Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 5 de 5
Filter
Add more filters

Database
Language
Publication year range
1.
Am J Occup Ther ; 72(5): 7205205030p1-7205205030p8, 2018.
Article in English | MEDLINE | ID: mdl-30157015

ABSTRACT

OBJECTIVE: We examined the efficacy of a 12-wk educational socialization program, Community Reintegration for Socially Isolated Patients (CRISP), in improving self-efficacy for people with multiple sclerosis (MS). We also examined whether participants in the experimental group with increased self-efficacy experienced reduced loneliness and depression. METHOD: This randomized controlled group design included 91 participants with MS (experimental group, n = 51; control group, n = 40). Participants were between ages 20 and 68 yr, and the majority experienced a relapsing-remitting MS course (86%) and mild to moderate disability. Participants completed baseline and posttreatment assessments, including questionnaires assessing self-efficacy, loneliness, and depression. RESULTS: Experimental group participants significantly improved in self-efficacy compared with control group participants. Experimental group participants who demonstrated improved self-efficacy reported reduced perceptions of loneliness but not depressive symptoms. CONCLUSION: CRISP is a promising intervention to improve self-efficacy for people with MS. However, results need to be treated with caution given the study's limitations.

2.
Mult Scler Relat Disord ; 90: 105792, 2024 Oct.
Article in English | MEDLINE | ID: mdl-39121597

ABSTRACT

BACKGROUND: The concept of shared decision-making (SDM) is valuable to ensure patients receive individualized care. SDM occurs when healthcare providers engage patients in making personal healthcare decisions that could contribute to better long-term outcomes. With the ever-increasing landscape of treatment options available, SDM can be challenging but valuable for patients. Patients from underserved populations are potentially less likely to engage in SDM, impacting their long-term care. This systematic literature review aimed to explore SDM in these patient populations. METHODS: Relevant articles were retrieved from PubMed using key search terms, without any restriction on publication date. All searches and data retrieval were conducted between May 25, 2022, and August 17, 2022, and abstracts were reviewed by two independent reviewers. A thematic analysis was used to present the data. RESULTS: All search terms yielded 418 articles; 89 were included (33 involving patients with multiple sclerosis [MS]). Reported mean percentage of patients with MS (including from underserved populations) who preferred SDM was 52 % (range: 37.5-71.5; n = 4). Differences in racial/ethnic assimilation of information communicated by clinicians were reported, impacted by the lower literacy level and certain cultural health beliefs in groups of underserved populations. Primary care clinicians play a key role in providing information to patients in underserved populations. CONCLUSIONS: There is a clear benefit for SDM for patients with MS, and without it, patients report dissatisfaction, decisional regret, and lack of confidence in the medical system. However, there are several challenges, including the need for further examination of social determinants of health, for underserved patient populations which still need to be addressed.


Subject(s)
Decision Making, Shared , Multiple Sclerosis , Vulnerable Populations , Humans , Multiple Sclerosis/therapy , Patient Participation
3.
Neurol Ther ; 12(2): 687-700, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36792812

ABSTRACT

BACKGROUND: Some multiple sclerosis (MS) disease-modifying therapies (DMTs) impair responses to vaccines, emphasizing the importance of understanding COVID-19 vaccine immune responses in people with MS (PwMS) receiving different DMTs. METHODS: This prospective, open-label observational study enrolled 45 participants treated with natalizumab (n = 12), ocrelizumab (n = 16), fumarates (dimethyl fumarate or diroximel fumarate, n = 11), or interferon beta (n = 6); ages 18-65 years inclusive; stable on DMT for at least 6 months. Responder rates, anti-SARS-CoV-2 spike receptor-binding domain IgG (anti-RBD) geometric mean titers (GMTs), antigen-specific T cells, and vaccination-related adverse events were evaluated at baseline and 8, 24, 36, and 48 weeks after first mRNA-1273 (Moderna) dose. RESULTS: At 8 weeks post vaccination, all natalizumab-, fumarate-, and interferon beta-treated participants generated detectable anti-RBD IgG titers, compared to only 25% of the ocrelizumab cohort. At 24 and 36 weeks post vaccination, natalizumab-, fumarate-, and interferon beta-treated participants continued to demonstrate detectable anti-RBD IgG titers, whereas participants receiving ocrelizumab did not. Anti-RBD GMTs decreased 81.5% between 8 and 24 weeks post vaccination for the non-ocrelizumab-treated participants, with no significant difference between groups. At 36 weeks post vaccination, ocrelizumab-treated participants had higher proportions of spike-specific T cells compared to other treatment groups. Vaccine-associated side effects were highest in the ocrelizumab arm for most symptoms. CONCLUSIONS: These results suggest that humoral response to mRNA-1273 COVID-19 vaccine is preserved and similar in PwMS treated with natalizumab, fumarate, and interferon beta, but muted with ocrelizumab. All DMTs had preserved T cell response, including the ocrelizumab cohort, which also had a greater risk of vaccine-related side effects.

4.
Int J MS Care ; 16(3): 117-22, 2014.
Article in English | MEDLINE | ID: mdl-25337053

ABSTRACT

BACKGROUND: Although there is substantial anecdotal evidence that clutter is common among people with multiple sclerosis (MS), the literature contains no reports of studies on the actual prevalence of the problem or its impact on functional performance in this population. Clutter promotes confusion and places individuals in potentially dangerous situations by increasing their risks of falling, losing medications, and misplacing important documents. In addition, it may negatively affect activities of daily living (ADLs). Many common MS symptoms such as decreased mobility, visual or cognitive changes, fatigue, and depression can exacerbate clutter accumulation, which in turn can have detrimental effects on physical, financial, emotional, cognitive, and social functioning. It is critical for MS clinicians to address clutter management in order to improve patients' overall functional independence and participation. METHODS: A clutter reduction protocol was developed and implemented at our institution for individuals with MS. Our group program addresses psychosocial issues preventing organization and offers practical strategies for clutter removal and management to improve performance in ADLs. A clutter questionnaire is administered to individuals before and after their participation in the group program. RESULTS: Anecdotal reports indicate that the intervention helped to reduce clutter, promote a more realistic attitude toward "possessions," and establish a sense of accomplishment in controlling one's environment. Participants also reported fewer falls, feeling less isolated, increased ease in finding their medications, and a general sense of cognitive clarity in accomplishing ADLs. Outcome assessments are now being developed to objectively measure these effects as well as the prevalence of clutter within the MS population. CONCLUSIONS: Clutter management is an important area for MS clinicians to address because it can significantly affect patients' functioning, safety, performance of ADLs, and quality of life.

5.
Int J MS Care ; 14(3): 160-8, 2012.
Article in English | MEDLINE | ID: mdl-24453747

ABSTRACT

This quasi-experimental pilot study examined the impact of multidisciplinary care, with a particular focus on occupational therapy (OT), on resilience in individuals with multiple sclerosis (MS). Individuals with a diagnosis of MS who were receiving multidisciplinary care including outpatient OT at an MS center were invited to participate. A total of 36 individuals agreed to enroll and were asked to complete a demographic questionnaire and the Resilience Scale (RS). After an 8-week period of multidisciplinary treatment, the 35 individuals who completed treatment were again asked to complete the RS. As a group they demonstrated statistically significant improvement in resilience. A cohort of participants unexpectedly did not follow through with OT but did follow through with their other referrals. These individuals completed the RS before and after the 8-week time period and became an ad hoc control group. The group receiving OT showed significant improvement in resilience, while the control group did not. This study shows that a multidisciplinary approach to care, especially when it includes OT, is effective in treating individuals with MS. Occupational therapy focuses on treating symptoms that specifically limit daily functioning and participation, and may be uniquely positioned to affect resilience. Because resilience plays an important role in functional recovery and maintenance, this study suggests that OT may be a critical component of MS care in developing characteristics that enhance resilience.

SELECTION OF CITATIONS
SEARCH DETAIL