ABSTRACT
PURPOSE: This systematic review sought to synthesise the qualitative literature exploring couples' experiences of dyadic coping, when one partner has Multiple Sclerosis (MS). METHODS: The review protocol was pre-registered with PROSPERO. Five databases (PubMed, EMBASE, CINAHL, PsycINFO and Scopus) were searched for relevant papers from inception to January 2024. Seven hundred and ninety three papers were screened against pre-defined inclusion criteria. Data from 11 studies (n = 204) were quality assessed using the Critical Appraisal Skills Programme qualitative checklist and included in the metasynthesis. RESULTS: The synthesis resulted in four themes related to couples' experiences of coping with MS: dance of accommodation, a sense of unity, outside of us and evolving as a unit. Communication attunement was perceived as key for couples to maintain cohesion in the relationship. Developing a shared narrative around MS helped couples to align their perspectives and co-ordinate their coping. The findings suggest that many couples coped by consciously maintaining a focus in the present. The wider system of social supports also appeared to frame the couples unique dyadic coping process in specific ways. CONCLUSIONS: The findings from this synthesis provide support for the conceptualisation of MS as a shared experience to support couples' rehabilitation efforts.
For couples coping with Multiple Sclerosis (MS), communication attunement is a key variable for maintaining cohesion and closeness in the relationship to manage disease impact. Framing MS as a shared challenge helps couples to co-ordinate their coping response, engage in collaborative disease management and rehabilitation, and jointly undertake lifestyle adaptations.Each couple's unique response to coping with MS should be considered within a broader ecological framework, including social and professional supports that may support rehabilitation efforts.
ABSTRACT
The primary aim of this study was to examine predictors of Return to Productive Roles (RTPR) in individuals with ABI following participation in a community-based RTPR intervention. One hundred and thirty participants were inducted to an ABI-specific RTPR programme. At induction, information on clinical and social demographics, previous education and employment roles were collected. Participants underwent a comprehensive neuropsychological assessment at baseline and completed assessments of disability, mental health and community integration. Participants were followed up at the end of their programme to assess RTPR. Three out of four participants who entered the RTPR programme returned to productive roles. Despite the relatively high levels of anxiety and depression in the sample, people who returned to productive roles were not significantly less anxious or depressed than those who did not. Logistic regression suggested that participants who returned to productive roles following the programme had higher levels of pre-ABI work engagement, less disability and performed better on neuropsychological assessment in terms of their language skills. Results suggest that these factors which cut across specific prior experience, cognitive performance, and social and disability areas of functioning represent barriers to an effective return to productive roles for people with ABI accessing RTPR intervention.
