE AND SELF-EFFICACY FOR PAIN CONTROL IN PATIENTS WITH MULTIPLE SCLEROSIS

INTRODUCTION

Multiple Sclerosis (MS) is one of the most common autoimmune diseases affecting the central nervous system. The prevalence of it is increasing in our country too. The pain from disorders can affect quality of life. Several studies have pointed to the improvement of patients through educational intervention. This study attempted to evaluate the effectiveness of an educational intervention based on raising the awareness and self-efficacy for pain control among patients with multiple sclerosis during 2015 under the coverage of Isfahan MS Society (IMSS).

MATERIALS AND METHODS

This was a quasi-experimental study involving pre-test, post-test and randomized control group conducted on 100 patients with MS referred to the Isfahan MS Society (IMSS). The educational intervention group learned the pain management self-care lesson during 4 weekly sessions. The data were collected through a self-structured questionnaire with adequate validity and reliability, containing demographic data, awareness and self-efficacy of pain control. The data were assessed through descriptive and analytical tests assisted by SPSS 17. The significant level was considered as P<0.05.

RESULTS

Concerning the questionnaire, 96% of the items were responded. Most participants were women. The frequency distribution of demographic variables was not significantly different between the two pre-test groups. After the intervention, the mean score of knowledge and efficacy among patients in the intervention group was significantly higher than the control group (P<0.001).

CONCLUSIONS

Educational interventions can improve awareness and self-efficacy for pain control among patients with MS. Therefore, such interventions can be designed to reduce physical and psychological complications following multiple sclerosis.