What would you say? Expressing the difficulties of living with multiple sclerosis.

This article used a mixed method approach to analyze qualitative and quantitative responses from individuals with multiple sclerosis (MS) to determine differences when patients' perceived stress levels and perceived quality of support are taken into account. Understanding the differences in these responses can help us understand how illness, specifically MS, may influence the relational messages sent by patients to their loved ones. Responses to both quantitative and qualitative questions were obtained from 145 persons who have been diagnosed with MS. Participants responded to scale questions measuring daily stress levels and levels of social support and were divided into four groups on the basis of their scores (low/low, high/low, high/high, and high/low). Thematic analysis was performed on the qualitative responses, and differences were analyzed based on participants' grouping. Additional outcome variables measuring quality of life, anxiety, depression, helplessness, and acceptance were also analyzed to determine the similarities and differences between the groupings. The information presented in this article both informs and supports the idea that patients' levels of stress and perception of support are two major variables that impact their responses to their loved ones and their scores on several outcome variables.

Individual and familial correlates of body satisfaction in male and female college students.

OBJECTIVE: This study investigates the relative contributions of global self-esteem, body mass index (BMI), dieting behaviors, and perceived parental control and care on body satisfaction among a nonclinical sample of college students. PARTICIPANTS AND METHODS: Participants (49 males and 299 females) reported weight and height (to calculate BMI) and completed the EAT 26 test. Perceived parental care and control, global self-esteem, and body satisfaction were measured and examined in relation to BMI and dieting behavior. RESULTS: High BMIs were associated with lower body satisfaction for both genders; dieting behavior, self-esteem, and perceived parental care and control demonstrated a unique gender-specific association among variables in prediction of body satisfaction and dieting behavior for each gender. CONCLUSIONS: Body satisfaction as a part of global self-esteem is constructed differently by males and females. Various aspects of parenting (care and control) are associated with self-esteem and body satisfaction for each gender, influencing dieting behavior.

Chronically ill mothers experiencing pain: relational coping strategies used while parenting young children.

OBJECTIVE: There has been little research on women who are parenting while they experience pain and none of this research has focused on mothers with young children. The purpose of this study was to consider relational coping strategies generated by mothers that they used when parenting young children and experiencing pain. METHODS: Two-hundred sixty-two mothers participated in this survey research; 171 who have either multiple sclerosis (MS) or rheumatoid arthritis (RA), and a comparison group of 91well mothers. Mothers completed questionnaires inquiring about (a) their coping strategies, (b) levels of pain, fatigue and physical functioning, and (c) if they were currently experiencing an exacerbation of their chronic illness. RESULTS: Well mothers reported using more self-care when parenting while experiencing pain. Mothers with RA were more likely to set boundaries around their behaviour. Women with MS who were experiencing an exacerbation changed their coping strategies to include more child activities and encourage more mature child behaviour when compared to women with RA who were experiencing an exacerbation. DISCUSSION: From the perspective of relational coping theory, mothers consider their own pain while simultaneously attending to their responsibilities as a parent. Previous research has suggested that women may withdraw or reduce their parenting activities when they are in pain and this study supported the previous research, especially for women with RA.

Maternal fatigue and its relationship to the caregiving environment.

For women with an autoimmune illness, fatigue can be a debilitating symptom that impacts many aspects of their life. There is scant research on maternal fatigue and its impact on the caregiving environment for either well women or women with chronic illnesses. The objective of this study was to examine the role maternal fatigue played in the caregiving environment, specifically in the mother's experience of the daily hassles of parenting, the discipline style she employed, and how she monitored her child's whereabouts. Two-hundred sixty-two mothers participated in this study: 103 mothers with multiple sclerosis (MS), 68 mothers with rheumatoid arthritis (RA), and a comparison group of 91 well mothers. Mothers completed questionnaires assessing their self-reported levels of fatigue, depression, quality and quantity of sleep, parenting daily hassles, discipline styles, and monitoring. After sleep, depression, and number of children were controlled for, fatigue explained additional variance in predicting monitoring for all three groups of mothers. Fatigue was also a significant predictor of parenting daily hassles for both well mothers and mothers with RA, but not for mothers with MS. For mothers with MS, it was the covariates (i.e., the number of children in the family and sleep quality and quantity) that were predictive of parenting daily hassles. Several explanations for mothers with MS not being as influenced by fatigue are discussed.

Invisible and visible symptoms of multiple sclerosis: which are more predictive of health distress?

The purpose of this study was to examine whether it is the invisible or the visible symptoms or signs of multiple sclerosis (MS) that are associated with greater health distress. Visible symptoms include the use of assistive devices, problems with balance, and speech difficulties, while invisible symptoms include fatigue, pain, depression, and anxiety. In a sample of 145 adults with MS, participants reported on these symptoms and their current level of self-reported health distress. Hierarchical regression analyses were used to determine whether invisible or visible symptoms were more predictive of health distress. When visible symptoms were added as the first step in the regression, 18% of the variance in health distress was explained. When invisible symptoms were added as the first step, 53% of the variance was accounted for. The invisible symptoms of pain and depression were the most significant predictors of distress. For a subset of the sample that had had MS for more than 11 years, pain and depression continued to be important predictors, but assistive-device use and fatigue were also important. Nurses should be aware that invisible symptoms may be more troubling to patients than visible symptoms and should ensure that adequate screening and treatment are provided for those with MS.

Multiple sclerosis patients talking with healthcare providers about emotions.

The purpose of this study was to consider multiple sclerosis (MS) patients' experiences of talking with healthcare professionals about emotions and their emotional well-being both at the time of diagnosis and while they are living with the illness. Relationships between talking about emotions and positive outcomes were examined. The 145 respondents completed a paper-and-pencil survey, an Internet survey, or a telephone interview. Forty-four percent of respondents indicated that a healthcare provider had discussed their emotional well-being at the time of their diagnosis. Fifty-six percent of respondents reported that their healthcare professional had talked with them about their fears, sadness, and anger related to living with their illness. For those respondents who wanted to talk with their healthcare professional, doing so appeared to be associated with several positive outcomes. The small number (N = 22) of respondents who did not want to talk with a healthcare professional about emotions were also doing well on several measures. Nurses can help MS patients deal with their uncertainty and emotional challenges by being willing to inquire about emotions and emotional well-being.