The effect of a creative art program on self-esteem, hope, perceived social support, and self-efficacy in individuals with multiple sclerosis: a pilot study.

BACKGROUND: Creative art has been found to be beneficial to some patients with chronic illness. Little is understood about how creative art can benefit individuals living with multiple sclerosis (MS). OBJECTIVES: The purpose of the pilot study was to determine if there was a difference in self-esteem, hope, perceived social support, and self-efficacy in individuals with MS after a 4-week creative art program. METHODS: A one-group, pretest/posttest design was used. The convenience sample of 14 individuals was recruited from MS Centers and the National MS Society. They ranged in age from 29 to 70 years (M = 51.3 years, SD = 12.5 years). Participants included 14 women. The creative art program included week 1-watercolor, week 2-collage making, week 3-beading, and week 4-knitting. Each of the four weekly sessions was facilitated by a registered nurse with expertise in MS and lasted 2 hours. Creative artists instructed participants and provided a hands-on experience for each of the creative projects. Participants were free to share thoughts, experiences, and words of support and encouragement during each session. The variables were measured before starting the creative art program and after the final session. The instruments included the Rosenberg Self-Esteem Scale, the Herth Hope Index, the Modified Social Support Survey, the MS Self-Efficacy Scale, and a sociodemographic questionnaire. The Statistical Package for the Social Sciences Version 16.0 was used to analyze the data. RESULTS: There was a significant increase in all variables after the creative art program as follows: self-esteem (t = -3.05, p = 009), hope (t = -3.96, p = .002), social support (t = -2.21, p = .046), self-efficacy to function with MS (t = -2.68, p = .019), and self-efficacy to control MS (t = 3.22, p = .007). The power analysis revealed a large effect size for hope (d = 1.06), self-esteem (d = 0.82), and self-efficacy (control; d = 0.86). A medium effect size was found for self-efficacy (function; d = 0.72) and social support (d = 0.59). CONCLUSIONS: The creative art program was found to be effective and had a positive influence on self-esteem, hope, social support, and self-efficacy to function and control MS. Creative art has the potential to enhance the lives of those living with MS and should be investigated with a larger sample of participants.

Family issues associated with military deployment, family violence, and military sexual trauma.

Today's military has a greater percentage of families and children in comparison with previous generations. There are many, and unique, demands on military families made by the ongoing conflicts, and military life can be stressful. The presence of an increasing number of stressors is associated with an increased likelihood of domestic violence in military families and sexual trauma in service members. In this article, literature and research are presented to provide an overview of military deployment and families, and the effect of deployment on families; this is followed by a review of research on family violence and military sexual trauma.

Updated research priorities for neuroscience nursing.

In 2007, the Neuroscience Nursing Foundation (NNF) convened a research panel to update NNF's research priorities used to guide funding. The research panel identified leaders in neuroscience nursing and conducted a review of neuroscience nursing research literature and an American Association of Neuroscience Nurses membership survey on research priorities. A workgroup of leaders in neuroscience nursing was then convened to draft and set priorities on the basis of the review of the literature and the membership survey. The updated priorities were submitted to the NNF Board of Trustees for approval. The revised document reviews the mission of NNF and outlines six strategies and five program areas (including specific subareas) that represent priorities for NNF research funding. The purpose of the updated priority document is to provide guidelines for the systematic development of knowledge in neuroscience nursing through the encouragement of selected neuroscience nursing research activities.

Gait disorder in older adults: is it NPH?

In normal pressure hydrocephalus (NPH), there is enlargement of the brain's ventricular system due to an excess of cerebrospinal fluid. The triad of symptoms in NPH are gait disorder, cognitive impairment, and urinary continence problems. NPs need to consider the possibility of NPH in older adults with a hypokinetic gait.

Correlates of sexual dysfunction in men and women with multiple sclerosis.

Sexual dysfunction (SD) is an often overlooked disability in multiple sclerosis (MS). The purpose of this study was to investigate the relationship between SD and other disabilities in men and women with MS. The sample included 32 men and 219 women. The men ranged in age from 32 to 65 years with a mean of 47.6 years. The women ranged in age from 22 to 77 years with a mean of 45.4 years. Data were collected using Guy's Neurological Disability Scale and a demographic questionnaire. In men, a significant positive relationship was found between SD and lower-limb and bladder disability. No relationship was found between SD and other MS disabilities. The most common problems for men involved erection and ejaculation. For women, a significant positive relationship was found between SD and all other MS disabilities. The strongest correlation was between SD and fatigue. The most common problems for women involved vaginal lubrication and orgasm. No relationship was found between SD and number of years with MS or age in either men or women. An open dialogue about SD may improve quality of life for people with MS. Interventions may include symptomatic treatment, referral of the couple for sexual counseling, and other approaches that may include sensory body mapping to enhance communication and pleasure for the couple living with MS.

Gait disorder is the cardinal sign of normal pressure hydrocephalus: a case study.

Normal pressure hydrocephalus (NPH) is one of the few reversible causes of dementia in older adults and accounts for approximately 6% of all dementias. The cardinal sign of NPH is a hypokinetic gait disorder in which the older adult's feet look as though they are glued to the floor. The gait also has been described as magnetic. People with NPH also may have mild dementia and bladder and bowel incontinence. A 78-year-old man exhibited symptoms of NPH for at least 4 years before being diagnosed. A neurological assessment of the patient revealed gait, posture, and balance abnormalities; mild dementia; and urinary urgency, frequency, nocturia, and incontinence at least once a day. His risk factors for NPH included diabetes and hypertension. A computed tomography (CT) scan revealed dilated lateral ventricles in the brain. A lumbar puncture was used to remove 50 ml of cerebrospinal fluid, which resulted in a transient improvement in his gait for approximately 18 hours. A ventriculoperitoneal shunt was then inserted in the patient, and during a 1-year period his symptoms gradually improved. He recovered without any complications and was eventually able to resume his usual activities. When the gait associated with NPH is observed in an older adult, he or she should be referred to a neurologist or multidisciplinary team for a comprehensive evaluation. If an individual receives treatment for NPH, he or she may have an improved quality of life and the opportunity to reduce functional limitations and disability. Families may also experience positive outcomes, such as having a loved one who is cognitively improved and requires less care.

A comparative study of self-efficacy in men and women with multiple sclerosis.

The purpose of this study was to examine if there was a difference in the level of self-efficacy between men and women with relapsing-remitting multiple sclerosis (RRMS) and progressive forms of multiple sclerosis (MS). A quantitative, descriptive, comparative design was used. The convenience sample included 556 individuals with MS, of which 124 were men (73 RRMS and 51 progressive MS) and 432 women (348 RRMS and 84 progressive MS). Participants completed the Multiple Sclerosis Self-Efficacy Scale (MSSE). This study found gender differences in self-efficacy among those living with MS. The women had a significantly greater belief in their ability to function with MS. The women also had a greater belief in their ability to control their MS than the men, although the difference was not significant. This study also found significant differences in self-efficacy between those with RRMS and those with progressive forms of MS. When men were compared by type of MS, those with RRMS had significantly greater belief in their ability to control their disease and function with it than those with progressive forms of MS. For women, those with RRMS had significantly greater belief in their ability to control their MS and function with it than women with progressive forms of MS. Individuals with MS could benefit from strategies that enhance self-efficacy. Such strategies include providing skills for self-management of MS, providing education and support of the patient and family, introducing the patient to a role model with MS, encouraging physical reconditioning, and referring to a support group that will meet individualized needs.

Psychometric testing of the Americanized version of the Guy's Neurological Disability Scale.

The Guy's Neurological Disability Scale (GNDS) was originally developed in the United Kingdom to measure disability in multiple sclerosis (MS). The purpose of this study was to test the reliability, validity, and sensitivity of the Americanized version of the GNDS. The following five research questions were considered: (1) Is there convergent validity of the Americanized version of the GNDS as evidenced by a significant relationship with the Short Form 36 (SF-36) and Activities of Daily Living Self-Care for MS Scale? (2) Does the Americanized version of the GNDS have the same four-factor structure as reported in the psychometric testing of the original GNDS? (3) Is the Americanized version of the GNDS a reliable measure when examined with a 2-week retest? (4) Does the Americanized version of the GNDS have internal consistency? (5) Is the Americanized version of the GNDS sensitive to changes in neurological disability from MS over time? Participants were diagnosed with relapsing-remitting MS and a history of one or more relapses in the previous 2 years. The sample included 253 participants--87% were women (n = 219), 13% were men (n = 32), and two participants did not indicate their sex. They ranged in age from 22 to 77 years (M = 46, SD = 9). The Americanized version of the GNDS was found to be a reliable, valid, and sensitive multidimensional measure of neurological disability for individuals with MS.

A prospective study of adherence to glatiramer acetate in individuals with multiple sclerosis.

The purpose of this prospective study was to investigate whether self-efficacy, hope, level of disability, perceived support, and previous use of an immunomodulatory therapy when measured at the initiation of a therapy can accurately predict adherence. A convenience sample included 108 individuals with multiple sclerosis who initiated therapy with glatiramer acetate (Copaxone), plus or minus 21 days, and completed instruments online that included the Multiple Sclerosis Self-Efficacy Scale (MSSE), the Herth Hope Index, Performance Scales, and a sociodemographic data sheet that included questions about previous use of immunomodulators and individuals considered most supportive of glatiramer acetate therapy. Logistic regression analysis revealed that the MSSE total (Control and Function subscales combined) was the only significant predictor of adherence. The higher the score, the more likely the individual was to adhere to glatiramer acetate. Those in the adherent group had a significantly greater level of self-efficacy. The MSSE measured at the initiation of glatiramer acetate therapy correctly classified 98.8% of those who were adherent at the 6-month follow-up. For each unit of increase in score, the likelihood of adherence increased. This prospective study revealed that the MSSE, when measured at the initiation of therapy, seems useful in predicting adherence category at the 6-month follow-up.

Predictors of adherence to glatiramer acetate therapy in individuals with self-reported progressive forms of multiple sclerosis.

The purpose of this study was to evaluate psychological, biophysical, and sociodemographic variables as predictors of adherence to glatiramer acetate (Copaxone) therapy in individuals with self-reported progressive forms of multiple sclerosis (MS). The literature lends support for self-efficacy, self-esteem, hope, and disability to be predictors of adherence. Therefore the hypotheses for this study were (a) higher self-efficacy will be a significant predictor of adherence, (b) higher self-esteem will be a significant predictor of adherence, (c) higher hope will be a significant predictor of adherence, and (d) a lower level of disability will be a significant predictor of adherence. The MS Self-Efficacy Scale (MSSE), Rosenberg Self-Esteem Scale, Herth Hope Index, and Performance Scales; a sociodemographic questionnaire; and an information sheet regarding consent to participate in the study were mailed to 1,200 potential participants. A total of 594 individuals responded, and for the evaluation of predictors of adherence in individuals with self-reported progressive forms of MS, 199 met the criteria. Logistic regression analysis revealed four significant predictors of adherence: the MSSE Control subscale, MSSE Function subscale, perceived support of the physician, and perceived support of the spouse. The higher the score on the MSSE Control subscale, the more likely the individual will adhere to glatiramer acetate therapy. The higher the score on the MSSE Function subscale, the more likely the individual will adhere to glatiramer acetate therapy. The MSSE Control and Function subscales show promise of being useful to predict adherence.

Cognitive symptoms and correlates of physical disability in individuals with multiple sclerosis.

There are inconsistencies in the literature regarding the prevalence of cognitive impairment among individuals with multiple sclerosis (MS). The purpose of this study was to examine perceived cognitive impairment in secondary progressive and relapsing-remitting multiple sclerosis (MS) and to examine the relationship between level of disability, age, and number of years with MS and self-reported cognitive symptoms. The sample consisted of 447 individuals (96 participants with secondary progressive MS and 351 participants with MS) who responded to mailed data collection instruments. The Performance Scales, a self-report measure of disability in eight domains of function, and a sociodemographic data sheet were analyzedfor this study. Of individuals with secondary progressive MS, 83% reported cognitive symptoms, while 82% of individuals with relapsing-remitting MS reported cognitive symptoms. Individuals with secondary progressive MS were reportedly experiencing a significantly greater level of total disability. A statistically significant, strong, positive relationship was found between cognitive symptoms and fatigue for those with secondary progressive MS and those with relapsing-remitting MS. Statistically significant, moderate, positive relationships were also found between cognitive symptoms in those with secondary progressive MS and those with relapsing-remitting MS, and sensory symptoms, vision, hand function, bladder/bowel symptoms, and spasticity. A statistically significant, weak, positive relationship was found between cognitive symptoms and mobility in individuals with relapsing-remitting MS. There was no relationship between cognitive symptoms and mobility in those with secondary progressive MS. Cognitive symptoms were not significantly related to age in those with secondary progressive MS or those with relapsing-remitting MS. In addition, cognitive symptoms were not significantly related to the number of years with MS in individuals with secondary progressive MS or those with relapsing-remitting MS. The perception of cognitive deficits in individuals with MS was found in this study to be even more prevalent than previously reported. Because cognitive deficits occur at all stages of MS, early identification and treatment is essential. Healthcare providers must aggressively screen for cognitive impairment and rehabilitate individuals with MS who exhibit symptoms.

Beneficios de la compañía de los animales para los ancianos / Benefit of animals’ company for elderly

El presente articulo se refiere a la importancia que para los ancianos puede tener la compañia de un animal doméstico y los beneficios que puede reportar desde el punto de vista sico afectivo, así como coadyuvante en el tratamiento de ciertos trastornos. Pérdidas o enfermedades en las que el animal puede representar la solución o una ayuda terapeútica para mantener un bienestar físico y mental en el anciano.