Motherhood Experiences of Women With Multiple Sclerosis: A Thematic Meta-Synthesis.

The nature and unpredictable prognosis of multiple sclerosis (MS) make pregnancy and motherhood challenging experiences for women with the disease. Using the thematic synthesis method, we aimed to systematically interpret and synthesize data from qualitative research examining the motherhood experiences of women with MS. The analyses revealed three analytical themes: "Deciding to become a mother," "The journey during pregnancy, childbirth, and the postpartum period," and "Surviving as a mother with multiple sclerosis." For women with MS, being a mother, pregnancy, and the postpartum period were complex and challenging issues. During this period, most women felt lonely, thought that they were contradictory and inadequately informed by healthcare professionals and that they could not get enough social support. Despite all the difficulties, being a mother was a source of motivation for them. This meta-synthesis study provides healthcare professionals with an in-depth understanding of the experiences of women with MS with pregnancy, childbirth, postpartum period, and motherhood from their perspectives.

Life Experiences of Patients With Multiple Sclerosis About Their Spasticity: A Phenomenological Study.

Spasticity is one of the main symptoms that is most common in patients with Multiple Sclerosis and causes increased disability. The aim of this study is to understand the experiences of patients with Multiple Sclerosis about their spasticity from their perspective. This study was conducted as a qualitative study with a Hermeneutic phenomenological framework. The data were evaluated by using VanManen's thematic analysis method. As a result of the data analysis, four main themes were elicited, namely, "the meaning of spasticity for the patient," "the difficulties of living with spasticity," 'coping with spasticity," and "the new me created by spasticity." It was understood that spasticity is a symptom that brings about difficulties in psychological, social, and working life as well as physical difficulties. Nurses should be aware of the psychological symptoms as well as the physical symptoms that patients experience due to spasticity and should create a patient-specific management program.

Investigation of the relationship between the use of complementary alternative medicine and illness perception and illness cognition in patients with diabetic foot ulcer.

OBJECTIVE: to examine the relationship between illness perception, illness cognition, and other sociodemographic characteristics of individuals with diabetic foot ulcer (DFU) and their complementary alternative therapies (CAM) use within the framework of self-regulation model (SRM). MATERIAL AND METHODS: This cross-sectional descriptive study was carried out with 220 individuals with DFU in the Endocrinology and Metabolic Diseases outpatient clinic of two training and research hospitals between December 5, 2020, and June 5, 2021. Research data were collected by using the Patient Information Form, Brief Illness Perception Scale (BIPS), and Illness Cognition Questionnaire (ICQ). Descriptive statistical methods and the Mann-Whitney U test were used to were used in the evaluation of the data. The determinants of the CAM use status of the patients were evaluated by logistic regression analysis. RESULTS: It was determined that 136 (61.81%) patients who used CAM mostly preferred herbal methods. Patients' mean scores were 42.23 ± 5.66 on the total BIPS, 39.65 ± 16.01 on the total ICQ. Increasing age, female gender, increased disease perception (BIPS) and disease cognition (ICQ) increased the use of CAM (Nagelkerke R2:0.552; Model: x2 = 168.579 p = 0.00) CONCLUSIONS: It was determined that our patients frequently preferred CAM. Predictors of CAM use were identified as female gender, advanced age, illness perception, and illness cognition. Accordingly, for effective management of DFU, besides the comprehensive evaluation of individuals with DFU and the provision of wound care by health care professionals, illness perceptions, illness cognition, and CAM use should be considered carefully.

Evaluating the effects of transcutaneous tibial nerve stimulation or pelvic floor muscle training on sexual dysfunction in female multiple sclerosis patients reporting overactive bladder.

AIMS: Sexual dysfunction (SD) is common in female patients with multiple sclerosis (MS) reporting overactive bladder (OAB) symptoms. The aim of the study was to evaluate the effects of transcutaneous tibial nerve stimulation (TTNS) and pelvic floor muscle training (PFMT) with biofeedback on SD in female patients with MS reporting OAB symptoms. METHODS: Patients with overactive bladder and SD were allocated to receive TTNS or PFMT daily. Overactive bladder symptoms, sexual functions, and sexual quality of life were assessed at baseline and 6th weeks. Female Sexual Function Index (FSFI), Overactive Bladder Questionnaire (OABv-8), and Sexual Quality of Life-Female (SQoL-F) questionnaires were used. RESULTS: Thirty patients (TTNS = 10, PFMT = 20) were included in the study. Compared to baseline, total FSFIOABv-8, and SQoL-F scores improved in both TTNS (p = 0.005, p = 0.011, p = 0.444, respectively) and PFMT (p = 0.002, p = 0.001, p = 0.001, respectively) groups. Between-group comparisons did not show any significant differences. CONCLUSION: This study demonstrates the efficacy of both TTNS and PFMT for improving sexual function in female MS patients with OAB symptoms, but did not show superiority of any particular method. Further studies are required to investigate the differences between these two non-invasive methods.

Effectiveness of the transcutaneous tibial nerve stimulation and pelvic floor muscle training with biofeedback in women with multiple sclerosis for the management of overactive bladder.

BACKGROUND: Overactive bladder (OAB) is common in patients with multiple sclerosis (MS) with a limited number of treatment options. OBJECTIVE: To investigate the effect of transcutaneous tibial nerve stimulation (TTNS) and pelvic floor muscle training (PFMT) with biofeedback on OAB symptoms in female MS patients. METHODS: This study was conducted at the outpatient MS clinic in Istanbul. At baseline bladder diary, post-voiding residue (PVR), OAB, and Qualiveen Scales (QoL: Quality of Life; Siup: Specific Impact of Urinary Problems on QoL) were assessed. Patients were allocated to receive TTNS or PFMT daily for 6 weeks and reevaluated using the same tests. RESULTS: Fifty-five patients (TTNS = 28, PFMT = 27) were included. Compared with baseline, both TTNS and PFMT groups improved in terms of OAB (p = 0.0001, p = 0.0001), Qualiveen-siup (p = 0.0001, p = 0.0001), Qualiveen-QoL (p = 0.002, p = 0.006), PVR (p = 0.0001, p = 0.21), frequency (p = 0.0001, p = 0.69), nocturia (p = 0.0001, p = 0.19), urgency (p = 0.0001, p = 0.0001), and urge incontinence (p = 0.0001, p = 0.0001). Between-group comparisons showed significant differences in 24-hour frequency (p = 0.002) in favor of TTNS. CONCLUSION: Our study demonstrates the efficacy of both TTNS and PFMT for managing OAB symptoms in MS, associated with a significant impact on QoL, but did not show superiority of the methods. Further studies are needed to explore differences between these two non-invasive treatments.

Systematic review of the prevalence, symptomatology and management options of sexual dysfunction in women with multiple sclerosis.

AIMS: Sexual dysfunction (SD) is highly prevalent in women with multiple sclerosis (MS), however little is known about treatment options. The aim of this paper is to review the prevalence, symptomatology, and management options of sexual dysfunction in women with MS. METHODS: The Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, PEDro, Database of International Rehabilitation Research, Occupational Therapy Systematic Evaluation of Evidence, ClinicalTrials.gov, and Current Controlled Trials databases were searched. No limitations were placed on the date. A critical appraisal of the literature on SD in women with MS was performed according to the PRISMA statement. Two reviewers screened and extracted data. Study quality was evaluated using a standardized tool. RESULTS: A search of 12 databases identified 61 relevant studies (33 observational, 14 case-control, 4 follow up, 10 interventional). Significant variability in the prevalence of SD and questionnaires used to evaluate SD were observed. The most commonly reported sexual difficulties were problems with desire, arousal, and orgasm. Different demographics and MS-related characteristics were found to contribute to SD. Few studies have evaluated interventions for treating SD, and bias was high because of the weak quality of trial designs. CONCLUSIONS: SD in women with MS is multidimensional, comparable in prevalence with other neurological disorders and increases with advancing disease. Studies evaluating practical strategies and pharmacological interventions are few, and properly designed trials using MS-specific validated outcome measures of SD are required to inform evidence-based treatment options for this high impact MS-related dysfunction.

Validation of the Turkish version of the eight-item actionable bladder symptom screening tool in multiple sclerosis.

AIMS: This study aimed to translate the eight-item Actionable Bladder Symptom Screening Tool (ABSST) and determine its psychometric properties in Turkish speaking subjects. METHODS: The study was conducted at the multiple sclerosis (MS) outpatient clinic of the Istanbul Faculty of Medicine, Istanbul University. First, the ABSST was translated into Turkish by an expert panel. We employed the back translation method for linguistic validation. Cronbach's α and test-retest analysis were performed for reliability analysis. The overactive bladder-v8 (OAB-v8) questionnaire was also administered for concurrent validation, and expanded disability status scale (EDSS) and multiple sclerosis quality of life scale-54 (MSQL-54) were used to evaluate construct validity. RESULTS: One hundred and five patients (84 females; mean age, 39.5 ± 11.6 years; mean EDSS score, 3.2 ± 1.8) participated in the study. Mean duration of MS was 9.7 ± 8.3 years, and most (n = 96; 91.5%) had relapsing-remitting MS. The mean ABSST score was 9.7 ± 5.8 (range, 0-21). Highest scores were obtained from urgency and frequency, and the lowest from psychosocial effects of lower urinary tract (LUT) symptoms. The Cronbach's α coefficient was 0.856, and item-total score correlations ranged between 0.485 and 0.845. Correlations of ABSST scores with OAB-v8, EDSS, and MSQL-54 scales were significant (P < .001). According to the questionnaire, 38.1% (n = 40) of the patients needed a referral to a urologist or gynecologist for their LUT symptoms. CONCLUSIONS: The Turkish version of the ABSST is a valid and reliable screening tool that can be used to identify LUT symptoms in an MS clinic.