Profile of depression, experienced distress and capacity for coping with stress in multiple sclerosis patients—A different perspective

Development and Validation of the Coping Capacity Measurement Scale of Public Health Emergencies in China

Public health emergency coping capacity has been an important direction in crisis research in recent years. The use of the public health emergency coping capacity scale to evaluate the public's response and feelings regarding public health emergencies is one of the essential ways to improve the effectiveness of public health emergency response. Based on literature research, this paper constructed the theoretical dimension of public health emergency coping ability and completed the development of the items of the initial scale in China. After using SPSS 22.0-conducted exploratory factor analysis, confirmatory factor analysis, and reliability test, the scale dimensions and items were deleted and optimized. The final public health emergency coping capacity measurement scale in China included 12 items and four dimensions. The results showed that the developed scale has high reliability and validity, which is helpful for the relevant personnel to understand the level of public health emergency coping ability and provides an essential basis for timely and accurate emergency prevention and control interventions.

Characteristic Personality Traits of Multiple Sclerosis Patients—An Unicentric Prospective Observational Cohort Study

Background and objectives: Multiple sclerosis (MS) patients tend to present peculiar personality traits that highly impact their quality of life. Our study aimed to determine which personality traits are more common in MS patients compared to a sex- and age-matched control group. Methods and materials: Patients with relapsing–remitting MS along with a sex- and age-matched control group were included. All subjects completed the DECAS Personality Inventory and an additional form including demographic characteristics. Data (including descriptive statistics and univariate and multivariate analysis) were analyzed using SPSS. Results: 122 subjects were included, out of which 61 were in the patient group, mostly females (71.31%) with a mean age of 42.06 ± 10.46 years. Mean duration of disease was 10.18 ± 5.53 years and mean EDSS score was 2.09; 36% of patients were treated with Interferon-beta 1a. Subjects in the patient group presented significantly lower scores for extraversion (p = 0.036), specifically those with higher EDSS score, even after adjusting for possible confounders (age, sex, marital status, early retirement, alcohol, and tobacco consumption). Additionally, regarding orientation in life, MS patients were more often philosophers (p = 0.001), especially young males, whereas the dominant emotional feeling was less common, the actor profile (p = 0.022). Regarding task involvement, MS patients were often passive and compassionate concerning other people. Higher EDSS score also correlated with avoidant (p = 0.006) and melancholic (p = 0.043) personality traits. Subjects with higher education associated more often pragmatic, experimenter, popular, and optimist traits, whereas the elderly had actor, authoritarian, and experimenter profiles. Conclusions: Some MS patients may have reduced levels of extraversion and specific personality traits compared to age- and sex-matched subjects. Determining the exact personality profile might help the neurologist to establish a better therapeutic alliance and to apply specific interventions.

'I want to be with you, but I have MS': Challenges of interpersonal relationships from the MS patients' point of view

Interpersonal relationships play an important role in adjustment to disease, coping and improving life quality after onset of Multiple sclerosis (MS). However, considering its specific nature, MS has a considerable effect on interpersonal relationships. Thus, this study was conducted to identify and describe effects of disease on interpersonal relationships through investigating lived experiences of patients. In this research, a total of 24 MS patients were selected through purposive sampling from individuals referred to the MS Clinic of Kashani Hospital in Isfahan, Iran, during 2016-2017, and then in-depth interviews were done with participants. After analysing interviews by Giorgi Descriptive Phenomenological Psychological Method, five main themes were obtained including 'Who is guilty?', 'The need for informed care', 'living with a secret', 'Change in relationships' and 'The Reality slap'. Content of experience for some of these themes was more influenced by nature of the disease, whereas some other themes were influenced more by patient's cultural context.

A Thematic Synthesis Considering the Factors which Influence Multiple Sclerosis Related Fatigue during Physical Activity

The purpose of this study is to consider the factors that influence fatigue related to physical activity in patients with multiple sclerosis (PwMS) and to identify the necessary adaptations undertaken by patients to remain active. A review using a thematic synthesis methodology situated within a subtle realist paradigm was undertaken. The review was completed in three stages: 1) search of relevant studies; 2) critical appraisal of literature; and 3) thematic synthesis. Nineteen studies met the inclusion criteria. This included a total of 263 participants of whom 243 were PwMS (159 females, 70 males and 14 unknown). The aggregated mean age was 53.3 years and aggregated mean time living with MS post diagnosis 11.3 years. Following critical appraisal, no articles were excluded. Three major themes were identified: (1) fatigue-related consequences, (2) exercise related barriers affecting fatigue, and (3) factors that make fatigue bearable for MS individuals. The thematic synthesis identified the cycle of activity and inactivity as a result of fatigue perception. Exercise experience, professional and social support, as well as the necessary adaptation of a training programme empower PwMS to adopt a more active coping strategy and enjoy the benefits of exercise. Clinicians could consider the implementation of a suitable, individualised exercise programme to reduce PwMS's stress during physical activities.

The Effect of Emotional Intelligence Training on Self-efficacy in Women with Multiple Sclerosis

Background:

Multiple sclerosis (MS), a chronic disease of the central nervous system (CNS), causing progressive nerve damage, has disabling symptoms, and undermines self-efficacy beliefs. Due to the importance of self-efficacy modified in adaptation and coping with stress, this study was conducted with the aim to investigate the effect of emotional intelligence training on self-efficacy in women with MS.

Materials and Methods:

This randomized clinical trial was conducted on 70 women referring to the Multiple Sclerosis Clinic of Kashani Hospital, Isfahan, Iran. The participants were randomly assigned to two groups through minimization method. In the experimental group, emotional intelligence training was performed within 8 weeks, once a week for 90 minutes, in groups of 8–9 individuals. Data were collected using the Multiple Sclerosis Self-efficacy Scale (MSSS) before, immediately after, and 3 months after the intervention in both groups. Data were analyzed using independent t-test and repeated measures ANOVA in SPSS.

Results:

The results of independent t-test showed no significant difference between the groups in terms of mean self-efficacy scores before the intervention (p > 0.05). However, there was a significant difference between the groups in this regard immediately after and 3 months after the intervention (p < 0.05). Repeated measures ANOVA showed a significant difference in the mean score of self-efficacy and its components between the groups at different times (p < 0.05).

Conclusions:

It seems that emotional intelligence training is effective on the improvement of self-efficacy of women with MS. Hence, this method can be recommended as an effective and affordable technique.

The effects of progressive muscular relaxation as a nursing procedure used for those who suffer from stress due to multiple sclerosis

Objective:

to evaluate the effect of progressive muscle relaxation as a nursing procedure on the levels of stress for sufferers of multiple sclerosis.

Method:

random clinical trials conducted at the Neurology outpatients unit at a University Hospital. The sample consisted of 40 patients who were being monitored as outpatients (20 in a control group and 20 in an experimental group). The Progressive Muscle Relaxation technique was used. The control variables were collected through interviews that were recorded on forms and on the Perceived Stress Scale that we used. Five meetings were held every fortnight covering a period of eight weeks. The experimental group was advised to carry out daily progressive muscle relaxation activities. After eight weeks of these activities, they were evaluated again to measure their levels of stress. In order to analyze the data used, the software package Statistics for Social Sciences version 19.0 was used.

Results:

the application of the t test showed a significant reduction in the Perceived Stress Scale scores in the experimental group (p<0.001), which in turn proved that there was a reduction in the levels of stress after the application of the relaxation practic-es.

Conclusion:

the progressive muscle relaxation activities contributed to the reduction in stress levels for multiple sclerosis suffers and thus can be used in nursing for patients. Clinical Trials Identifier: NCT 02673827.

Psychological profiles of patients with multiple sclerosis based on Hobfoll’s conservation of resources theory

<b>Background</b><br /> The psychological perspective plays a crucial role in designing therapy for people suffering from multiple sclerosis. The aim of the article is to distinguish different psychological profiles of patients.<br /> <br /> <b>Participants and procedure</b><br /> The study was conducted using the paper-and-pencil method on 77 patients suffering from multiple sclerosis. The theory we applied was Hobfoll’s conservation of resources theory. We also analyzed the impact of personal and situational variables on the functioning of patients with different kinds of resources.<br /> <br /> <br /> <b>Results</b><br /> Cluster analysis was used to construct the profiles of patients. Based on statistical analyses using the k-means method, we distinguished: Profile 1, with a prevalence of resource losses (n = 30), Profile 2, covering people who value their resources the most (n = 25), and Profile 3, with a prevalence of resource gains (n = 18).<br /> <br /> <b>Conclusions</b><br /> The obtained psychological profiles reflect the varied dynamics of the patients’ functioning and should inspire an improvement of multidisciplinary rehabilitation.

The role of dopamine in modulation of Th-17 immune response in multiple sclerosis

Neuromediators may modulate neuroinflammation, particularly in multiple sclerosis (MS). We investigated the effects of dopamine (DA) on the pro-inflammatory Th17-branch of immunity in 43 patients with relapsing-remitting MS and 20 healthy subjects. Serum DA was lower in MS relapse, whereas percentages of blood CD4(+)CD26(+)CD161(+)CD196(+) Th17-cells and production of interleukin-17 (IL-17) and interferon-gamma by anti-CD3/anti-CD28-stimulated peripheral blood mononuclear cells (PBMC) were higher in MS relapse than in remission or healthy subjects. DA suppressed IL-17 production by PBMC from MS patients and healthy subjects. The suppressive effect of DA was abolished in the presence of an antagonist of D2-like receptors (sulpiride). These data suggest an anti-inflammatory role for DA in MS.

Delayed initial recovery and long lie after a fall among middle-aged and older people with multiple sclerosis

OBJECTIVES

To determine (1) the prevalence of lying on the floor or ground for ≥10 minutes (delayed initial recovery [IR]) and for >1 hour (long lie) after a fall; and (2) the factors associated with delayed IR among people with multiple sclerosis (PwMS).

DESIGN

A secondary analysis of data available from a national, cross-sectional descriptive study of PwMS. Information regarding postfall experiences was extracted from open-ended questions about participants' most recent fall.

SETTING

Community.

PARTICIPANTS

PwMS (N=700) aged ≥55 years were recruited from the North America Committee on Multiple Sclerosis Registry; 354 of them completed the interview, and 322 provided a fall story that included information regarding postfall experiences.

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

Participants' self-reports regarding time lying on the floor or ground after their most recent fall were used to determine delayed IR and long lie.

RESULTS

A total of 89 (27.6%) of 322 fallers reported delayed IR; 15 (4.7%) of them reported a long lie. Logistic regression analysis revealed 5 factors associated with delayed IR: longer disease duration (odds ratio [OR]=1.03; 95% confidence interval [CI], 1.00-1.05), fall leading to a fracture (OR=2.73; 95% CI, 1.11-6.72), received help to get up (OR=3.94; 95% CI, 2.07-7.50), depression (OR=1.96; 95% CI, 1.10-3.49), and leg weakness (OR=2.14; 95% CI, 1.13-4.03). No significant differences were found between fallers who reported a long lie and those who reported a delayed IR.

CONCLUSIONS

The findings suggest that while delayed IR is common, long lies are not prevalent among PwMS. The high prevalence of delayed IR highlights the importance of including fall management strategies in fall prevention programs for PwMS.

Is the Psychotic Depression Assessment Scale a useful diagnostic tool? The CRESCEND study

BACKGROUND

The Psychotic Depression Assessment Scale (PDAS) has been validated as a method of assessing the severity and treatment outcomes of psychotic depression (PD). We aimed to compare the results of the PDAS in PD and non-psychotic depression (non-PD) patients and validate the PDAS as a diagnostic tool for PD.

METHODS

We included 53 patients with PD and 441 with non-PD who participated in the Clinical Research Center for Depression study in South Korea. In addition to the PDAS, psychometric tools including the HAMD17, HAMA, BPRS, CGI-S, SOFAS, SSI-Beck, WHOQOL-BREF, AUDIT, and FTND were used to assess, respectively, depression, anxiety, overall symptoms, global severity, social functioning, suicidal ideation, quality of life, alcohol use, and nicotine use.

RESULTS

After adjusting for age and total HAMD17 score, PD patients had higher scores for depressive mood, hallucinations, unusual thought content, suspiciousness, blunted affect, and emotional withdrawal on the PDAS and higher total scores on the SSI-Beck than non-PD patients. Binary logistic regression identified hallucinatory behavior and emotional withdrawal as predictors of PD. Receiver operating characteristic analysis showed that emotional withdrawal could be used to differentiate psychotic from non-psychotic depression.

LIMITATIONS

The inter-rater reliability for psychometric assessments was not evaluated.

CONCLUSIONS

In addition to assessing the severity and treatment outcomes of PD, PDAS can help in the diagnosis of PD.