Psychological well-being in people with multiple sclerosis: a descriptive review of the effects obtained with mindfulness interventions

Health, Wellness, and the Effect of Comorbidities on the Multiple Sclerosis Disease Course: Tackling the Modifiable

Multiple sclerosis (MS) is a disease of the central nervous system characterized by inflammatory demyelination and neurodegeneration. Numerous disease-modifying therapies for MS exist but are only partially effective, making it essential to optimize all factors that may influence the course of the disease. This includes conscientious management of both mental and physical comorbidities, as well as a comprehensive strategy for promoting wellness in patients with MS. Thoughtful engagement of those living with MS through shared decision making and involvement of a multidisciplinary team that includes primary care, relevant specialists, psychology, and rehabilitation is likely to lead to better outcomes.

Investigating the effectiveness of cognitive behavioral group therapy on psycho-social and emotional adaptability and cognitive flexibility in people with multiple sclerosis in Hamedan, Iran

INTRODUCTION

Multiple sclerosis is a chronic disease that profoundly impacts the patient's life. This study investigates the effectiveness of cognitive behavioral group therapy on psycho-social and emotional adaptability and cognitive flexibility in patients with multiple sclerosis in Hamedan city.

METHODS

The current study was semi-experimental and was designed with a pretest-posttest and follow-up with a control group. The statistical population included all people suffering from MS who referred to the MS association in Hamedan, Iran, in 2022, among whom 30 people were selected by sampling and randomly assigned to two experimental and control groups (each group of 15 people). The experimental group received cognitive behavioral intervention during eight sessions of 90 min weekly. The control group did not receive any interventions. The subjects were re-evaluated after 2 months for follow-up. The data were collected using a psycho-social adaptability with illness scale questionnaire, Bell's emotional adjustment questionnaire, and cognitive flexibility inventory questionnaire. The data were analyzed using variance analysis with repeated measurements using SPSS-21 software.

RESULTS

The results revealed that the cognitive behavioral therapy intervention significantly impacted the improvement of psycho-social and emotional adaptability and cognitive flexibility compared to the control group. This impact persisted until the follow-up stage.

CONCLUSION

Cognitive behavioral therapy removes cognitive barriers related to attitude and self-management by increasing the information, which improves psycho-social and emotional adaptability, cognitive flexibility, and, consequently, self-care behaviors.

Examining the Use of Autonomous Systems for Home Health Support Using a Smart Mirror

The home is becoming a key location for healthcare delivery, including the use of technology driven by autonomous systems (AS) to monitor and support healthcare plans. Using the example of a smart mirror, this paper describes the outcomes of focus groups with people with multiple sclerosis (MS; n = 6) and people who have had a stroke (n = 15) to understand their attitudes towards the use of AS for healthcare in the home. Qualitative data were analysed using a thematic analysis. The results indicate that the use of such technology depends on the level of adaptability and responsiveness to users' specific circumstances, including their relationships with the healthcare system. A smart mirror would need to support manual entry, responsive goal setting, the effective aggregation of data sources and integration with other technology, have a range of input methods, be supportive rather than prescriptive in messaging, and give the user full control of their data. The barriers to its adoption include a perceived lack of portability and practicality, a lack of accessibility and inclusivity, a sense of redundancy, feeling overwhelmed by multiple technological devices, and a lack of trust in data sharing. These results inform the development and deployment of future health technologies based on the lived experiences of people with health conditions who require ongoing care.

Interventions to Improve Quality of Life in Multiple Sclerosis: New Opportunities and Key Talking Points

Background

Today, living well with multiple sclerosis (MS) is often measured by a person's overall quality of life rather than being limited to the more traditional metrics of reduced frequency of relapses or progression of disability. This change in focus, to a more holistic view of health, such as overall quality of life, has shifted the views of what both providers and people with multiple sclerosis view as essential for living well with MS.

Purpose

This narrative review aims to examine the relevant literature on existing and emerging non-pharmacological interventions shown to improve the quality of life for people with multiple sclerosis across all health domains.

Methods

A literature search was conducted on MEDLINE, CINAHL, and Scopus electronic databases using the following search terms: quality of life, health-related quality of life, life quality, life satisfaction, non-pharmacological intervention, non-drug, and intervention. After screening the abstracts, 24 were selected for this review.

Results

Common non-pharmacological interventions were used for fatigue and sleep, mental and emotional health, cognition, physical health, and chronic pain. Several non-pharmacological interventions included in this review positively improved the overall quality of life for people with multiple sclerosis. These interventions included exercise, cognitive behavior therapy, and cognitive rehabilitation.

Conclusion

Non-pharmacological interventions such as exercise and cognitive behavioral therapy improve the quality of life for people with MS. These interventions should be prescribed more during routine medical care. Translating this research into standard clinical practice should be one area of focus. In addition, higher quality studies, such as randomized control trials, need to be conducted on emerging nonpharmacological interventions to assess effectiveness.

Evaluation of the feasibility and acceptability of an integrative group psychological intervention for people with Multiple Sclerosis: A study protocol

Multiple Sclerosis (MS) is characterised by significant symptom diversity and complexity. The unpredictability of the symptoms and the emotional and cognitive facets of the disease have a significant impact on the patients' quality of life, relationships and other significant areas of living. Psychological interventions have been found to have moderate effects on quality of life, depression, stress reduction, improvement of wellbeing, anxiety, fatigue, sleep disturbances and emotion regulation. Most interventions so far are based on generic models of therapy which cannot always cover the complexity and unpredictability of MS. The present research project follows from an exploratory mixed method study on the experience of psychological interventions and the impact on the management of MS. The results of that study generated themes that led to the development of an integrative group psychological intervention named MyMS-Ally. The current study aims to explore the feasibility and acceptability of MyMS-Ally intervention and obtain preliminary data on the effects on quality of life, emotion regulation, depression and anxiety through the application of a convergent mixed methods design. People with MS will be recruited at the Bristol and Avon Multiple Sclerosis centre, North Bristol NHS Trust. They will participate in MyMS-Ally group intervention for 8 weeks. Individual semi-structured interviews drawing on Interpretative Phenomenological methodology will be conducted before and after the intervention and at three months follow up. Participants will complete quantitative measures on quality of life, emotion regulation, depression and anxiety before and after the intervention and at one and three months follow up. The aim is to explore the relevance, sustainability and adherence to the intervention and study processes (feasibility) as well as the appropriateness of the intervention based on the emotional and cognitive responses, satisfaction and perceived effectiveness (acceptability). It is aspired that this patient-centred psychological intervention will address needs and preferences of people with MS. The results of the present study will provide data for further development of the intervention and will lead to a big scale evaluation study.

The Western origins of mindfulness therapy in ancient Rome

Stoic philosophy has multiple parallels with cognitive behavioural therapy interventions. In their ancient texts, the Roman Stoics present a set of theoretical principles and behavioural strategies that are directly relevant to the clinical care of patients with a wide range of neuropsychiatric conditions. Mindfulness is a key component of the 'third wave' of modern psychotherapy that closely resembles the ancient Stoic practice of attention or 'concentration on the present moment'. Stoic mindfulness draws attention to one of the main principles driving both Stoicism and modern psychotherapy: the assumption that cognitive activity (reasoning) mediates emotions and behaviours. This principle can be traced back to Epictetus' Enchiridion, where he recognises that 'men are disturbed not by things, but by the views which they take of things'. It has been shown that cognitive behavioural therapies and mindfulness-based interventions directed at patients with neuropsychiatric disorders were originally developed as Stoic-inspired treatment interventions. Both Albert Ellis and Aaron Beck (the founders of rational emotive behaviour therapy and cognitive behavioural therapy, respectively) explicitly acknowledged the role of Stoicism as the philosophical precursor of their treatment approaches. The effective implementation of evidence-based guidelines would benefit from an increased awareness of the influence of the Stoic tradition of philosophical therapy on the treatment approaches currently in use in neuropsychiatry.

Methodological Investigation of Time Perspective Scoring and Quality of Life among Individuals with Multiple Sclerosis

Achieving and maintaining a high quality of life following the diagnosis of chronic illness has a positive impact on the experience of illness, including delayed disease progression and fewer relapses. Time perspective has shown promising relationships with quality of life, though studies using the construct in samples with chronic illness are sparse and methodologically heterogeneous. Participants (n = 123) were diagnosed with relapsing-remitting multiple sclerosis at least five years prior to enrollment and were beginning a new disease modifying therapy (DMT). The Zimbardo Time Perspective Inventory (ZTPI) and the World Health Organization Quality of Life (WHOQoL-100) assessment were administered at baseline and the WHOQoL-100 was administered six-weeks after starting the new DMT. This study investigated the utility of three common methods of scoring and interpreting ZTPI (balanced vs. deviation-from-balanced, categorical, and continuous scores) to predict change in quality of life. Independent sample t-tests revealed no difference in quality of life for balanced vs. deviation-from-balanced. One-way ANOVA revealed no difference in quality of life across time perspective categories. Linear regression analysis found that past-negative scores predicted decreases in all quality of life domains as well as overall score while present hedonistic scores predicted increases in psychological and overall quality of life.