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Topcu G, Mhizha-Murira JR, Griffiths H, Bale C, Drummond A, Fitzsimmons D, Potter KJ, Evangelou N, das Nair R. Experiences of receiving a diagnosis of multiple sclerosis: a meta-synthesis of qualitative studies. Disabil Rehabil 2023; 45:772-783. [PMID: 35254195 PMCID: PMC9928430 DOI: 10.1080/09638288.2022.2046187] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE This meta-synthesis aimed to synthesise qualitative evidence on experiences of people with Multiple Sclerosis (MS) in receiving a diagnosis, to derive a conceptual understanding of adjustment to MS diagnosis. METHODS Five electronic databases were systematically searched to identify qualitative studies that explored views and experiences around MS diagnosis. Papers were quality-appraised using a standardised checklist. Data synthesis was guided by principles of meta-ethnography, a well-established interpretive method for synthesising qualitative evidence. RESULTS Thirty-seven papers were selected (with 874 people with MS). Synthesis demonstrated that around the point of MS diagnosis people experienced considerable emotional upheaval (e.g., shock, denial, anger, fear) and difficulties (e.g., lengthy diagnosis process) that limited their ability to make sense of their diagnosis, leading to adjustment difficulties. However, support resources (e.g., support from clinicians) and adaptive coping strategies (e.g., acceptance) facilitated the adjustment process. Additionally, several unmet emotional and informational support needs (e.g., need for personalised information and tailored emotional support) were identified that, if addressed, could improve adjustment to diagnosis. CONCLUSIONS Our synthesis highlights the need for providing person-centred support and advice at the time of diagnosis and presents a conceptual map of adjustment for designing interventions to improve adjustment following MS diagnosis.Implications for RehabilitationThe period surrounding Multiple Sclerosis diagnosis can be stressful and psychologically demanding.Challenges and disruptions at diagnosis can threaten sense of self, resulting in negative emotions.Adaptive coping skills and support resources could contribute to better adjustment following diagnosis.Support interventions should be tailored to the needs of newly diagnosed people.
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Affiliation(s)
- Gogem Topcu
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- CONTACT Gogem Topcu Institute of Mental Health, Jubilee Campus, University of Nottingham, B Floor, Nottingham, NG7 2TU, UK
| | | | - Holly Griffiths
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Clare Bale
- Multiple Sclerosis Patient and Public Involvement Group, Nottingham, UK
| | - Avril Drummond
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Deborah Fitzsimmons
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Kristy-Jane Potter
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Nikos Evangelou
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Roshan das Nair
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Trust, Nottingham, UK
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Benini S, Pellegrini E, Descovich C, Lugaresi A. Burden and resources in caregivers of people with multiple sclerosis: A qualitative study. PLoS One 2023; 18:e0265297. [PMID: 37068110 PMCID: PMC10109507 DOI: 10.1371/journal.pone.0265297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/27/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Caregivers of people with Multiple Sclerosis are required to provide ongoing assistance especially during the advanced stages of the disease. They have to manage interventions and assume responsibilities which significantly impact both their personal quality of life and family's dynamics. OBJECTIVE A qualitative phenomenological study was carried out to understand the experience of burden in caregivers and their resources to manage it. The study also explores how healthcare services involved in the Multiple Sclerosis Clinical Pathway respond to the needs of well-being of patients and family members. METHODS 17 caregivers were involved in focus groups and in semi-structured individual interviews. RESULTS Fatigue is experienced by all respondents and it starts when physical disabilities increase or when people become aware of them. Many caregivers declare that they refer to intrinsic (love towards their relatives, patience and dedication) or extrinsic (family members, hobbies) resources to cope with the burden of assistance. Patient associations and the Multiple Sclerosis Clinical Pathway play a significant role in supporting caregivers. CONCLUSIONS Fatigue, loneliness, and isolation are experienced by caregivers and strongly affect their quality of life and health status. The study highlights caregivers' need to reconcile working times with care times, to give more space to self-care and to have moments to share their experiences with someone else. These needs should be at the core of health policies in order to avoid physical and emotional breakdowns which could lead to the rupture of the relational balance on which home care is based.
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Affiliation(s)
| | | | | | - Alessandra Lugaresi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italia
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italia
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Gamble R, Sumner P, Wilson-Smith K, Derry-Sumner H, Rajenderkumar D, Powell G. Using interpretative phenomenological analysis to probe the lived experiences of persistent postural-perceptual dizziness (PPPD). J Vestib Res 2023; 33:89-103. [PMID: 36710692 PMCID: PMC10041438 DOI: 10.3233/ves-220059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 01/05/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND Persistent Postural-Perceptual Dizziness (PPPD) is a chronic neuro-vestibular condition characterised by subjective dizziness, non-spinning vertigo, and postural imbalance. Symptoms are typically induced by situations of visuo-vestibular conflict and intense visual-motion. OBJECTIVE Little research has focused on the lived experiences of people with PPPD. Therefore, our objective was to present an in-depth exploration of patient experiences and sense-making, and the effect of PPPD on psycho-social functioning. METHODS We conducted semi-structured interviews with 6 people with PPPD, who were recruited from an Audiovestibular department in Wales. We present a case-by-case Interpretive Phenomenological Analysis (IPA) for each participant and present common themes. RESULTS Our analysis revealed a range of superordinate and subordinate themes, individualised to each participant, but broadly described under the following headings: dismissal and non-belief, identity loss, dissociative experiences, poor psychological well-being and processes of sense-making. CONCLUSION The qualitative experiences documented in this study will help clinicians and researchers to better understand the lived experiences of PPPD, how PPPD patients make sense of their symptoms, and the psycho-social impacts of the condition.
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Affiliation(s)
- Ryan Gamble
- School of Psychology, Cardiff University, Cardiff, UK
| | - Petroc Sumner
- School of Psychology, Cardiff University, Cardiff, UK
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Parkinson A, Brunoro C, Leayr J, Fanning V, Chisholm K, Drew J, Desborough J, Phillips C. Intertwined like a double helix: A meta-synthesis of the qualitative literature examining the experiences of living with someone with multiple sclerosis. Health Expect 2022; 25:803-822. [PMID: 35118764 PMCID: PMC9122458 DOI: 10.1111/hex.13432] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/16/2021] [Accepted: 12/31/2021] [Indexed: 12/01/2022] Open
Abstract
Background Multiple sclerosis (MS) is a chronic serious condition of uncertain course and outcome. There is relatively little literature on the experiences of people who live with a person with MS. They inhabit a locus of care that spans caring for (a relational act) and caring about (a moral stance, addressing fairness, compassion and justice) the person with MS. Methods Using the theoretical lens of personhood, we undertook a scoping review and meta‐synthesis of the qualitative literature on the experiences of people who live with a person with MS, focusing on the nature of, and constraints upon, caring. Results Of 330 articles, 49 were included in the review. We identified five themes. One of these—seeking information and support—reflects the political economy of care. Two are concerned with the moral domain of care: caring as labour and living with uncertainty. The final two themes—changing identities and adapting to life with a person with MS—point to the negotiation and reconstitution of personhood for both the person with MS and the people they live with. Conclusion People with MS are embedded in relational social networks of partners, family and friends, which are fundamental in the support of their personhood; the people who live with them are ‘co‐constituents of the patient's identity’ assisting them to make sense of their world and self in times of disruption due to illness. Support services and health care professionals caring for people with MS are currently very much patient‐centred; young people in particular report that their roles are elided in the health system's interaction with a parent with MS. There is a need to look beyond the person with MS and recognize the relational network of people who surround them and broaden their focus to encompass this network. Patient and Public Involvement Our research team includes four members with MS and two members with lived experience of living or working with people with MS. A third person (not a team member) who lives with a partner with MS provided feedback on the paper.
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Affiliation(s)
- Anne Parkinson
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
| | - Crystal Brunoro
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
| | - Jack Leayr
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
| | - Vanessa Fanning
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
| | - Katrina Chisholm
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
| | - Janet Drew
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
| | - Jane Desborough
- Department of Health Services Research and Policy, Australian National University, Acton, Australia
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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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Neate SL, Taylor KL, Nag N, Jelinek GA, Simpson-Yap S, Bevens W, Weiland TJ. Views of the Future of Partners of People with Multiple Sclerosis Who Attended a Lifestyle Modification Workshop: A Qualitative Analysis of Perspectives and Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010085. [PMID: 33374429 PMCID: PMC7796062 DOI: 10.3390/ijerph18010085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/15/2020] [Accepted: 12/21/2020] [Indexed: 11/24/2022]
Abstract
People with multiple sclerosis (PwMS) often experience uncertainty and fear about their futures. Partners of PwMS may share their concerns and experience fears about their own futures, limitations on their lives, ability to work, and becoming a carer. For PwMS, modification of lifestyle-related risk factors has been associated with improved health outcomes. For PwMS who attended residential lifestyle modification workshops (RLMW), sustained improved health outcomes have been demonstrated. Whether improved outcomes for PwMS who engage with lifestyle modification translate to improved partner perceptions of the future, is yet to be explored. We explored the perspectives of partners of PwMS who had attended a RLMW and the impact that the person with MS’s illness and their engagement with lifestyle modification had on their partners’ views of the future. Analysis of 21 semi-structured interviews used a methodology informed by Heidegger’s Interpretive Phenomenology. Three themes emerged: ‘uncertainty’, ‘planning for the future’ and ‘control, empowerment and confidence’. Subthemes included MS and lifestyle modification being a catalyst for positive change; developing a sense of control and empowerment; and hope, optimism and positivity. Lifestyle modification may provide benefits, not only to PwMS, but also to their partners, and should be considered part of mainstream management of MS.
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Affiliation(s)
- Sandra L. Neate
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3010, Australia; (K.L.T.); (N.N.); (G.A.J.); (S.S.-Y.); (W.B.); (T.J.W.)
- Correspondence:
| | - Keryn L. Taylor
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3010, Australia; (K.L.T.); (N.N.); (G.A.J.); (S.S.-Y.); (W.B.); (T.J.W.)
- Department of Psychiatry and Psychosocial Cancer Care, St Vincent’s Hospital Melbourne, Fitzroy 3065, Australia
| | - Nupur Nag
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3010, Australia; (K.L.T.); (N.N.); (G.A.J.); (S.S.-Y.); (W.B.); (T.J.W.)
| | - George A. Jelinek
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3010, Australia; (K.L.T.); (N.N.); (G.A.J.); (S.S.-Y.); (W.B.); (T.J.W.)
| | - Steve Simpson-Yap
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3010, Australia; (K.L.T.); (N.N.); (G.A.J.); (S.S.-Y.); (W.B.); (T.J.W.)
| | - William Bevens
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3010, Australia; (K.L.T.); (N.N.); (G.A.J.); (S.S.-Y.); (W.B.); (T.J.W.)
| | - Tracey J. Weiland
- Neuroepidemiology Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3010, Australia; (K.L.T.); (N.N.); (G.A.J.); (S.S.-Y.); (W.B.); (T.J.W.)
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Richardson EV, Motl RW. The experience and meaning of aging with multiple sclerosis: An existential phenomenological approach. J Aging Stud 2020; 54:100872. [PMID: 32972621 DOI: 10.1016/j.jaging.2020.100872] [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] [Received: 04/16/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Over the past 3 decades there have been significant advances in the development of pharmaceutical and rehabilitative treatments for persons with multiple sclerosis (MS), such that life expectancy is continuing to increase. Whilst these advancements are exciting, there are also concerns and unknowns regarding what it is like to age with MS. The objectives of this research were to explore the lived experiences and meaning of aging in conjunction with having MS. METHODS Semi-structured interviews with 40 persons with MS over 60 years were conducted. Thereafter data were subject to an existential phenomenological analysis. RESULTS Four different ways were discussed with regards to embodied experiences of aging with MS: aging makes MS worse; MS makes aging worse; aging makes MS better; and MS makes aging better. DISCUSSION This research highlighted the complexity of aging with MS and the various of ways persons over 60 with MS experience and interpret this phenomenon.
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Affiliation(s)
- Emma V Richardson
- School of Sport and Exercise, College of Business, Psychology and Sport, University of Worcester, UK.
| | - Robert W Motl
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
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Neate SL, Taylor KL, Jelinek GA, De Livera AM, Simpson, Jr S, Bevens W, Weiland TJ. On the path together: Experiences of partners of people with multiple sclerosis of the impact of lifestyle modification on their relationship. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:1515-1524. [PMID: 31368624 PMCID: PMC6851851 DOI: 10.1111/hsc.12822] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 06/20/2019] [Accepted: 07/09/2019] [Indexed: 05/04/2023]
Abstract
Multiple sclerosis (MS) has a major impact on the relationship of couples living with the illness. Although some positives of dealing with MS as a couple have been identified, MS has been associated with higher rates of relationship breakdown and worse Quality of Life (QOL) for both people in the relationship, especially if the person with MS experiences a decline in mental or physical health or develops disability. Modification of lifestyle-related risk factors has been associated with improved outcomes for people with MS, including physical and mental health-related QOL, and these improved outcomes may lead to improved experiences for their partners. We aimed to explore the perspectives and experiences of the partners of people with MS, when the people with MS had undertaken an intensive residential workshop regarding healthy lifestyle, to understand the impact of MS and lifestyle modification on these partners' experiences of their relationship. Within the framework of Heidegger's interpretive phenomenology, semi-structured interviews were thematically analysed. Participants were in a spousal relationship with people with MS who had attended an intensive residential workshop regarding modification of lifestyle-related risk factors between 2002 and 2016. Participants lived in Australia, New Zealand, the United Kingdom and Europe. Three major themes were identified relating to the couple's relationships: providing support, remaining connected and togetherness. Aspects of these themes, not commonly previously reported, included the personal and relationship benefits experienced from providing support with lifestyle modification, improved communication, and the resultant greater sense of closeness. These experiences of partners of people with MS improve our understanding of both the complexities of living with MS and adopting lifestyle modification, and suggest some potential benefits to relationships.
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Affiliation(s)
- Sandra L. Neate
- Neuroepidemiolgy Unit, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVic.Australia
| | - Keryn L. Taylor
- Neuroepidemiolgy Unit, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVic.Australia
- Department of Psychiatry and Psychosocial Cancer CareSt Vincent’s HospitalMelbourneVic.Australia
| | - George A. Jelinek
- Neuroepidemiolgy Unit, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVic.Australia
| | - Alysha M. De Livera
- Neuroepidemiolgy Unit, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVic.Australia
| | - Steve Simpson, Jr
- Neuroepidemiolgy Unit, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVic.Australia
| | - William Bevens
- Neuroepidemiolgy Unit, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVic.Australia
| | - Tracey J. Weiland
- Neuroepidemiolgy Unit, Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVic.Australia
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Neate SL, Taylor KL, Jelinek GA, De Livera AM, Brown CR, Weiland TJ. Taking active steps: Changes made by partners of people with multiple sclerosis who undertake lifestyle modification. PLoS One 2019; 14:e0212422. [PMID: 30817765 PMCID: PMC6394935 DOI: 10.1371/journal.pone.0212422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 02/01/2019] [Indexed: 01/08/2023] Open
Abstract
Background Multiple sclerosis (MS), a demyelinating condition of the central nervous system with an unpredictable course, has a major impact on the lives of people with MS. Partners of people with MS may be significantly affected by the diagnosis, management and uncertainty around disease progression and may provide substantial support and care. Modification of lifestyle risk factors in conjunction with standard medical management has been associated with improved physical and mental quality of life. Adopting major lifestyle modification may have a multi-faceted impact on the person with MS and their partner. Experiences of partners of people with MS have been previously explored, but the experiences of partners of people with MS who adopt this strategy have not. As part of a larger study that aimed to explore partners’ lived experiences of and attitudes towards MS and lifestyle modification, this study reports the active steps and significant changes partners undertook to assist the person with MS and, at times, to also modify their own lives. Design Within an interpretive framework, using Heidegger’s phenomenological philosophy, a qualitative study of semi-structured interviews was conducted. Participants Aged greater than 18 years and in a spousal relationship with a person with MS who had undertaken an intensive residential lifestyle educational intervention promoting healthy lifestyle. Results Themes identified were: adjusting to lifestyle modification, understanding motivations and practical aspects of adjustment; seeking knowledge and support, exploring the ways partners sought positive support for themselves and the person with MS and abandoned negative influences; and embracing well-being, commitment and change, describing the major changes that partners made to their lives professionally and personally. Conclusions The experiences of these partners provide clinicians with insight into potential motivations and outcomes of lifestyle modification and suggest potentially positive aspects for those directly and indirectly affected by MS.
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Affiliation(s)
- Sandra L. Neate
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
- * E-mail:
| | - Keryn L. Taylor
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - George A. Jelinek
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Alysha M. De Livera
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Chelsea R. Brown
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Tracey J. Weiland
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
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Dehghani A, Keshavarzi A. Development and validation of a multidimensional health literacy questionnaire for multiple sclerosis patients. Mult Scler Relat Disord 2018; 25:156-162. [PMID: 30081315 DOI: 10.1016/j.msard.2018.07.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/18/2018] [Accepted: 07/10/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Assessment of health literacy among patients with multiple sclerosis can be used in education planning, disease management, compliance, and quality of life. In addition, health literacy can be assessed using a standard questionnaire based on the social and cultural context more accurately. This study aimed to develop and validate a questionnaire for the assessment of health literacy in patients with multiple sclerosis. METHODS This is an exploratory sequential mixed method research which was conducted in three sections. In the first section, the concept of health literacy among patients with MS was analyzed using the hybrid concept analysis in the theoretical work, field work, and final analysis stages in order to extract features of the concept. In the second section, an initial pool of items of the questionnaire was designed based on the extracted features from the concept, reviewed texts, and related questionnaires. In the third section, psychometric properties of the questionnaire were evaluated including validity (face, content and construct) and reliability (internal consistency and stability). RESULTS Totally, 68 items were included in the initial pool, which shrank to 22 items in the final questionnaire after reviewing the psychometric features. Factor analyses led to the extraction of four factors including appraisal of health information, ability to search health information, knowledge of caring for the disease, and successful practices in health conditions. Internal consistency of the questionnaire was also confirmed by Cronbach's alpha coefficient of 0.94, and its stability was calculated and confirmed by the inter-class coefficient of correlation of 0.96. CONCLUSION The developed 22-item-questionnaire is valid and reliable for assessment of levels of health literacy in Iranian patients with MS.
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Affiliation(s)
- Ali Dehghani
- Department of Nursing, School of Nursing and Paramedical, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Abdolkhalegh Keshavarzi
- Department of General Surgery, School of Medicine, Member of Shiraz burn research center, Shiraz University of Medical Sciences, Shiraz, Iran
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Neate SL, Taylor KL, Jelinek GA, De Livera AM, Brown CR, Weiland TJ. Psychological Shift in Partners of People with Multiple Sclerosis Who Undertake Lifestyle Modification: An Interpretive Phenomenological Study. Front Psychol 2018; 9:15. [PMID: 29445346 PMCID: PMC5797767 DOI: 10.3389/fpsyg.2018.00015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 01/05/2018] [Indexed: 01/03/2023] Open
Abstract
Introduction: Being in an intimate relationship with a person with multiple sclerosis (MS) may have a substantial impact on the partner's quality of life. Existing research has largely focused on negative impacts of MS for both people with MS (PwMS) and their partners and has sampled the population of partners of PwMS who have primarily adopted standard medical management only. Modifiable lifestyle factors have become increasingly recognized in the management of MS symptoms and disease progression. For partners of PwMS who have undertaken lifestyle modification as an additional strategy to minimize disease progression, the impacts, both positive and negative remain unexplored. This research is unique as it focuses on partners of PwMS who have attempted to adopt major lifestyle interventions outside of the prevailing paradigm of MS management. Aim: To explore and interpret the lived experiences of partners of PwMS who have adopted lifestyle modification, to understand partners' attitudes to and experiences of the effect of MS and lifestyle modification on their life, relationship and view of the future. Method: Design: a qualitative, interpretive, phenomenological study using semi-structured interviews. Participants: English-speaking; aged 18 years or more; in a spousal relationship for 12 months or more with a person with MS who had attended a residential lifestyle educational intervention and undertaken lifestyle modification. Analysis: Interviews were recorded, transcribed verbatim and thematically analyzed using NVivo™ software. Results: Twenty-one partners were interviewed. This paper reports one of the study's themes, the psychological shift experienced by partners of PwMS. Sub-themes included adaptation; loss and grief; difficult emotions; reframing, re-evaluating and re-prioritizing; hope and optimism; empowerment and taking control; and self-awareness, greater understanding and personal growth. Conclusion: Partners of PwMS who have undertaken lifestyle modification experienced a broad range of psychological adjustments. Whilst reflecting the potential difficulties that partners of PwMS may experience, this group experienced a range of positive psychological changes that add to the literature regarding partners' potential experiences and may provide hope for those in partnerships with people with MS. This study provides themes to potentially inform a quantitative study of a larger population of partners of PwMS.
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Affiliation(s)
- Sandra L Neate
- Neuroepidemiolgy Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Keryn L Taylor
- Neuroepidemiolgy Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - George A Jelinek
- Neuroepidemiolgy Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Alysha M De Livera
- Neuroepidemiolgy Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Chelsea R Brown
- Neuroepidemiolgy Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Tracey J Weiland
- Neuroepidemiolgy Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Dealing with Chronic Illness: Experiences of Iranian Families of Persons with Multiple Sclerosis-A Qualitative Study. Mult Scler Int 2017; 2017:9243161. [PMID: 29082042 PMCID: PMC5610797 DOI: 10.1155/2017/9243161] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/03/2017] [Accepted: 08/01/2017] [Indexed: 02/03/2023] Open
Abstract
Background Today family members are providing care and support to each other during illness. In particular, in chronic illness, such as multiple sclerosis, the families are more involved in caring for and supporting their patients, so they use several strategies to cope with this situation. The purpose of this study was to explore the coping strategies in family caregivers of persons with multiple sclerosis in Iran. Methods This is a qualitative study that was conducted through 18 family caregivers of persons with multiple sclerosis. A purposeful sampling method was used. Data were collected through semistructured and in-depth interviews conducted in Multiple Sclerosis Society and hospitals of Tabriz in Iran. The collected data was analyzed according to qualitative content analysis. Results Five main categories were elicited from interviews: “using spirituality,” “living with hope,” “experiencing persistence and stability,” “seeking support,” and “seeking alternative treatments.” Conclusion. The study findings can help to inform the support given to families to help them cope with the effects of caring for someone with multiple sclerosis. Health system managers and professionals by using these results are able to support patients and their families appropriately in order to improve their quality of life and alleviate the complications of disease.
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Strickland K, Worth A, Kennedy C. The liminal self in people with multiple sclerosis: an interpretative phenomenological exploration of being diagnosed. J Clin Nurs 2017; 26:1714-1724. [DOI: 10.1111/jocn.13593] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Karen Strickland
- School of Nursing & Midwifery; The Robert Gordon University; Aberdeen UK
| | - Allison Worth
- Wellcome Trust Clinical Research Facility; The University of Edinburgh; Edinburgh UK
| | - Catriona Kennedy
- School of Nursing & Midwifery; The Robert Gordon University; Aberdeen UK
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Abualfaraj R, Daly B, McDonald F, Scambler S. Cleft lip and palate in context: Learning from, and adding to, the sociological literature on long-term conditions. Health (London) 2017; 22:372-388. [DOI: 10.1177/1363459317693409] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cleft lip and palate is a common congenital anomaly affecting males and females. While there is psychological research on cleft lip and palate, there is relatively little research exploring the social context of cleft lip and palate and the experiences of living with the condition on a daily basis. Drawing on common themes emerging from sociological work which have explored the experiences of people living with long-term conditions (uncertainty, social relations, self-esteem and self-image and biomedical concerns), we argue that these themes can be used to help elucidate the experiences of people living with cleft lip and palate. Within this framework, the findings of a qualitative study exploring the experiences of people living with cleft lip and palate are presented. The results suggest that all four themes can be found within the accounts of people living with cleft lip and palate, and there are many commonalities between the experiences of these people and those living with other long-term conditions. Conversely there are interesting areas of divergence. Unlike most long-term conditions, cleft lip and palate is not degenerative and treatment means symptoms will reduce over time. This is reflected in narratives around ‘normality’ as the endpoint of the care pathway. In addition, prenatal diagnosis means that the vast majority of participants within this study were born into, and grew up within, the care pathway. This has implications for the way in which cleft lip and palate is understood and the provision of information, relationships with members of the care team over time and the temporal and contextualised impact of cleft lip and palate on social relations and the self.
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Affiliation(s)
| | - Blanaid Daly
- Dublin Dental University Hospital, Ireland
- King’s College London, UK
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Mjøsund NH, Eriksson M, Espnes GA, Haaland-Øverby M, Jensen SL, Norheim I, Kjus SHH, Portaasen IL, Vinje HF. Service user involvement enhanced the research quality in a study using interpretative phenomenological analysis - the power of multiple perspectives. J Adv Nurs 2016; 73:265-278. [PMID: 27509545 DOI: 10.1111/jan.13093] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2016] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to examine how service user involvement can contribute to the development of interpretative phenomenological analysis methodology and enhance research quality. BACKGROUND Interpretative phenomenological analysis is a qualitative methodology used in nursing research internationally to understand human experiences that are essential to the participants. Service user involvement is requested in nursing research. DESIGN We share experiences from 4 years of collaboration (2012-2015) on a mental health promotion project, which involved an advisory team. METHODS Five research advisors either with a diagnosis or related to a person with severe mental illness constituted the team. They collaborated with the research fellow throughout the entire research process and have co-authored this article. We examined the joint process of analysing the empirical data from interviews. Our analytical discussions were audiotaped, transcribed and subsequently interpreted following the guidelines for good qualitative analysis in interpretative phenomenological analysis studies. RESULTS The advisory team became 'the researcher's helping hand'. Multiple perspectives influenced the qualitative analysis, which gave more insightful interpretations of nuances, complexity, richness or ambiguity in the interviewed participants' accounts. The outcome of the service user involvement was increased breadth and depth in findings. CONCLUSION Service user involvement improved the research quality in a nursing research project on mental health promotion. The interpretative element of interpretative phenomenological analysis was enhanced by the emergence of multiple perspectives in the qualitative analysis of the empirical data. We argue that service user involvement and interpretative phenomenological analysis methodology can mutually reinforce each other and strengthen qualitative methodology.
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Affiliation(s)
- Nina Helen Mjøsund
- Department of Mental Health Research and Development, Vestre Viken Hospital Trust, Drammen, Norway
| | - Monica Eriksson
- Center on Salutogenesis, Department of Health Sciences, University West, Trollhättan, Sweden
| | - Geir Arild Espnes
- Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mette Haaland-Øverby
- Department of Mental Health Research and Development, Vestre Viken Hospital Trust, Drammen, Norway
| | - Sven Liang Jensen
- Department of Mental Health Research and Development, Vestre Viken Hospital Trust, Drammen, Norway
| | - Irene Norheim
- Department of Mental Health Research and Development, Vestre Viken Hospital Trust, Drammen, Norway
| | | | - Inger-Lill Portaasen
- Department of Mental Health Research and Development, Vestre Viken Hospital Trust, Drammen, Norway
| | - Hege Forbech Vinje
- Department of Health Promotion, Faculty of Health Sciences, University College of Southeast Norway, Kongsberg, Norway
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