Experience of Identity Change in People Who Reported a Diagnosis of Multiple Sclerosis: A Qualitative Inquiry.

BACKGROUND: A diagnosis of multiple sclerosis (MS) can lead to changes to a person's sense of self. The aim of this study was to investigate the subjective experience of identity change and subsequent adjustment to MS. METHODS: Semistructured interviews were conducted with 16 people who reported having MS. Interviews were analyzed using thematic analysis. RESULTS: In the early stages of disease progression, participants wanted to compartmentalize the disease. Over time, through reflected self-appraisals, brought about by increasing symptoms and changed relationships with others, the disease became a part of participants' self-identity. CONCLUSIONS: For people with MS, incorporating and accepting the disease as part of their self-identity can have positive implications for seeking and receiving support.

Comparing individual and group intervention for psychological adjustment in people with multiple sclerosis: a feasibility randomised controlled trial.

OBJECTIVE: To modify a published group intervention for adjustment to multiple sclerosis (MS) to suit an individual format, and to assess the feasibility of a randomised controlled trial (RCT) to compare individual and group intervention for people with multiple sclerosis and low mood. DESIGN: Feasibility randomised controlled trial. SETTING: Participants were recruited through healthcare professionals at a hospital-based multiple sclerosis service and the MS Society. SUBJECTS: People with multiple sclerosis. INTERVENTIONS: Adjustment to multiple sclerosis in individual or group delivery format. MAIN MEASURES: Participants completed mood and quality of life assessments at baseline and at four-month follow-up. Measures of feasibility included: recruitment rate, acceptability of randomisation and the intervention (content and format), and whether the intervention could be adapted for individual delivery. Participants were screened for inclusion using the General Health Questionnaire-12 and Hospital Anxiety and Depression Scale, and were randomly allocated to receive either individual or group intervention, with the same content. RESULTS: Twenty-one participants were recruited (mean age 48.5 years, SD 10.5) and were randomly allocated to individual (n=11) or group (n=10) intervention. Of those offered individual treatment, nine (82%) completed all six sessions. Of those allocated to group intervention, two (20%) attended all six sessions and three (30%) attended five sessions. There were no statistically significant differences between the groups on the outcome measures of mood and quality of life. CONCLUSIONS: The intervention could be provided on an individual basis and the trial design was feasible. There were lower attendance rates at group sessions compared to individual sessions.

An evaluation of treatment integrity in a randomised controlled trial of memory rehabilitation for people with multiple sclerosis.

OBJECTIVE: To assess the treatment integrity of a memory rehabilitation programme for people with multiple sclerosis. SUBJECTS: Data were drawn from the intervention group of a randomised controlled trial of memory rehabilitation. This comprised 24 participants with multiple sclerosis. MEASURES: Four core session components were identified from the treatment manual: recap, activities, take-home activity and other. One video-recording of each of ten intervention sessions was transcribed and amount of time spent on components recorded. RESULTS: There were no significant differences between early and late stages of the programme in time spent on the core components (recap Z= -0.87, P=0.49; activities Z = -0.29, P=0.89; take-home activity Z = -0.59, P=0.69; other Z = -0.58, P=0.69). Thus, adherence to the manual was good with no evidence of programme drift. CONCLUSIONS: Good adherence indicates the intervention was delivered as described in the manual and strengthens confidence in the findings of the randomised controlled trial.