Feasibility of Addressing the Spiritual Well-Being of Persons With Multiple Sclerosis: A Mixed-Methods Program Evaluation.

IMPORTANCE: Spiritual well-being is an important aspect of health-related quality of life for persons with chronic illnesses such as multiple sclerosis (MS), yet research on interventions remains limited. OBJECTIVE: To assess the feasibility of an occupational therapy intervention addressing the spiritual well-being of people with MS. DESIGN: Mixed-methods program evaluation using theoretical thematic analysis of qualitative data. SETTING: Community center serving people with MS in a midwestern U.S. city. PARTICIPANTS: A total of 42 participants attended at least one session; 22 participants provided qualitative data. Ten met the inclusion criteria for quantitative analysis, including completion of pretest and posttest measures and attendance of at least half of the sessions. INTERVENTION: Making Meaning, a group intervention based on the Model of Occupational Wholeness, was conducted over eight weekly 45-min sessions. The focus was on exploring and integrating spiritual practices into daily life. OUTCOMES AND MEASURES: Participants completed the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12-Item Scale (FACIT-Sp-12) to measure spiritual well-being and answered open-ended questions. Attendance was recorded and the facilitator and observers provided qualitative observations. RESULTS: Pretest-posttest comparisons of FACIT-Sp-12 scores indicated a moderate improvement in spiritual well-being (d = 0.41). Attendance and qualitative data supported the intervention's feasibility and suggested areas for refinement. CONCLUSIONS AND RELEVANCE: Making Meaning is a feasible intervention, showing promise for promoting spiritual well-being for people with MS. Further research is warranted. Plain-Language Summary: This study introduces a practical and acceptable occupational therapy group intervention, Making Meaning, which shows promising potential for improving the spiritual well-being of people with multiple sclerosis.

Clinical performance characteristics of a new photometric lithium assay: a multicenter study.

BACKGROUND: Therapeutic monitoring of lithium is important because of its narrow therapeutic range and therapeutic index, low protein binding and single route of elimination. We characterized a new photometric method that avoids the specialized requirements of ion-specific electrode (ISE), atomic absorption and flame emission methods. METHODS: Minimum detectable concentration (MDC), linearity and calibration drift over 65 days were determined. Within-run, between-run and total imprecision were assessed over 20 days in accordance with NCCLS EP5. Interference studies were conducted for 46 endogenous and exogenous compounds. Two production lots of the new photometric method (LI) were compared on the Dimension(R) RxL system and two ISE methods [Ciba Corning (n=124) and DuPont (n=131)], an established photometric method (Vitros) 950 system; n=63) and atomic absorption (Thermo-Jerell Ash; n=63). RESULTS: The MDC was 0.04 mmol/l. Linearity was demonstrated from 0.12 to 5.8 mmol/l by the regression equation: observed=(1.01 x expected)-0.0005 mmol/l, S(y/x)=0.03 mmol/l, r=0.999. Drift for the lithium calibrators over the 65-day study period was <5%, except for the lowest calibrator, which showed 0.04 mmol/l drift. None of the 46 potential interfering substances showed greater than a 6.5% difference between control and test solutions. ISE method comparisons showed the following: LI=(1.08 x Ciba Corning ISE)-0.15 mmol/l, S(y/x)=0.05, r=0.999, and LI=(1.03 x DuPont ISE)+0.00 mmol/l, S(y/x)=0.06 mmol/l, r=0.999. Comparison of the LI method with the atomic absorption and Vitros system showed proportionality error <10%. Bias between the LI method and atomic absorption was 7%, substantially less than that documented in proficiency surveys for the Vitros and other systems. No lot-to-lot or site-to-site differences were observed. CONCLUSION: This new photometric method is an attractive alternative for Li measurement and is adaptable to instruments having spectrophotometric capability.