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Kessler D, Franz M, Malakouti N, Rajachandrakumar R, Baharnoori M, Finlayson M. Randomized Controlled Trial of Occupational Performance Coaching for Adults With Multiple Sclerosis. Arch Phys Med Rehabil 2024:S0003-9993(24)01042-6. [PMID: 38851554 DOI: 10.1016/j.apmr.2024.05.022] [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: 12/21/2023] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVE To determine if the receipt of occupational performance coaching (OPC) by adults living with multiple sclerosis (MS) improves participants' satisfaction with performance in daily activities (primary outcome); improves perceived performance in daily activities, resilience, autonomy, and participation; and reduces illness intrusiveness and effect of MS (secondary outcomes). DESIGN Two-group randomized clinical trial with a waitlist control. SETTING Community. PARTICIPANTS Convenience sample of adults with MS were recruited through a research registry. Eighty-three individuals were approached; 35 were assessed for eligibility and 31 were enrolled and 30 completed baseline assessment (Final sample size, N=30). Participants were English-speaking, were without serious cognitive impairment or severe depression, and were not receiving other coaching interventions. INTERVENTIONS Six telephone sessions of OPC were delivered by a trained facilitator over 10 weeks. Initial sessions focused on goal setting, prioritization, and action planning. Subsequent sessions involved goal and action plan review, discussion of facilitators and barriers, and goal and plan refinement. MAIN OUTCOME MEASURES Primary outcome was participants' satisfaction with performance in daily activities, as measured by the Canadian Occupational Performance Measure (COPM). Secondary outcome measures included the COPM performance rating, Connor-Davidson Resilience Scale, Impact on Participation and Autonomy Questionnaire, Adapted Illness Intrusiveness Rating Scale, and MS Impact Scale. Measures were administered by a blinded assessor at baseline, 10 weeks, and 2 months. RESULTS Participants in the intervention and waitlist control groups were equivalent on demographic and outcome measures at baseline. At 10 weeks, the intervention group had significantly higher COPM ratings for both satisfaction (P<.001) and performance (P=.002). No other outcomes were significantly different. For the intervention group, the benefits of OPC were maintained at 2 months. CONCLUSIONS OPC led to improved satisfaction with performance and performance in daily activities. Future research with a larger sample is needed to determine other effects and who benefits most from OPC.
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Affiliation(s)
- Dorothy Kessler
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
| | - Martina Franz
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Niloufar Malakouti
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | | | - Moogeh Baharnoori
- Department of Medicine, Division of Neurology, Queen's University, Kingston, Ontario, Canada
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
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Yaktine N, Fares S, Khoury SJ, Darwish H. Psychometric validation of the Arabic multiple sclerosis resiliency scale: Uncovering resilience factors in Lebanese MS patients for clinical and research advancements. eNeurologicalSci 2024; 34:100489. [PMID: 38162985 PMCID: PMC10755527 DOI: 10.1016/j.ensci.2023.100489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Background Multiple sclerosis (MS) is an autoimmune demyelinating disease that involves the central nervous system (CNS). Individuals with Multiple Sclerosis (MS) may experience difficulty adapting to their diagnosis as the unpredictable nature of the disease can be challenging to cope with. Methods The purpose of this study is twofold. First, we have culturally adapted and analyzed the Arabic version of the Multiple Sclerosis Resiliency Scale (MSRS) psychometric properties. Second, we aimed to explore resilience in a sample of Lebanese patients with MS in the face of the chronic disease and financial hardship that Lebanon is going through to evaluate their strengths and struggles. The sample consisted of 306 participants aged between 18 and 79 diagnosed with MS for at least one year. Results After examining criterion validity, construct validity, internal consistency, and test-retest reliability, the Arabic version of the MSRS exhibited good psychometric properties. The study also revealed that resilience increases with age and lower disability scores. Additionally, individuals with higher resilience levels displayed lower levels of depression. The research revealed that MS patients have high resilience, mainly relying on cognitive and emotional strategies, social support from family and friends, MS peer support, and spirituality. Conclusion These findings highlight the importance of emotional coping strategies and social support in building resilience among MS patients.
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Affiliation(s)
- Nour Yaktine
- Department of Psychology, Saint Joseph University of Beirut, Beirut, Lebanon
- American University of Beirut, Beirut, Lebanon
| | - Souha Fares
- Hariri School of Nursing, American University of Beirut, Lebanon
| | - Samia J. Khoury
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut, Lebanon
| | - Hala Darwish
- School of Nursing and Department of Neurology, University of Michigan, 400 North Ingalls, Rm 4345, Ann Arbor, MI 48109, United States of America
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Riley C, Venkatesh S, Dhand A, Doshi N, Kavak K, Levit E, Perrone C, Weinstock-Guttman B, Longbrake E, De Jager P, Xia Z. Impact of the COVID-19 Pandemic on the Personal Networks and Neurological Outcomes of People With Multiple Sclerosis: Cross-Sectional and Longitudinal Case-Control Study. JMIR Public Health Surveill 2024; 10:e45429. [PMID: 38319703 PMCID: PMC10879979 DOI: 10.2196/45429] [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: 12/30/2022] [Revised: 08/05/2023] [Accepted: 08/31/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has negatively affected the social fabric. OBJECTIVE We evaluated the associations between personal social networks and neurological function in people with multiple sclerosis (pwMS) and controls in the prepandemic and pandemic periods. METHODS During the early pandemic (March-December 2020), 8 cohorts of pwMS and controls completed a questionnaire quantifying the structure and composition of their personal social networks, including the health behaviors of network members. Participants from 3 of the 8 cohorts had additionally completed the questionnaire before the pandemic (2017-2019). We assessed neurological function using 3 interrelated patient-reported outcomes: Patient Determined Disease Steps (PDDS), Multiple Sclerosis Rating Scale-Revised (MSRS-R), and Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function. We identified the network features associated with neurological function using paired 2-tailed t tests and covariate-adjusted regressions. RESULTS In the cross-sectional analysis of the pandemic data from 1130 pwMS and 1250 controls during the pandemic, having a higher percentage of network members with a perceived negative health influence was associated with worse disability in pwMS (MSRS-R: β=2.181, 95% CI 1.082-3.279; P<.001) and poor physical function in controls (PROMIS Physical Function: β=-5.707, 95% CI -7.405 to -4.010; P<.001). In the longitudinal analysis of 230 pwMS and 136 controls, the networks of all participants contracted, given an increase in constraint (pwMS-prepandemic: mean 52.24, SD 15.81; pwMS-pandemic: mean 56.77, SD 18.91; P=.006. Controls-prepandemic: mean 48.07, SD 13.36; controls-pandemic: mean 53.99, SD 16.31; P=.001) and a decrease in network size (pwMS-prepandemic: mean 8.02, SD 5.70; pwMS-pandemic: mean 6.63, SD 4.16; P=.003. Controls-prepandemic: mean 8.18, SD 4.05; controls-pandemic: mean 6.44, SD 3.92; P<.001), effective size (pwMS-prepandemic: mean 3.30, SD 1.59; pwMS-pandemic: mean 2.90, SD 1.50; P=.007. Controls-prepandemic: mean 3.85, SD 1.56; controls-pandemic: mean 3.40, SD 1.55; P=.01), and maximum degree (pwMS-prepandemic: mean 4.78, SD 1.86; pwMS-pandemic: mean 4.32, SD 1.92; P=.01. Controls-prepandemic: mean 5.38, SD 1.94; controls-pandemic: mean 4.55, SD 2.06; P<.001). These network changes were not associated with worsening function. The percentage of kin in the networks of pwMS increased (mean 46.06%, SD 29.34% to mean 54.36%, SD 30.16%; P=.003) during the pandemic, a change that was not seen in controls. CONCLUSIONS Our findings suggest that high perceived negative health influence in the network was associated with worse function in all participants during the pandemic. The networks of all participants became tighter knit, and the percentage of kin in the networks of pwMS increased during the pandemic. Despite these perturbations in social connections, network changes from the prepandemic to the pandemic period were not associated with worsening function in all participants, suggesting possible resilience.
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Affiliation(s)
- Claire Riley
- Columbia University Irving Medical Center, New York, NY, United States
| | | | - Amar Dhand
- Brigham and Women's Hospital, Boston, MA, United States
| | - Nandini Doshi
- University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Elle Levit
- Yale University, New Haven, CT, United States
| | | | | | | | - Philip De Jager
- Columbia University Irving Medical Center, New York, NY, United States
| | - Zongqi Xia
- University of Pittsburgh, Pittsburgh, PA, United States
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Fournier H, Hasdenteufel M, Garrouteigt C, Perie M, Gliksohn A, Jouanne B, Hadj-Rabia S, Arveiler B, Morice-Picard F, Quintard B. The experience of albinism in France: a qualitative study on dyads of parents and their adult child with albinism. BMC Med 2024; 22:40. [PMID: 38281904 PMCID: PMC10823752 DOI: 10.1186/s12916-024-03251-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/09/2024] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND To date, almost no research on the psychosocial implications of albinism has been conducted in France and an exploration of albinism-related experiences could be beneficial, in order to better understand this condition. The aim of this study was to examine how French people with albinism and their parents live with and adapt to this condition in all the areas of their lives. METHODS Semi-structured phone interviews were conducted with 9 parent-child dyads, each participating separately. Participants were recruited by convenience sampling, thanks to the combined efforts of a patient association (Genespoir) and professionals from the partner medical referral centers involved in the project. Dyads in which the individual with albinism had any comorbidity were excluded. The interviews were then transcribed and subjected to in-depth thematic analysis. Two codebooks were constructed in a mirrored process: one for people with albinism; the other for their parents. They were finally merged at the end of the coding step. RESULTS Four main categories were identified: personal perceptions and social representations of albinism, difficulties and obstacles encountered by people with albinism, resources and facilitators, and the importance of parent-child functioning. The results indicated that experiences of stigmatization during childhood and adolescence are common and that people with albinism face challenges in adapting to certain obstacles related to their visual impairments (VI) (e.g., inability to drive a car; eye strain...). Parents emerged as one, if not as the main, source of support for people with albinism throughout their development. Although external support systems exist to assist them in various aspects of their lives, some of them primarily rely on their own personal resources to cope. CONCLUSIONS This research highlights the importance of a systemic and transdisciplinary approach to make sure families receive the support that best meets their needs.
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Affiliation(s)
- Hugo Fournier
- Laboratory of Psychology (LabPsy) UR 4139, University of Bordeaux, Bordeaux, F-33000, France.
| | - Marie Hasdenteufel
- Laboratory of Psychology (LabPsy) UR 4139, University of Bordeaux, Bordeaux, F-33000, France
| | - Constance Garrouteigt
- Laboratory of Psychology (LabPsy) UR 4139, University of Bordeaux, Bordeaux, F-33000, France
| | - Mathieu Perie
- National Institute for Research in Digital Science and Technology, Talence, F-33405, France
| | - Antoine Gliksohn
- Genespoir Association, Rennes, F-35000, France
- Global Albinism Alliance, Fontenay-sous-Bois, F-94120, France
| | | | | | - Benoit Arveiler
- CHU Bordeaux, Bordeaux, F-33404, France
- Laboratory of Rare Diseases: Genetics and Metabolism (MRGM) INSERM U1211, University of Bordeaux, Bordeaux, F-33076, France
| | | | - Bruno Quintard
- Laboratory of Psychology (LabPsy) UR 4139, University of Bordeaux, Bordeaux, F-33000, France
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Riegler KE, Beauvais J, Neto LO, Gromisch ES. The association between sleep disorders and resilience in persons with multiple sclerosis. Mult Scler Relat Disord 2024; 81:105137. [PMID: 37979407 DOI: 10.1016/j.msard.2023.105137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 11/20/2023]
Abstract
While lower resilience has been connected to self-reported sleep problems in persons with multiple sclerosis (PwMS), there has yet to be an examination with diagnosed sleep disorders. This study examined differences in resilience (MS Resiliency Scale) between PwMS with sleep disorders (n = 27), sleep problems (n = 39), and no sleep disorders/problems (n = 46). PwMS with sleep disorders had significantly lower resilience than PwMS with no sleep disorders/problems (p = .035), with support from family and friends driving this difference. These findings further illustrate the connection between sleep and resilience in PwMS, highlighting the importance of social support in this relationship.
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Affiliation(s)
- Kaitlin E Riegler
- Psychology Service, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 84401, USA; Department of Psychology, The Pennsylvania State University, 140 Moore Building, University Park, PA 16802, USA
| | - John Beauvais
- Psychology Service, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 84401, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT 06511, USA
| | - Lindsay O Neto
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT 06112, USA; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT 06473, USA
| | - Elizabeth S Gromisch
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT 06112, USA; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT 06473, USA; Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT 06473, USA; Department of Neurology, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA.
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Manche S, Probst Y. Exploring the socio-ecological factors impacting lifestyle management of multiple sclerosis: A scoping review. Mult Scler Relat Disord 2023; 79:104958. [PMID: 37708822 DOI: 10.1016/j.msard.2023.104958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 08/01/2023] [Accepted: 08/20/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic, autoimmune, neurodegenerative disorder affecting over 2.9 million people worldwide. First line care revolves around disease modifying therapy and supporting people living with MS to manage their disease. Early management often sees lifestyle modification as people living with MS try to gain a sense of control. Lifestyle management is an evolving area of care with variable strength of evidence for different lifestyle factors. OBJECTIVE To explore factors that impact on the self-management of MS with a socio-ecological focus. METHODS A scoping review following the Joanna Briggs Institute guidelines for a systematic search was conducted across six databases with 9241 articles identified and 51 included in the review. The results were analysed in conjunction with the socio-ecological model considering the categories: individual, interpersonal, organisational, community, and public policy. RESULTS A map of health behaviour (lifestyle) factors extending across all levels of the socio-ecological model revealed a complex web of pathways to behavioural patterns impacting MS self-management. Factors followed a cascading effect towards either of two key principles: (1) self-identity or (2) accessibility. These principles in-turn impact on an individual's self-efficacy, and hence, effectiveness of MS self-management strategies. CONCLUSIONS MS care is highly individualised to the personal context and circumstances of the individual, with consideration towards suitable management strategies required. Healthcare professionals must consider these lifestyle influences and coordinate an approach to assisting people living with MS to self-manage their disease in relation to their personal circumstances. Person-centred care addressing both barriers and motivators to health behaviour changes is key to effective MS self-management.
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Affiliation(s)
- Sarah Manche
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.
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Broche-Perez Y, Jimenez-Morales RM, Vázquez-Gómez LA, Bauer J, Fernández-Fleites Z. Fear of relapse and quality of life in multiple sclerosis: The mediating role of psychological resilience. Mult Scler Relat Disord 2023; 79:105026. [PMID: 37839366 DOI: 10.1016/j.msard.2023.105026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/07/2023] [Accepted: 09/23/2023] [Indexed: 10/17/2023]
Abstract
The goal of this study was to examine the mediating role of psychological resilience in the relationship between fear of relapse and quality of life in a sample of patients with multiple sclerosis (PwMS). This cross-sectional study was developed online. A total of 240 PwMS were surveyed using the Multiple Sclerosis Quality of Life inventory, the Fear of Relapse Scale and the Connor-Davidson Resilience Scale. To perform the mediation analysis PROCESS macro was used. In our study, fear of relapse was a predictor of psychological resilience and quality of life, and psychological resilience was a predictor of quality of life. Finally, psychological resilience showed a mediating role in the relationship between fear of relapse and quality of life. Considering that resilience is a modifiable variable, the implementation of interventions aimed at enhancing resilience can have a favorable impact on the psychological well-being and quality of life of patients with multiple sclerosis.
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Affiliation(s)
- Yunier Broche-Perez
- Department of Psychology Central University "Marta Abreu" of Las Villas Santa Clara, Cuba
| | | | - Lázaro A Vázquez-Gómez
- Department of Neurology Arnaldo Milián Castro Provincial University Hospital Santa Clara, Cuba
| | - Johana Bauer
- Multiple Sclerosis Association of Argentina (EMA) Argentina
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Lee B, McDaniels B, Grenawalt TA. Resilience as a Moderator in the Relationship between Disability Related Stress and Community Participation in Individuals with Multiple Sclerosis. PSYCHOL HEALTH MED 2023; 28:2745-2755. [PMID: 35607736 DOI: 10.1080/13548506.2022.2072915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
Resilience can be defined as one's ability to maintain or return to relatively stable psychological and physical functioning despite stressful life events and adversity. For people with multiple sclerosis (MS), building resilience has been shown to contribute to enhanced positive rehabilitation and mental health outcomes. However, there is no literature examining the role of resilience influencing the relationship between disability-related stress and community participation in individuals with MS. The present study aimed to examine the moderating role of resilience between disability-related stress and community participation among people with MS. Our findings suggested that the effect of disability-related stress on community participation was influenced by resilience. Interventions targeting resilience may help individuals effectively cope with MS and increase community participation in meaningful life situations.
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Affiliation(s)
- Beatrice Lee
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, MI, United States
| | - Bradley McDaniels
- Department of Rehabilitation and Health Services, University of North Texas, Denton, TX, United States
| | - Teresa Ann Grenawalt
- Educational Studies in Psychology, Research Methodology, & Counseling, the University of Alabama, Tuscaloosa, AL, United States
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Yıldırım Üşenmez T, Öner U, Şanlı ME, Dinç M. The Effect of Spirituality on Psychological Resilience in Women with Breast Cancer Who Have Received Chemotherapy: A Cross-sectional Study from Turkey. JOURNAL OF RELIGION AND HEALTH 2023; 62:1964-1975. [PMID: 36131107 DOI: 10.1007/s10943-022-01668-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 06/15/2023]
Abstract
Spirituality involves all of the internal resources of the individual, including religion, the desire to live, and a commitment to life. This study was conducted to determine the effect of spirituality on psychological resilience in women with breast cancer who have received chemotherapy. The study was conducted in a chemotherapy unit between April and June 2022. The sample size of the current cross-sectional study consisted of 85 women who have received chemotherapy. For the measuring of spirituality and psychological resilience, the Spirituality Scale (SS) and the Brief Resilience Scale (BRS), respectively, were completed. In the current study, it was determined that there was a positive weak correlation between the mean SS total score and the mean BRS total score (r = 0.471, p < 0.05). In addition, among women with breast cancer who have received chemotherapy, spirituality accounted for 22% of the variance in psychological resilience (R2 = 0.22, p < 0.05). It can also be said that the level of spirituality of women may positively affect their psychological resilience.
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Affiliation(s)
- Tülay Yıldırım Üşenmez
- Atatürk Health Sciences Faculty, Department of Psychiatric and Mental Health Nursing, Dicle University, Diyarbakir, Turkey.
| | - Uğur Öner
- Health Sciences Faculty, Department of Nursing, Batman University, Batman, Turkey
| | - Mehmet Emin Şanlı
- Vocational Higher School of Health Services, Department of Medical Services and Techniques, Batman University, Batman, Turkey
| | - Mahmut Dinç
- Health Sciences Faculty, Department of Nursing, Batman University, Batman, Turkey
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Novak AM, Lev-Ari S. Resilience, Stress, Well-Being, and Sleep Quality in Multiple Sclerosis. J Clin Med 2023; 12:jcm12020716. [PMID: 36675644 PMCID: PMC9864697 DOI: 10.3390/jcm12020716] [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: 12/01/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
(1) Background: Multiple Sclerosis (MS) is a chronic, progressive, immune-mediated disorder that affects the Central Nervous System and is the most common cause of non-traumatic neurological disability in young adults. The study aimed to assess the levels of stress, resilience, well-being, sleep quality, and fatigue in Israeli people with MS (PwMS), and to examine the associations between these factors and the sociodemographic and clinical characteristics. These factors had never before been studied in conjunction in PwMS, nor had they been systematically addressed in Israel, the unique geopolitical situation of which may pose unique challenges. (2) Methods: This was a survey-based, cross-sectional study conducted through an Internet platform. (3) Results: Israeli PwMS who participated in the study were experiencing relatively high levels of stress and low resilience, poor sleep quality, and severe fatigue. The analysis revealed significant associations between resilience and stress, well-being, and anxiety, as well as stress and well-being, resilience, sleep quality, fatigue, and Clinically Isolated Syndrome (CIS). (4) Conclusions: the Israeli PwMS who participated in the study were experiencing higher levels of stress, lower resilience and worse sleep quality than PwMS in other countries, as compared to results previously reported in literature. The findings of this study ought to serve as a call to action for the MS care providers in Israel and warrant further research into the possible causes of the phenomenon and strategies to address it.
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Gromisch ES, Turner AP, Neto LO, Ruiz JA, Lo AC, Agresta T, Foley FW. Establishing the Test-Retest Reliability and Minimal Detectable Change of the Multiple Sclerosis Resiliency Scale. Int J MS Care 2023; 25:15-19. [PMID: 36711223 PMCID: PMC9881417 DOI: 10.7224/1537-2073.2021-126] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Multiple Sclerosis Resiliency Scale (MSRS) was designed to assess factors connected to resilience when facing MS-related challenges. Although the MSRS has demonstrated good internal consistency and construct validity, its test-retest reliability has yet to be established. Identifying the minimal detectable change (MDC) of the scale will also improve its utility as an outcome measure for resilience-based interventions. This study aimed to determine the test-retest reliability and MDC of the MSRS. METHODS Participants were 62 persons with MS who completed the MSRS twice, with a mean ± SD of 16.60 ± 3.97 days (range, 14-30 days) between assessments. Test-retest reliability was evaluated using a 2-way, random-effects, single-measurement intraclass correlation coefficient (ICC), with agreement between time 1 and time 2 visualized with a Bland-Altman plot. The MDC was calculated using the standard error of measurement with a 95% CI. RESULTS At time 1, the mean ± SD MSRS score was 77.19 ± 11.97 (range, 45.83-97.00); at time 2, the mean ± SD score was 76.38 ± 12.75 (range, 46-98). The MSRS total score had good test-retest reliability (ICC = 0.88), with the subscale ICCs ranging from 0.77 (MS Peer Support) to 0.93 (Spirituality). The MDC for the total score was 11.95. CONCLUSIONS These findings suggest that the MSRS has good test-retest reliability and that persons with MS with a difference of 12 points or more between assessments have experienced a reliable change. The results support the utility of the MSRS as a potential outcome measure for MS-related resilience.
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Affiliation(s)
- Elizabeth S. Gromisch
- From the Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT, USA (ESG, LON, JAR, ACL)
- From the Department of Rehabilitative Medicine (ESG, LON, JAR), Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA
- From the Department of Medical Sciences (ESG, JAR), Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA
- From the Department of Neurology, University of Connecticut School of Medicine, Farmington, CT, USA (ESG)
| | - Aaron P. Turner
- From the Multiple Sclerosis Center of Excellence West, Veterans Affairs, Seattle, WA, USA (APT)
- From Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA, USA (APT)
- From the Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA (APT)
- From the Department of Family Medicine and the Center for Quantitative Medicine, University of Connecticut Health Center, Farmington, CT, USA (TA)
| | - Lindsay O. Neto
- From the Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT, USA (ESG, LON, JAR, ACL)
- From the Department of Rehabilitative Medicine (ESG, LON, JAR), Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA
| | - Jennifer A. Ruiz
- From the Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT, USA (ESG, LON, JAR, ACL)
- From the Department of Rehabilitative Medicine (ESG, LON, JAR), Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA
- From the Department of Medical Sciences (ESG, JAR), Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA
| | - Albert C. Lo
- From the Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT, USA (ESG, LON, JAR, ACL)
| | - Thomas Agresta
- From the Department of Family Medicine and the Center for Quantitative Medicine, University of Connecticut Health Center, Farmington, CT, USA (TA)
| | - Frederick W. Foley
- From Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA (FWF)
- From Holy Name Medical Center Multiple Sclerosis Center, Teaneck, NJ, USA (FWF)
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An Analysis and Evaluation of Kumpfer's Resilience Framework. ANS Adv Nurs Sci 2023; 46:88-100. [PMID: 36044351 DOI: 10.1097/ans.0000000000000446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Kumpfer's resilience framework (KRF) was initially developed from evidence on resilience and its predictors among at-risk youth. This framework has been expanded to guide resilience research in diverse populations facing a variety of stressors. However, KRF's strengths and weaknesses have not been evaluated since its publication. Guided by Walker and Avant's method, an analysis of KRF was conducted drawn from 41 publications. A revised KRF diagram was proposed on the basis of the analysis to improve clarity, consistency, logical structure, and parsimony in the diagram of KRF. Overall, KRF provides a useful, generalizable, and testable theoretical framework for future resilience research.
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13
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Johnson U, Hertting K, Ivarsson A, Lindgren EC. Favorable Adaptation during SARS-CoV-2-Pandemic as Told by Student-Athletes-A Longitudinal and Behavioral Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12512. [PMID: 36231812 PMCID: PMC9564911 DOI: 10.3390/ijerph191912512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: The aim was to explore the impact of adaptive responses (resilience factors) on student-athletes' behaviors during a stressful period of life during the SARS-CoV-2-pandemic of 2020 and 2021. (2) Methods: A constructivist-based grounded theory (CGT) was used guided by a biopsychosocial approach. Based on purposeful sampling, 22 male and female student-athletes were divided into four focus group interviews (FGI) seven months after the outbreak of the SARS-CoV-2-pandemic (October 2020) and 18 of these were followed up by FGI seven months later (May 2021). The mean age was 17.65 and they represented golf and handball. (3) Results: The CGT contained four main categories seven months after the SARS-CoV-2-pandemic outbreak: Social support, Self-discipline, Physical practice and recovery and Management of everyday life. Fourteen months after the SARS-CoV-2-pandemic outbreak, four additional main categories emerged: More extensive social support, Belief in the future, Self-awareness and Responsibility and problem-solving. (4) Conclusions: The CTG suggests that student-athletes' favorable adaptations to the stressful SARS-CoV-2-pandemic period 2020-2021 are based on a gradually developed ability to take responsibility for one's own actions, insight into the importance of deepened social interaction, belief in a positive post-COVID future and increased awareness of physical activity and its relation to perceived health.
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Affiliation(s)
- Urban Johnson
- School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden
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14
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Using a Clinical Formulation to Understand Psychological Distress in People Affected by Huntington’s Disease: A Descriptive, Evidence-Based Model. J Pers Med 2022; 12:jpm12081222. [PMID: 35893316 PMCID: PMC9332789 DOI: 10.3390/jpm12081222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/19/2022] [Accepted: 07/19/2022] [Indexed: 11/17/2022] Open
Abstract
Huntington’s disease (HD) is an inherited, life-limiting neurodegenerative condition. People with HD experience changes in cognitive, motor and emotional functioning, and can also, mainly at later stages, exhibit behaviours that professionals and carers might find distressing such as hitting others, throwing objects, swearing or making inappropriate comments. While clinical formulation (an individualised approach used by mental health professionals to describe an individual’s difficulties) is a helpful tool to conceptualise patients’ wellbeing, a specific formulation framework has not yet been developed for HD. However, evidence has shown that formulation can help guide clinical interventions and increase consistency of approach across multi-disciplinary teams, refine risk management, and improve staff or carers’ empathic skills and understanding of complex presentations. As a consequence, this paper proposes a new clinical formulation model for understanding distress among people with HD, based on a biopsychosocial framework. More specifically, this includes key elements centring on an individual’s past experience and personal narratives, as well as anticipatory cognitions and emotions about the future. In-depth discussions regarding the components of the model and their importance in HD formulations are included, and a fictional yet representative case example is presented to illustrate their application within the context of personalised care.
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15
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Lee B, Rumrill P, Tansey TN. Examining the Role of Resilience and Hope in Grit in Multiple Sclerosis. Front Neurol 2022; 13:875133. [PMID: 35651340 PMCID: PMC9150841 DOI: 10.3389/fneur.2022.875133] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to examine the effects of resilience and hope on grit when controlling for demographic covariates, depression, and anxiety in people with multiple sclerosis (MS). This was a cross-sectional study with a sample of 348 participants with MS. Descriptive statistics were performed to examine participants' demographic characteristics. A three-step hierarchical regression analysis was conducted to evaluate the extent to which resilience and hope explain the unique variance in grit while controlling for demographic covariates, depression, and anxiety. Findings suggested that resilience and hope explained a significant amount of variance in grit when controlling for demographic covariates, depression, and anxiety. Furthermore, higher resilience and hope scores were associated with higher grit scores. Given that resilience, hope, and grit are modifiable, rehabilitation and mental health professionals (e.g., psychologists, psychiatrists, rehabilitation counselors) can integrate strength-based interventions into their practices to bolster resilience, hope, and grit in people with MS. Our paper also has implications for interdisciplinary research and clinical practice.
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Affiliation(s)
- Beatrice Lee
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, MI, United States
| | - Phillip Rumrill
- Human Development Institute, University of Kentucky, Lexington, KY, United States
| | - Timothy N Tansey
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, Madison, WI, United States
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16
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Broche-Pérez Y, Jiménez-Morales RM, Monasterio-Ramos LO, Bauer J. Validity and reliability of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) in a sample of Spanish-speaking patients with Multiple Sclerosis. Mult Scler Relat Disord 2022; 63:103914. [DOI: 10.1016/j.msard.2022.103914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/12/2022] [Accepted: 05/26/2022] [Indexed: 11/25/2022]
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17
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Karademas EC, Simos P, Pat-Horenczyk R, Roziner I, Mazzocco K, Sousa B, Stamatakos G, Tsakou G, Cardoso F, Frasquilho D, Kolokotroni E, Marzorati C, Mattson J, Oliveira-Maia AJ, Perakis K, Pettini G, Vehmanen L, Poikonen-Saksela P. The Interplay Between Trait Resilience and Coping Self-efficacy in Patients with Breast Cancer: An International Study. J Clin Psychol Med Settings 2022; 30:119-128. [PMID: 35488971 DOI: 10.1007/s10880-022-09872-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2022] [Indexed: 01/22/2023]
Abstract
The role of self-efficacy to cope with breast cancer as a mediator and/or moderator in the relationship of trait resilience to quality of life and psychological symptoms was examined in this study. Data from the BOUNCE Project ( https://www.bounce-project.eu/ ) were used. Women diagnosed with and in treatment for breast cancer (N = 484), from four countries, participated in the study. Trait resilience and coping self-efficacy were assessed at baseline (soon after the beginning of systemic treatment), and outcomes (quality of life, psychological symptoms) 3 months later. Hierarchical regression, mediation, moderation, and conditional (moderated) mediation and moderation analyses were performed to examine the study hypotheses. Coping self-efficacy mediated the impact of trait resilience. In addition, higher levels of resilience in combination with higher levels of coping self-efficacy were associated with better outcomes. Country of origin had no impact on these results. Overall, it seems that coping self-efficacy is a key factor that should be taken into account for research and intervention efforts in cancer.
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Affiliation(s)
- E C Karademas
- Department of Psychology, University of Crete, and Foundation for Research and Technology - Hellas, Rethymno, Greece.
| | - P Simos
- Medical School, University of Crete, and Foundation for Research and Technology - Hellas, Heraklion, Greece
| | - R Pat-Horenczyk
- Department of Communication Disorders, Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel
| | - I Roziner
- Department of Communication Disorders, Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel
| | - K Mazzocco
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology & Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - B Sousa
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Champalimaud Research, Lisbon, Portugal
| | - G Stamatakos
- Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - G Tsakou
- SingularLogic S.A, Athens, Greece
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal
| | - D Frasquilho
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal
| | - E Kolokotroni
- Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - C Marzorati
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
| | - J Mattson
- Helsinki University Hospital Comprehensive Cancer Center, Helsinki University, Helsinki, Finland
| | - A J Oliveira-Maia
- Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, and NOVA Medical School, NMS, Universidade Nova de Lisboa, Lisbon, Portugal
| | | | - G Pettini
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
| | - L Vehmanen
- Helsinki University Hospital Comprehensive Cancer Center, Helsinki University, Helsinki, Finland
| | - P Poikonen-Saksela
- Helsinki University Hospital Comprehensive Cancer Center, Helsinki University, Helsinki, Finland
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18
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Li J, Bishop M, Fraser R, Rumrill PD, LaRocca N, Burns M, Lee D, Bhattarai M. Quality of life and experience with the national multiple sclerosis society strategic plan priorities for people with multiple sclerosis: Findings from a path analysis. Work 2022; 71:987-1005. [DOI: 10.3233/wor-205038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: The National Multiple Sclerosis Society (NMSS) strives to ensure that people affected by multiple sclerosis (MS) can live their best lives. This mission is reflected in the Society’s strategic plan, which establishes the roadmap for the Society’s continued commitment to a world free of MS. OBJECTIVE: The purpose of this article is to add to the understanding of both the scope and complexity of the impact of MS and MS-related supports on quality of life (QOL). METHODS: A national sample of people with MS (n = 748) participated in the study by completing validated surveys assessing their QOL, physical and mental health, MS self-efficacy, resilience, participation in NMSS, perceived stress, emotional support, and social roles and activities. A path model was used to examine how the frequently identified MS QOL predictors, including demographic, MS, psychosocial, and physical functional status variables relate to each other and to QOL. RESULTS: The model exhibited reasonable model fit with hypothesized paths being statistically significant and in the hypothesized direction. CONCLUSION: Findings revealed that the relationships among mental health, demographic factors, overall MS experiences, QOL, NMSS participation, and resonance with the mission of the NMSS are complex, highly nuanced, and yet strongly correlated. More importantly, the study highlights the strong influence of variables that are more readily amenable to change through programmatic and clinical intervention, and active self-management and participation.
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Affiliation(s)
- Jian Li
- Kent State University, Kent, OH, USA
| | | | | | | | | | - Maura Burns
- National Multiple Sclerosis Society, New York, NY, USA
| | - Deborah Lee
- University of Wisconsin-Madison, Madison, WI, USA
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19
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Sadeghi-Bahmani D, Kidwell A, Bollaert R, Motl RW. Resilience among older adults with multiple sclerosis: Pattern and correlates. Mult Scler Relat Disord 2022; 57:103360. [PMID: 35158431 DOI: 10.1016/j.msard.2021.103360] [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: 05/28/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is an increasing number of older adults with multiple sclerosis (MS) who present with significant challenges associated with aging in conjunction with a chronic, disabling disease. Resilience has been associated with healthy aging in the general population, yet there is limited research on resilience and its correlates among older adults with MS. The current study investigated the difference in resilience between older adults with MS and demographically matched healthy controls. We then examined the associations between resilience and functional, symptomatic, socio-behavioral, and QOL outcomes, along with demographic and clinical characteristics, among only older adults with MS. METHOD The sample included 40 older adults with MS and 40 sex and age matched healthy controls who completed measures of resilience and a battery of demographic, clinical, functional, symptomatic, socio-behavioral, and QOL outcomes. RESULT There were no differences between older adults with MS and healthy controls regarding overall resilience scores and resilience subscale scores. Resilience was significantly associated with neurological disability, depression, walking performance, self-efficacy, and purpose in life. CONCLUSION This study suggests that resilience in older adults with MS was comparable with healthy older adults, and positively associated with walking performance, self-efficacy, and purpose of life, and negatively associated with depression and neurological disability. We believe the time is ripe for developing and delivering interventions among those with lower resilience for improving resilience and associated secondary outcomes.
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Affiliation(s)
| | - Ariel Kidwell
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rachel Bollaert
- Program in Exercise Science, Department of Physical Therapy, Marquette University, Wisconsin, WI, USA
| | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
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20
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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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21
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Randolph JJ, Randolph JS, Wishart HA. Subgroup Analysis of Individuals with Multiple Sclerosis Showing Cognitive Resilience. Arch Clin Neuropsychol 2021; 37:302-308. [PMID: 34386812 DOI: 10.1093/arclin/acab067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Cognitive dysfunction is known to occur in many individuals with multiple sclerosis (MS). However, little is currently known about MS patients without cognitive impairment, including protective factors associated with intact cognition. The present study considered these issues in a sample of MS patients screened for intact subjective and objective cognitive functioning. METHODS Two MS participant groups from a larger sample were derived: i) participants within 1 standard deviation of controls on measures of objective cognition, subjective cognition, and informant-observed subjective cognition [cognitively resilient MS group (MScr)], and ii) those classified as not cognitively resilient (MSncr). Both groups were compared with age- and gender-matched controls. RESULTS Findings indicated that the MScr group was similar to the MSncr group on most disease and demographic variables, and level of fatigue. The MScr group showed higher estimated baseline intellectual ability and reported less anxiety, subclinical depressive symptoms, and pain interference. MScr participants also showed a trend toward more reported compensatory cognitive strategy use than MSncr participants. The MScr group showed comparable reading recognition and pain symptoms to controls. CONCLUSIONS Our findings provide preliminary information on factors associated with cognitive resilience in MS. Future research should examine resilient individuals with MS to further clarify positive outcomes in this condition.
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Affiliation(s)
- John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.,Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | - Jennifer S Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.,Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | - Heather A Wishart
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
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22
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Gromisch ES, Neto LO, Sloan J, Tyry T, Foley FW. Using the multiple sclerosis resiliency scale to identify psychological distress in persons with multiple sclerosis. Mult Scler Relat Disord 2021; 53:103079. [PMID: 34157629 DOI: 10.1016/j.msard.2021.103079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The Multiple Sclerosis Resiliency Scale (MSRS) is the first resilience measure that is specific to multiple sclerosis (MS)-related challenges. In order for the MSRS to be a valuable tool for clinicians, it is important to identify what is a meaningful score. As such, this study aimed to examine the MSRS' ability to identify persons with MS experiencing depression or anxiety symptoms, as determined using clinically significant scores on the Hospital Anxiety and Depression Scale (HADS). METHODS Participants (n = 884) were persons with MS who were recruited electronically primarily through the North American Research Committee on MS (NARCOMS). In addition to the MSRS, participants completed the HADS, which was used to categorize them into possible depression and anxiety groups using two criteria from the literature: ≥8 and ≥11. Receiver-operating-characteristic (ROC) curves were run to determine the MSRS total and subscale scores' classification accuracies, with optimal scores for detecting possible depression and anxiety cases determined using the Youden index. RESULTS The MSRS total score's classification accuracy ranged between 86.2% and 92.2% for depression, with scores of 70 and 68 for the ≥8 and ≥11 criteria, respectively. For anxiety, the MSRS total score's classification accuracy ranged between 78.1% and 82.8%, with scores of 72 and 71 for the ≥8 and ≥11 criteria, respectively. The Emotional and Cognitive Strategies subscale had the strongest classification accuracy of all the subscales. CONCLUSIONS The MSRS can be used to identify persons with MS experiencing mental health difficulties with relatively good classification accuracy, which may help clinicians to triage who needs additional assistance or support.
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Affiliation(s)
- Elizabeth S Gromisch
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT, 06112, USA; Department of Neurology, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, 06030, USA; Departments of Rehabilitative Medicine; Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT, 06473, USA.
| | - Lindsay O Neto
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT, 06112, USA; Departments of Rehabilitative Medicine
| | - Jessica Sloan
- Rocky Mountain Regional Veterans Affairs Medical Center, 1700 N Wheeling Street, Aurora, CO, 80045, USA
| | - Tuula Tyry
- Dignity Health, St. Joseph's Hospital and Medical Center, 350 W Thomas Road, Phoenix, AZ, 85013, USA
| | - Frederick W Foley
- Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Bronx, NY, 10468, USA; Holy Name Medical Center Multiple Sclerosis Center, 718 Teaneck Road, Teaneck, NJ, 07666, USA
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23
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Demirtepe-Saygılı D. Multiple sclerosis experiences of couples: Examination of patient and partner perspectives. J Health Psychol 2021; 27:2079-2090. [PMID: 34111986 DOI: 10.1177/13591053211017192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The study aims to investigate Multiple Sclerosis (MS) experiences of couples. Using a dyadic qualitative method, separate simultaneous interviews were conducted with 20 couples, including one partner with MS. The themes resulting from content analysis were examined in two categories: Convergent (anxiety about future, acceptance of MS and MS as an accelerator of the relationship) and divergent (sexual problems, the experience of MS symptoms, the priority of the problems and untold issues). The findings revealed shared and unique perspectives of partners in the illness process, having the potential to guide the psychosocial interventions for couples living with a chronic illness.
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The Relationship between Spiritual Well-Being and Resilience in Patients with Psoriasis. Dermatol Res Pract 2021; 2021:8852730. [PMID: 33854545 PMCID: PMC8019391 DOI: 10.1155/2021/8852730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 02/02/2021] [Accepted: 03/18/2021] [Indexed: 11/30/2022] Open
Abstract
Psoriasis skin disease affects the patients' health and quality of life to a great extent. Given the chronic nature of the disease, identifying the factors affecting adaptation to the disease can provide guidelines required for helping these patients deal with their problems. This study was conducted with the purpose of investigating the relationship between spiritual well-being and resilience in patients suffering from psoriasis. The present study is a descriptive-analytical work conducted in the largest city in the south of Iran in 2019. 150 patients diagnosed with psoriasis completed Ellison and Paloutzian's Spiritual Well-Being Scale and Connor and Davidson's Resiliency Scale. Data were analyzed using SPSS v. 20, descriptive (frequency distribution, mean, and standard deviation) and inferential statistics (Pearson, regression, and t-test). The significance level was set at 0.05. The obtained mean scores were 54.84 ± 13.25 for resilience and 73.22 ± 11.13 for spiritual health. Spiritual health predicted 43% of the variance of resilience, and all resilience-related factors had a significant positive relationship with spiritual well-being-related factors (P > 0.05). An analysis of the relationship between demographic variables on the one hand and resilience and spiritual well-being on the other indicated that an increase in the patients' academic status, duration of the disease, and age correlated with an increase in their resilience and spiritual well-being. Also, male patients and married patients were found to possess higher levels of resilience and spiritual well-being. According to the findings of the present study, spiritual well-being correlates with resilience in patients with psoriasis. Considering the chronic nature of the disease, it is recommended that more attention be paid to promoting spiritual health in the care plans of these patients.
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25
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Donisi V, Gajofatto A, Mazzi MA, Gobbin F, Busch IM, Ghellere A, Klonova A, Rudi D, Vitali F, Schena F, Del Piccolo L, Rimondini M. A Bio-Psycho-Social Co-created Intervention for Young Adults With Multiple Sclerosis (ESPRIMO): Rationale and Study Protocol for a Feasibility Study. Front Psychol 2021; 12:598726. [PMID: 33708157 PMCID: PMC7940381 DOI: 10.3389/fpsyg.2021.598726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/18/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS), the most common neurological disease that causes disability in youth, does not only affect physical functions but is also associated with cognitive impairment, fatigue, depression, and anxiety and can significantly impact health-related quality of life (HRQoL). Since MS is generally diagnosed at a young age-a period of great significance for personal, relational, and professional development-adaptation can become highly challenging. Therefore, enhancing the competence of young people to adaptively cope with these potential challenges is of utmost importance in order to promote their potentialities and talents. It has been shown that psychological interventions targeting MS patients can enhance resilience and HRQoL and that regular physical activity (PA) and social engagement can improve psychological well-being. However, literature on the development of global interventions based on the bio-psycho-social model of the disease is missing. Even less attention has been paid to interventions dedicated to young adults with MS (YawMS) and to the involvement of patients in the development of such programs. AIMS In collaboration with MS patients, this study aims to develop a bio-psycho-social intervention (ESPRIMO) for YawMS, aiming to improve their HRQoL and to explore its feasibility, acceptability, and effects. METHODS To tailor the intervention to the specific needs of YawMS, "patient engagement principles" will be adopted in the co-creation phase, performing a web survey and focus groups with patients and healthcare professionals. In the intervention phase, a pilot sample of 60 young adults with MS will be enrolled. The co-created intervention, composed of group sessions over a 12-week period, will cover psycho-social strategies and include physical activities. Adopting a longitudinal, pre-post evaluation design, self-report questionnaires measuring HRQoL and other bio-psycho-social features (e.g., resilience, well-being, mindfulness traits, self-efficacy, perceived social support, psychological symptoms, illness perception, committed action, fatigue, attitudes, subjective norms, perceived behavioral control, motivation, perception of autonomy support for PA, barriers and intentions to PA) will be administered, the quantity and quality of PA will be measured, and a questionnaire developed by the authors will be used to evaluate the feasibility and acceptability of the ESPRIMO intervention.
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Affiliation(s)
- Valeria Donisi
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alberto Gajofatto
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Maria Angela Mazzi
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesca Gobbin
- Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Isolde Martina Busch
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Annamaria Ghellere
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alina Klonova
- Section of Movement Sciences, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Latvian Academy of Sport Education, Riga, Latvia
| | - Doriana Rudi
- Section of Movement Sciences, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesca Vitali
- Section of Movement Sciences, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Schena
- Section of Movement Sciences, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Lidia Del Piccolo
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michela Rimondini
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Ovaska-Stafford N, Maltby J, Dale M. Literature Review: Psychological Resilience Factors in People with Neurodegenerative Diseases. Arch Clin Neuropsychol 2021; 36:283-306. [PMID: 31768521 DOI: 10.1093/arclin/acz063] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 09/16/2019] [Accepted: 10/07/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Psychological distress is frequently observed in neurodegenerative diseases (NDDs) having a significant impact on function, quality of life (QOL), caregiver burden, and illness cost. As higher psychological resilience can protect against negative outcomes and aid in the successful adjustment to illness, identifying resilience factors is important. Understanding what enhances or lowers psychological resilience allows us to offer support/interventions to people with NDDs and their carers starting early in the disease process. OBJECTIVE To investigate factors associated with psychological resilience in NDDs by completing a systematic review of relevant studies. METHOD Five electronic databases were searched for studies relating to psychological resilience in NDDs. Eighteen articles were reviewed using a narrative synthesis approach. RESULTS Studies with varied aims and methodologies were found. The identified factors were categorized into core, internal, and external resilience. Regarding core factors contradicting evidence was found about the relationship between resilience and physical function. Fatigue, however, appears to be associated with less resilience. A limited number of studies focused on pain and demographics. Of internal resilience factors, studies found positive associations between higher resilience and improved mental health, even over time. Resilience appears to correlate positively with various psychological and QOL factors. Importantly, external resilience factors (e.g., social connectedness and intervention) were discovered to be linked to resilience. The evidence for resilience-enhancing intervention suggests that resilience can be modified. CONCLUSION Various factors were identified to be associated with psychological resilience in NDDs. As resilience appears to be modifiable, it is important to focus on resilience-enhancing interventions for people with NDDs.
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Affiliation(s)
- Noora Ovaska-Stafford
- Neuroscience, Psychology, and Behaviour, College of Life Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - John Maltby
- Neuroscience, Psychology, and Behaviour, College of Life Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Maria Dale
- Leicestershire Partnership NHS Trust, Huntington's Disease Service, Mill Lodge, The Rise, Leicester, Leicestershire LE19 4SL, UK
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Lynskey SJ, Ling F, Greenberg AM, Penny-Dimri JC, Sutherland AG. The influence of patient resilience and health status on satisfaction after total hip and knee arthroplasty. Surgeon 2021; 19:8-14. [DOI: 10.1016/j.surge.2020.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/27/2020] [Accepted: 02/20/2020] [Indexed: 12/27/2022]
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Morse JM, Kent-Marvick J, Barry LA, Harvey J, Okang EN, Rudd EA, Wang CY, Williams MR. Developing the Resilience Framework for Nursing and Healthcare. Glob Qual Nurs Res 2021; 8:23333936211005475. [PMID: 33869667 PMCID: PMC8020405 DOI: 10.1177/23333936211005475] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/08/2021] [Accepted: 03/08/2021] [Indexed: 12/11/2022] Open
Abstract
Despite four decades of resilience research, resilience remains a poor fit for practice as a scientific construct. Using the literature, we explored the concepts attributed to the development of resilience, identifying those that mitigate symptoms of distress caused by adversity and facilitate coping in seven classes of illness: transplants, cancer, mental illness, episodic illness, chronic and painful illness, unexpected events, and illness within a dyadic relationship. We identified protective, compensatory, and challenge-related coping-concept strategies that healthcare workers and patients use during the adversity experience. Healthcare-worker assessment and selection of appropriate coping concepts enable the individual to control their distress, resulting in attainment of equanimity and the state of resilience, permitting the resilient individual to work toward recovery, recalibration, and readjustment. We inductively developed and linked these conceptual components into a dynamic framework, The Resilience Framework for Nursing and Healthcare, making it widely applicable for healthcare across a variety of patients.
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Affiliation(s)
- Janice M. Morse
- University of Utah, Salt Lake City, USA
- University of Alberta
| | | | - Lisa A. Barry
- University of Utah, Salt Lake City, USA
- Intermountain Healthcare, Primary Children’s Hospital, Salt Lake City, UT, USA
| | - Jennifer Harvey
- University of Utah, Salt Lake City, USA
- Alaska Native Medical Center, Anchorage, Alaska
| | | | | | | | - Marcia R. Williams
- University of Utah, Salt Lake City, USA
- Cedarville University, Ohio
- Kettering Health Network, Cedarville, Ohio
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Martin S, Kasser SL. The role of resilience: Physical activity continuation after falling in adults with multiple sclerosis. Disabil Health J 2020; 14:101046. [PMID: 33279462 DOI: 10.1016/j.dhjo.2020.101046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/29/2020] [Accepted: 11/24/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND As activity curtailment is common after a fall, the ability to harness resiliency is particularly salient for those with multiple sclerosis (MS) who fall frequently and who significantly benefit from remaining physically active. OBJECTIVE The purpose of the study was to identify resilience factors, coping processes, and benefit finding underscoring the continuation of physical activity after experiencing a fall in individuals with MS. METHODS Twelve individuals with MS (seven females and five males) participated in this qualitative study. Participants were asked general questions regarding their physical activity engagement and experiences around falling. Specific questions focused on health perceptions, personal characteristics, strategies and behaviors employed after a fall that related to remaining physically active, and any positives they perceived from falling. Transcribed interviews were analyzed and semantic themes identified. RESULTS From the data, specific protective factors, resilience processes, and benefit finding emerged to explain participant capability to bounce back and continue with physical activity after falling. These personal factors included Locus of Control, Perseverance, Positive Attitude and Optimism, and Flexibility. Resilience processes included Utilizing Support, Problem Based Coping, and Perspective Taking. Finally, the theme of Looking Beyond Oneself was identified as a benefit. CONCLUSIONS Understanding existing resilience factors that allow an individual to remain physically active after falling can potentially inform resilience-building interventions that broaden and build resilience resources and improve psychological and physical health in those with MS.
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Affiliation(s)
- Sierra Martin
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Susan L Kasser
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA.
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Reguera-García MM, Liébana-Presa C, Álvarez-Barrio L, Alves Gomes L, Fernández-Martínez E. Physical Activity, Resilience, Sense of Coherence and Coping in People with Multiple Sclerosis in the Situation Derived from COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218202. [PMID: 33172022 PMCID: PMC7664264 DOI: 10.3390/ijerph17218202] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/29/2020] [Accepted: 11/04/2020] [Indexed: 02/08/2023]
Abstract
The confinement forced by COVID-19 can have repercussions on the health of people diagnosed with multiple sclerosis. The objective of this study is to analyze the relationships between physical activity, a sense of coherence, resilience and coping among people diagnosed with Multiple Sclerosis during the health emergency situation. To achieve this goal, this transversal descriptive study included 84 patients that belonged to multiple sclerosis associations during the period of confinement. Participants filled out the Physical Activity (IPAQ-SF), Sense of Coherence (SOC-13), Resilience Scale (ER-14) and coping (COPE-28) questionnaires. The results showed that the average age was 46.9 and that 67.9% had Relapsing Remittent Multiple Sclerosis diagnosed on average 13.9 years ago. They had a high degree (33.3%) and moderate degree (34.5%) of physical activity, high levels of resilience, while the level of a sense of coherence was average and the most commonly used strategies for coping were active confrontation and religion. Physical activity was not related to the rest of the studied variables, but there were correlations between the other variables. The people with multiple sclerosis who belong to patient associations have remained physically active during the obligatory confinement period and have elevated degrees of resilience and an average sense of coherence, as well as using suitable coping strategies, which is why the social-health resource of belonging to a patient association could be boosting these variables that are beneficial to their health.
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Affiliation(s)
- María Mercedes Reguera-García
- SALBIS Research Group, Faculty of Health Sciences, Campus of Ponferrada, University of León, 24401 Ponferrada, Spain; (M.M.R.-G.); (E.F.-M.)
| | - Cristina Liébana-Presa
- SALBIS Research Group, Faculty of Health Sciences, Campus of Ponferrada, University of León, 24401 Ponferrada, Spain; (M.M.R.-G.); (E.F.-M.)
- Correspondence:
| | - Lorena Álvarez-Barrio
- Department of Nursing and Physiotherapy, Faculty of Health Sciences, Campus of Ponferrada, University of León, 24401 Ponferrada, Spain;
| | | | - Elena Fernández-Martínez
- SALBIS Research Group, Faculty of Health Sciences, Campus of Ponferrada, University of León, 24401 Ponferrada, Spain; (M.M.R.-G.); (E.F.-M.)
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Reliability and validity of the multiple sclerosis resiliency scale (MSRS). J Neurol Sci 2020; 418:116983. [DOI: 10.1016/j.jns.2020.116983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 01/25/2023]
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Halstead EJ. A feasibility study of a manualized resilience-based telehealth program for persons with multiple sclerosis and their support partners. Mult Scler J Exp Transl Clin 2020; 6:2055217320941250. [PMID: 32913660 PMCID: PMC7444140 DOI: 10.1177/2055217320941250] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 06/15/2020] [Accepted: 06/21/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Resilience is a protective factor that emerges when individuals are faced with challenges and stressors. Multiple sclerosis (MS) is a chronic neurological disease that introduces a great deal of stress for the individual and his/her support partner. We designed a telehealth resilience-building dyadic program for persons with MS (PwMS) and their support partners. OBJECTIVES To evaluate the feasibility of the resilience intervention. The secondary objective was to assess the benefits of the intervention. METHODS Sixty-two participants (M = 49.5 years, 31 dyads of PwMS) and support partners) were recruited to participate. Out of the 31 dyads, 26 were spouses, 2 were cohabiting partners, and 3 were parent-child dyads. RESULTS The feasibility goals of the intervention were met, as determined by high participant satisfaction and acceptable completion rates. Preliminary outcomes relating to resilience were positive, suggesting that this intervention had a positive impact on participants. CONCLUSIONS To the best of our knowledge, this is the first resilience-building intervention delivered via telehealth for both PwMS and their support partners. The study showed an increase in resilience-building skills for addressing the challenges faced by PwMS and their support partners. These skills can be promoted and taught, clinically supported by telehealth, an affordable, accessible healthcare solution. Trial Registration at ClinicalTrials.gov (NCT03555253).
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Kasser SL, Zia A. Mediating Role of Resilience on Quality of Life in Individuals With Multiple Sclerosis: A Structural Equation Modeling Approach. Arch Phys Med Rehabil 2020; 101:1152-1161. [DOI: 10.1016/j.apmr.2020.02.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 02/07/2023]
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Ploughman M, Downer MB, Pretty RW, Wallack EM, Amirkhanian S, Kirkland MC. The impact of resilience on healthy aging with multiple sclerosis. Qual Life Res 2020; 29:2769-2779. [DOI: 10.1007/s11136-020-02521-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2020] [Indexed: 02/07/2023]
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Fasczewski KS, Garner LM, Clark LA, Michels HS, Migliarese SJ. Medical Therapeutic Yoga for multiple sclerosis: examining self-efficacy for physical activity, motivation for physical activity, and quality of life outcomes. Disabil Rehabil 2020; 44:106-113. [PMID: 32393075 DOI: 10.1080/09638288.2020.1760364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: Multiple Sclerosis (MS) is an incurable neurodegenerative disease that results in deficits in physical and cognitive function, and often fosters low levels of self-efficacy for physical activity, motivation for physical activity, and quality of life [1]. Drug therapies, physical therapy rehabilitation, and lifestyle modifications such as increased physical activity are standard protocol for symptom management, yet persons with MS tend to be physically inactive [2,3]. Additionally, single-modality interventions do not inherently address the challenges faced concurrently by individuals with MS [4,5].Methods: This project examined the effects of a 5-week holistic biopsychosocial Medical Therapeutic Yoga program on physical activity behavior outcomes in individuals diagnosed with MS. A mixed-methods approach was used to examine self-efficacy for physical activity, motivation for physical activity, and quality of life outcomes in 15 participants.Results: Quantitative measures demonstrated increased self-efficacy (t(14) = -2.23, p = 0.042), and emotional quality of life (t(14) = -2.66, p = 0.019). Responses to an open-ended written questionnaire and follow-up interviews indicated overall positive response to the program including increases in self-efficacy for physical activity, motivation for physical activity, and quality of life. These results may help future holistic programming for individuals with MS incorporate behavioral interventions with therapeutic rehabilitation to increase physical activity adherence.IMPLICATIONS FOR REHABILITATIONMultiple sclerosis is a neurological disease impacting physical and cognitive functioning that may be managed with a combination of drug therapies, rehabilitation, and physical activity.Individuals diagnosed with multiple sclerosis tend to be physically inactive and physical inactivity is a challenge for optimal disease management.Medical Therapeutic Yoga offers an interdisciplinary biopsychosocial framework to simultaneously address the behavioral challenges and physical impairments facing individuals diagnosed with multiple sclerosis.Health care providers should consider developing programs that use a biopsychosocial framework to aid in developing long-term adherence in health behaviors such as physical activity participation.
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Affiliation(s)
| | - LaVerene M Garner
- Physical Therapy, Winston-Salem State University, Winston-Salem, NC, USA
| | - Lauren A Clark
- Health and Exercise Science, Appalachian State University, Boone, NC, USA
| | - Hannah S Michels
- Health and Exercise Science, Appalachian State University, Boone, NC, USA
| | - Sara J Migliarese
- Physical Therapy, Winston-Salem State University, Winston-Salem, NC, USA
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Battalio SL, Tang CL, Jensen MP. Resilience and Function in Adults With Chronic Physical Disabilities: A Cross-Lagged Panel Design. Ann Behav Med 2020; 54:297-307. [PMID: 31674642 PMCID: PMC7455804 DOI: 10.1093/abm/kaz048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Resilience is a psychological construct referring to one's positive adaptation in response to adversity. Evidence suggests that resilience may contribute to various function domains in adults with chronic physical disabilities. PURPOSE To test hypothesized temporal associations between resilience and four function domains (anxiety, depression, social role satisfaction, and physical function) in individuals with chronic physical disabilities. METHODS Participants were 1,574 adults with one of four chronic physical disabilities (spinal cord injury, muscular dystrophy, multiple sclerosis, or postpolio myelitis syndrome) who were participating in a large, ongoing USA-based longitudinal survey study. Three surveys were mailed on an approximately yearly basis. Resilience was assessed using the Connor-Davidson Resilience Scale 10-item (CDRSC-10) and each function domain was assessed using the respective Patient Reported Outcome Measurement System (PROMIS) short-form. RESULTS Cross-lagged path models evidenced statistically significant reciprocal relationships between resilience and each function domain except physical function. The standardized lagged coefficients corresponding to resilience predicting social role satisfaction (T1-T2 = 0.09, T2-T3 = 0.09) had similar effect sizes as those corresponding to social role satisfaction predicting resilience (T1-T2 = 0.11, T2-T3 = 0.04), although resilience was a slightly stronger predictor in the second lag. In models assessing psychological function, resilience was a stronger predictor of later psychological function (resilience-to-anxiety, T1-T2 = -0.15, T2-T3 = -0.11; resilience-to-depression, T1-T2 = -0.21, T2-T3 = -0.13) than the inverse (anxiety-to-resilience, T1-T2 = -0.11, T2-T3 = -0.06; depression-to-resilience, T1-T2 = -0.12, T2-T3 = -0.05). CONCLUSIONS The study findings suggest that resilience is a significant prospective predictor of psychological and social function over time in individuals with chronic physical disabilities.
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Affiliation(s)
- Samuel L Battalio
- Department of Rehabilitation Medicine, University of Washington, WA, USA
| | - Connie L Tang
- Department of Rehabilitation Medicine, University of Washington, WA, USA
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, WA, USA
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A resilience group training program for people with multiple sclerosis: Results of a pilot single-blind randomized controlled trial and nested qualitative study. PLoS One 2020; 15:e0231380. [PMID: 32271833 PMCID: PMC7145197 DOI: 10.1371/journal.pone.0231380] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/21/2020] [Indexed: 01/22/2023] Open
Abstract
Introduction An Australian case series study demonstrated the effectiveness of the REsilience and Activities for every DaY for people with multiple sclerosis (READY for MS), a resilience group training program based on Acceptance and Commitment Therapy, in improving quality of life in people with MS. This study aimed to evaluate the feasibility and acceptability of the Italian READY for MS program, and to preliminary assess its efficacy when compared to an active control intervention (group relaxation). Methods Single-blind phase II randomized controlled trial (RCT) and nested qualitative study (ISRCTN registration number: 38971970). Health-related quality of life (primary study outcome), mood, resilience, psychological flexibility and its protective factors were measured at baseline, after seven, 12 and 24 weeks. READY participants completed the purpose-built satisfaction questionnaire after 12 weeks. After trial completion, the control group also received READY. One-to-one participant interviews were conducted within three months of finishing the READY groups. Results Four intervention groups were conducted with 39 participants (20 READY, 19 relaxation). Two patients (READY) withdrew before beginning the intervention due to unexpected work commitments. Feasibility and acceptability of READY were good, with high participant engagement and satisfaction. No statistical effects of READY were detected vs relaxation. Thirty participants were interviewed (18 READY; 12 relaxation + READY). Content data analysis revealed seven overarching themes: “Attitudes towards participation”; “Perceptions of program composition”; “Program impacts on life domains”; “Program active elements”; “Program improvement trajectories”; “Program differences and similarities”; “Suggested READY improvements”. Conclusion READY was well accepted by MS patients with varied socio-demographic and clinical characteristics. Qualitative (but not quantitative) data provided evidence in favour of READY. Our findings will inform methodological and intervention refinements for the multi-centre RCT that will follow.
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Stern BZ, Strober LB, Goverover Y. Relationship between sensory processing patterns, trait anxiety, and health-related quality of life in multiple sclerosis. J Health Psychol 2020; 26:2106-2117. [PMID: 31992086 DOI: 10.1177/1359105319901316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Sensory processing patterns may predict health-related quality of life. This study examined this relationship in persons with multiple sclerosis considering trait anxiety as a potential mediator. Participants (n = 94) completed the Adolescent/Adult Sensory Profile and other self-report measures at one time point. Sensory processing patterns were significantly associated with trait anxiety and health-related quality of life. Direct and indirect effects of sensory processing patterns were identified on physical health-related quality of life, and indirect effects were identified on mental health-related quality of life. Facilitating adaptive behavioral responses to sensory information may promote health-related quality of life in this population.
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Fasczewski KS, Cook HM, Campbell KE, Anderes B. I ride for MS: The impact of bike MS participation on motivation for physical activity in individuals with multiple sclerosis. Disabil Health J 2019; 13:100853. [PMID: 31679952 DOI: 10.1016/j.dhjo.2019.100853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 10/07/2019] [Accepted: 10/15/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic neurodegenerative disease that results in deficits in physical and cognitive functioning. Research supports the use of physical activity (PA) to aid in MS symptom management and slow disease progression, however individuals diagnosed with MS are generally physically inactive. Social support has been shown to increase PA behavior in group exercise settings. Events such as Bike MS, a charity bicycle ride where individuals raise money for MS, could increase motivation for participation and therefore may be an ideal setting to introduce PA to individuals diagnosed with MS. OBJECTIVE /Hypothesis: The objective of the current research was to explore motives for participation in a Bike MS event in individuals diagnosed with MS and their family members, and examine if their Bike MS participation has translated to long-term PA behavior change and positive quality of life outcomes. METHODS A descriptive qualitative approach using semi-structured focus group, individual, and phone interviews, combined with observational field notes, was used to explore the experiences of seven individuals diagnosed with MS and four family members from two regional self-help groups who all actively participated in a Bike MS event. RESULTS Participants reported important social bonds, raising awareness for the cause, fundraising, long-term physical benefits, and overall increased quality of life as motives for participation. All participants reported long-term PA participation as a result of Bike MS participation. CONCLUSION Results support using Bike MS to increase long-term PA participation in individuals with MS, resulting in positive quality of life outcomes.
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Affiliation(s)
- Kimberly S Fasczewski
- Appalachian State University, Department of Health and Exercise Science, Boone, NC, USA.
| | - Hannah M Cook
- Appalachian State University, Department of Health and Exercise Science, Boone, NC, USA
| | - Katie E Campbell
- Appalachian State University, Department of Health and Exercise Science, Boone, NC, USA
| | - Blair Anderes
- Appalachian State University, Department of Health and Exercise Science, Boone, NC, USA
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Gajofatto A, Donisi V, Busch IM, Gobbin F, Butturini E, Calabrese M, Carcereri de Prati A, Cesari P, Del Piccolo L, Donadelli M, Fabene P, Fochi S, Gomez-Lira M, Magliozzi R, Malerba G, Mariotti R, Mariotto S, Milanese C, Romanelli MG, Sbarbati A, Schena F, Mazzi MA, Rimondini M. Biopsychosocial model of resilience in young adults with multiple sclerosis (BPS-ARMS): an observational study protocol exploring psychological reactions early after diagnosis. BMJ Open 2019; 9:e030469. [PMID: 31377712 PMCID: PMC6687017 DOI: 10.1136/bmjopen-2019-030469] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 07/06/2019] [Accepted: 07/12/2019] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Multiple sclerosis (MS), the most common neurological disease causing disability in young adults, is widely recognised as a major stress factor. Studies have shown that the first years after the diagnosis are distressing in terms of adjustment to the disease and that MS negatively affects patients' psychological well-being, quality of life (QoL) and social functioning. However, the links between disease-specific variables at diagnosis, resilience and psychological adjustment of patients with MS remain largely unexplored, especially in adolescents and young adults. This observational study aims to fill the gap of knowledge on biopsychosocial characteristics and resilience of young adults with MS to evaluate the relationship among these variables and to develop a biopsychosocial model of resilience. METHODS AND ANALYSIS Biological and clinical characteristics of young adults newly diagnosed with MS will be investigated by collecting clinical information, performing neurological examinations, MRI and analysing cerebrospinal fluid and blood biomarkers (eg, measures of inflammation), body composition, gut microbiota and movement/perceptual markers. Psychosocial characteristics (eg, psychological distress, coping strategies), QoL, psychological well-being and resilience will be assessed by self-report questionnaires. Comparative statistics (ie, analysis of variance or unpaired samples t-test, correlation and regression analyses) will be applied to evaluate the relationship among biological, psychological and social factors. The results are expected to allow a comprehensive understanding of the determinants of resilience in young patients with MS and to inform resilience interventions, tailored to young patients' specific needs, aiming to reduce the risk of maladaptive reactions to the disease and to improve psychological well-being and QoL. ETHICS AND DISSEMINATION The study has been approved by the Verona University Hospital Ethics Committee (approval number: 2029CESC). The findings will be disseminated through scientific publications in peer-reviewed journals, conference presentations, social media and specific websites. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT03825055).
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Affiliation(s)
- Alberto Gajofatto
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Valeria Donisi
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Isolde Martina Busch
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesca Gobbin
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Elena Butturini
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Massimiliano Calabrese
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Paola Cesari
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Lidia Del Piccolo
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Massimo Donadelli
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Paolo Fabene
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Stefania Fochi
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Macarena Gomez-Lira
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Roberta Magliozzi
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Giovanni Malerba
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Raffaella Mariotti
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sofia Mariotto
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Milanese
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Maria Grazia Romanelli
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Andrea Sbarbati
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Schena
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Maria Angela Mazzi
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michela Rimondini
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Amtmann D, Bamer AM, Nery-Hurwit MB, Liljenquist KS, Yorkston K. Factors associated with disease self-efficacy in individuals aging with a disability. PSYCHOL HEALTH MED 2019; 24:1171-1181. [PMID: 31033342 DOI: 10.1080/13548506.2019.1612082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Self-management of a disability consists of treatment adherence, obtaining information about the disease and treatment options, caring for oneself, participating in decisions, and maintaining social relationships and emotional balance. Understanding and measuring an individual's beliefs about their ability to successfully self-manage and live well with a disability allows researchers and clinicians to better target interventions aimed at increasing disability management self-efficacy (DMSE). The purpose of this study was to examine the associations between demographic and clinical indicators, and self-efficacy for DMSE in individuals with chronic physical conditions. Adults (N = 815) with muscular dystrophy, multiple sclerosis, spinal cord injury, or post-polio syndrome completed a self-report mailed survey assessing DMSE, perceived social support, depression symptoms, resilience, fatigue, pain interference, satisfaction with participation in social roles, physical function, and demographics. A cross-sectional regression model was used to examine the associations between the clinical and demographic factors, and DMSE. The model explained 67% of the variance in DMSE. Satisfaction with participation in social roles, resilience, pain interference, social support, and fatigue were statistically significant. Better social functioning, more resilience, and less pain and fatigue were most strongly associated with DMSE. Interventions aimed at increasing DMSE should include strategies for improving social participation.
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Affiliation(s)
- Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington , Seattle , WA , USA
| | - Alyssa M Bamer
- Department of Rehabilitation Medicine, University of Washington , Seattle , WA , USA
| | - Mara B Nery-Hurwit
- Department of Rehabilitation Medicine, University of Washington , Seattle , WA , USA
| | - Kendra S Liljenquist
- Department of Rehabilitation Medicine, University of Washington , Seattle , WA , USA
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington , Seattle , WA , USA
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Pagnini F, Cavalera C, Rovaris M, Mendozzi L, Molinari E, Phillips D, Langer E. Longitudinal associations between mindfulness and well-being in people with multiple sclerosis. Int J Clin Health Psychol 2019; 19:22-30. [PMID: 30619494 PMCID: PMC6300715 DOI: 10.1016/j.ijchp.2018.11.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/13/2018] [Indexed: 12/29/2022] Open
Abstract
Background/Objective: Depression, anxiety, fatigue, and sleep problems are typical conditions reported in people with multiple sclerosis (MS), often resulting in a reduction of their quality of life (QOL) and well-being. Mindfulness is a multifaceted and complex construct that has been increasingly explored for its correlated to well-being. Despite preliminary evidence, longitudinal data about the impact of mindfulness on QOL in MS remain limited. In addition, Langerian mindfulness, one of the prominent approaches to mindfulness, is yet unexplored in this field. The study aims to examine the longitudinal relationships between two forms of mindfulness (Langerian and contemplative) and QOL, anxiety, depression, fatigue, and sleep. Method: Within a larger randomized controlled trial of an online mindfulness-based stress reduction intervention, a cohort of 156 people with MS was recruited and assessed for both mindfulness constructs, QOL, anxiety, depression, fatigue, and sleep problems. Assessments were repeated after 2 and after another 6 months. Results: Both mindfulness constructs were highly correlated with all investigated outcomes. Both Langerian and contemplative mindfulness predicted higher QOL, lower anxiety, depression, fatigue, and sleep, over time. Conclusions: In both approaches dispositional mindfulness is a protective factor against depression, anxiety, fatigue, and sleep in people with MS.
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Affiliation(s)
- Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Cesare Cavalera
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Marco Rovaris
- Multiple Sclerosis Center and Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Laura Mendozzi
- Multiple Sclerosis Center and Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Enrico Molinari
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milano, Italy
| | - Deborah Phillips
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Ellen Langer
- Department of Psychology, Harvard University, Cambridge, MA, USA
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Arewasikporn A, Ehde DM, Alschuler KN, Turner AP, Jensen MP. Positive factors, pain, and function in adults with multiple sclerosis. Rehabil Psychol 2018; 63:612-620. [PMID: 30299136 DOI: 10.1037/rep0000242] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Much is known about the associations between negative factors and adjustment to chronic pain. However, less is known about how positive factors (e.g., positive affect [PA], resilience) function in relation to disability and mood in individuals with multiple sclerosis (MS). To better understand how positive factors contribute to function we sought to determine if (a) PA and/or trait resilience moderate the associations between pain intensity and function (pain interference, depressive symptoms), and (b) trait resilience concurrently mediates the association between PA and function in a sample of individuals with MS. METHOD There were 455 adults with MS who provided data via an ongoing survey. RESULTS Controlling for negative affect, demographic, and disease-related variables, cross-sectional path analysis revealed the following: PA and trait resilience did not moderate the associations between pain intensity and pain interference (βPA = 0.01, p = .86; βRESILIENCE = 0.04, p = .33), and pain intensity and depression (βPA = 0.01, p = .79; βRESILIENCE = -0.02, p = .60). However, trait resilience significantly mediated the associations between PA and both criterion variables (abINTERFERENCE = -0.03, p = .03; abDEPRESSION = -0.13, p < .001). CONCLUSIONS The findings provide preliminary support for the conclusion that PA is indirectly related to pain interference and depression via resilience, rather than serves as a protective function. The findings are consistent with theoretical models suggesting that increases in PA build personal resources. Research examining the potential benefits of increasing PA and resilience to improve pain outcomes in individuals with MS is warranted. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Aaron P Turner
- Multiple Sclerosis Center of Excellence-West, Veteran Affairs Puget Sound Health Care System
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Arewasikporn A, Turner AP, Alschuler KN, Hughes AJ, Ehde DM. Cognitive and affective mechanisms of pain and fatigue in multiple sclerosis. Health Psychol 2018; 37:544-552. [PMID: 29672097 DOI: 10.1037/hea0000611] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine the extent to which pain catastrophizing, fatigue catastrophizing, positive affect, and negative affect simultaneously mediated the associations between common symptoms of multiple sclerosis (MS; i.e., pain, fatigue) and impact on daily life, depressive symptoms, and resilience. METHOD Participants were community-dwelling adults with MS (N = 163) reporting chronic pain, fatigue, and/or moderate depressive symptoms. Multiple mediation path analysis was used to model potential mediators of pain and fatigue separately, using baseline data from a randomized controlled trial comparing two symptom self-management interventions. RESULTS In the pain model, pain catastrophizing was a mediator of pain intensity with pain interference and depression. Negative affect was a mediator of pain intensity with depression and resilience. In the fatigue model, fatigue catastrophizing was a mediator of fatigue intensity with fatigue impact and depression. Positive affect was a mediator of fatigue intensity with depression and resilience. CONCLUSIONS These findings provide preliminary support for the presence of differential effects of cognitive-affective mediators and suggest potential targets for psychological interventions based on an individual's clinical presentation. The differential mediating effects also support the inclusion of both positive and negative aspects of psychological health in models of pain and fatigue, which would not be otherwise apparent if negative constructs were examined in isolation. To our knowledge, this is the first study to utilize a multivariate path analysis approach to examine cognitive-affective mediators of pain and fatigue in MS, while also examining positive and negative constructs concurrently. (PsycINFO Database Record
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Affiliation(s)
- Anne Arewasikporn
- Department of Rehabilitation Medicine, University of Washington School of Medicine
| | - Aaron P Turner
- Department of Rehabilitation Medicine, University of Washington School of Medicine
| | - Kevin N Alschuler
- Department of Rehabilitation Medicine, University of Washington School of Medicine
| | - Abbey J Hughes
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington School of Medicine
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Bravo-González F, Álvarez-Roldán A. [Multiple sclerosis, loss of functionality and gender]. GACETA SANITARIA 2017; 33:177-184. [PMID: 29203325 DOI: 10.1016/j.gaceta.2017.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 09/15/2017] [Accepted: 09/21/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To identify the type of support and assistance that patients with multiple sclerosis need in order to cope with the loss of functionality, and to show how gender affects the perception of these needs. METHOD Interpretative-phenomenological qualitative study. LOCATION Granada (Spain). Year: 2014. Intentional sample: 30 patients and 20 family caregivers. Data were gathered from 26 interviews and 4 focus groups. The data were coded and analysed with the NVivo programme. RESULTS The multiple sclerosis patients and family caregivers had different perceptions of the loss of capacity to undertake activities of daily living. Being able to self care was considered the last vestige of autonomy. The women with multiple sclerosis tried to take on the responsibility of housework, but the male caregivers became gradually involved in these tasks. Gender roles were redefined with respect to housekeeping. The multiple sclerosis patients showed a need for emotional support. Some of the men had abandoned the stereotype of the strong male as a result of the decline in their health. Adaptations in the home took place without planning them in advance. The use of mobility devices started on an occasional basis. A fear of stigma was an obstacle for regular use of assistive technology. CONCLUSIONS Health care for people with multiple sclerosis should include family caregivers. Gender influences the perception that caregivers and patients have of the assistance they require to maximise their quality of life. This flags up several intervention areas for the follow-up and long-term care of these patients by the healthcare system.
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Affiliation(s)
- Félix Bravo-González
- Departamento de Antropología Social, Universidad de Granada, Granada, España; Asociación Granadina de Esclerosis Múltiple, Granada
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Neils-Strunjas J, Paul D, Clark AN, Mudar R, Duff MC, Waldron-Perrine B, Bechtold KT. Role of resilience in the rehabilitation of adults with acquired brain injury. Brain Inj 2017; 31:131-139. [DOI: 10.1080/02699052.2016.1229032] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jean Neils-Strunjas
- Department of Communication Sciences and Disorders, Western Kentucky University, Bowling Green, KT, USA
| | - Diane Paul
- American Speech-Language-Hearing Association, Rockville, MD, USA
| | - Allison N. Clark
- Department of Physical Medicine & Rehabilitation, Baylor College of Medicine and Brain Injury Research Center at TIRR Memorial Hermann, Houston, TX, USA
| | - Raksha Mudar
- Department of Speech & Hearing Science, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Melissa C. Duff
- Department of Communication Sciences & Disorders, University of Iowa, Iowa City, IA, USA
| | | | - Kathleen T. Bechtold
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore, MD, USA
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Resilience and Function in Adults With Physical Disabilities: An Observational Study. Arch Phys Med Rehabil 2016; 98:1158-1164. [PMID: 27993585 DOI: 10.1016/j.apmr.2016.11.012] [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] [Received: 08/05/2016] [Revised: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To determine if resilience is uniquely associated with functional outcomes (satisfaction with social roles, physical functioning, and quality of life) in individuals with physical disabilities, after controlling for measures of psychological health (depression and anxiety) and symptom severity (pain, fatigue, and sleep disturbance); and to examine the potential moderating effect of sex, age, and diagnosis on the hypothesized associations between resilience and function. DESIGN Cross-sectional survey study. SETTING Surveys were mailed (81% response rate) to a community sample of 1949 individuals with multiple sclerosis, muscular dystrophy, postpoliomyelitis syndrome, or spinal cord injury. Participants were recruited through the Internet or print advertisement (28%), a registry of previous research participants who indicated interest in future studies (21%), a departmental registry of individuals interested in research (19%), disability-specific registries (18%), word of mouth (10%), or other sources (3%). PARTICIPANTS Convenience sample of community-dwelling adults aging with physical disabilities (N=1574), with a mean Connor-Davidson Resilience Scale (10 items) score of 29. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Patient-Reported Outcomes Measurement Information System measures of Satisfaction with Social Roles and Activities and Physical Functioning, the World Health Organization's brief Older People's Quality of Life Questionnaire, and the Connor-Davidson Resilience Scale (10 items). RESULTS After controlling for age, age squared, sex, diagnosis, psychological health, and symptom severity, resilience was significantly and positively associated with satisfaction with social roles (β=.17, P<.001) and quality of life (β=.39, P<.001), but not physical function (β=.04, P>.05). For every 1-point increase in scores of resilience, there was an increase of .50 in the quality of life score and .20 in the satisfaction with social roles score. Sex also moderated the association between resilience and satisfaction with social roles (F1,1453=4.09, P=.043). CONCLUSIONS The findings extend past research, providing further evidence indicating that resilience plays a unique role in nonphysical functional outcomes among individuals with physical disabilities.
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Psychosocial difficulties of individuals with multiple sclerosis: the PARADISE-24 questionnaire. Int J Rehabil Res 2016; 39:339-345. [PMID: 27631722 DOI: 10.1097/mrr.0000000000000194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study is to identify the most relevant psychosocial difficulties (PSDs) experienced by persons with multiple sclerosis (PwMS); to evaluate the relation between an overall level of PSDs measured with the PARADISE-24 and other variables; to assess which factors may predict PARADISE-24 overall score. Adults PwMS were consecutively enrolled and completed a battery of eight self-reported instruments (i.e. SCQ, EUROHIS-QOL 8, BRS, BFI-10, JSPE, OSS-3, WHODAS-12, PARADISE-24). A clinical evaluation was performed for each patient and the Expanded Disability Status Scale (EDSS) score was determined by neurologists. A total of 80 PwMS, mean age 41.0, 65% women, 62% married, and 76.3% working, 86.3% relapsing-remitting MS, with an EDSS median score of 1.5, took part in the study. The mean disease duration was 7.7 years. The most frequently reported PSDs involved motor and emotional functioning. Free of charge access to medicines; health treatments and family, friends and health professionals' assistance represented the most important facilitators. WHODAS-12 and EUROHIS-QOL 8 were excluded from regression because of their strong correlation with PARADISE-24. EDSS, BRS, OSS-3, and neuroticism were the main predictors of the PARADISE-24 score. Despite MS heterogeneity, a common pattern of PSDs can be observed among PwMS. The level of physical impairment and personal resilience were the main predictors of the overall level of PSDs in PwMS, with a lower but significant additional role played by social support and personality traits. Attention to PSDs and their predictors, using PARADISE-24, can help clinicians to plan tailored and personalized rehabilitation programs.
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Shamaskin-Garroway AM, Lageman SK, Rybarczyk B. The roles of resilience and nonmotor symptoms in adjustment to Parkinson’s disease. J Health Psychol 2016; 21:3004-3015. [DOI: 10.1177/1359105315590268] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Resilience contributes to better chronic disease adjustment but is understudied in Parkinson’s disease. Although nonmotor symptoms affect quality of life, their effect on other aspects of Parkinson’s disease adjustment is less understood. Hierarchical regression analyses from a cross-sectional survey of 138 community-dwelling adults with Parkinson’s disease (mean (standard deviation) age = 64.15(10.09) years) investigated relationships between nonmotor symptoms and resilience on depression, apathy, life satisfaction, and quality of life. After controlling for demographic variables, functional status, and nonmotor symptoms, resilience was associated with all adjustment variables. Nonmotor symptoms were associated with depression and worse quality of life. Nonmotor symptoms and resilience appear to play critical roles in Parkinson’s disease adjustment.
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