Articles
Iranian Journal Of Psychiatry (17354587)15(4)pp. 322-330
Objective: Multiple sclerosis (MS) is a chronic neurological disease that could aggressively affect patients' quality of life in most instances. This study aimed to compare the effectiveness of an existential-spiritual psychotherapy with a cognitive-behavioral therapy on quality of life and meaning in life in women with multiple sclerosis. Method: A convenience sample of 43 women with multiple sclerosis participated in this quasi-experimental study. They were randomly assigned into 3 groups: an existential-spiritual intervention, a cognitive-behavioral intervention, and the control group. Participants were assessed for outcome measures (quality of life and meaning in life) at 3 points in time: pretest, posttest, and 5-months follow-up. The Multiple Sclerosis Quality of Life-54 (MSQOL-54) and the Meaning in Life Questionnaires (MLQ) were used as outcome measures. To compare outcomes among the study groups, repeated measures analysis of variance was performed. Results: The results showed that while no difference was observed for the control group, scores for meaning in life improved significantly for existential-spiritual intervention and cognitive-behavioral therapy (p = 0.027, p = 0.039). Also, both mental (p < 0.001, p = 0.014) and physical (p = 0.001, p = 0.013) health dimensions of quality of life increased significantly in the 2 intervention groups. However, the results indicated that women in the existential-spiritual intervention group showed greater improvement in some aspects of meaning in life (search for meaning) and quality of life (role physical and role emotional, pain and energy) compared to women in the cognitive-behavioral intervention group. However, the latter group showed better improvements on 2 subscales (physical function and health distress). Conclusion: Both existential-spiritual and cognitive-behavioral interventions can improve quality of life and meaning in life among women with multiple sclerosis. However, the findings suggest that although both interventions were effective, the existential-spiritual intervention resulted in more positive improvements in some aspects of meaning in life and quality of life. © 2020 Tehran University of Medical Sciences. All rights reserved.
Journal of Health System Research (27834093)15(4)pp. 296-303
Background: Multiple Sclerosis (MS) is a chronic progressive disease coinciding with the ages of social activities. Therefore, this disease is associated with significant effects on the quality of life and psychological status of these patients. It is well-accepted that the psychological status of patients is an effective factor in the process of treatment and living in chronic conditions. With this background in mind, the present study was conducted to identify the psychological status of these patients from their own perspective and specialists' viewpoints. Methods: The current qualitative study was conducted with a thematic analysis approach. The participants of the current study included 24 MS patients with maximum diversity in gender, age, illness duration and severity, and 8 experts in neurology, psychiatry, clinical psychology, and nursing from Guilan province. Participants were selected by a purposive sampling method and the data were gathered through unstructured interviews which continued up to data saturation. Data analysis was performed using a thematic analysis approach by the Attride-Stirling method. Findings: From the total information, three global themes, including individual problems, interactive problems, and disease-related problems were identified. Individual problems included: personality disorders, depression, sleep, cognitive, anxiety, physical, self-regulation, self-destructive behaviors, psychosis, as well as substance and alcohol abuse. Interactive problems incorporated: interpersonal sensitivity, aggression, sexual, social, and dependence. In addition, disease-related problems involved reaction to disease. Conclusion: As evidenced by the obtained results, patients with MS are involved in several psychological problems in individual, interactive and disease-related domains. Accordingly, it is necessary to develop and present psychological programs and interventions based on these problems in order to improve their mental status, quality of life, and adaptability. © 2020 Journal of Health System Research.
