This study explored the relationship between health locus of control and the trajectory of multiple sclerosis. A random sample of 100 respondents with multiple sclerosis was selected from the membership list of a state multiple sclerosis support group. The subjects were interviewed in their homes and completed study instruments. Respondents with an internal health locus of control orientation had more knowledge of their disease, practiced more self-care, and had a more benign course of multiple sclerosis than those with an external locus of control. Additional findings included an overall lower divorce rate for the respondents as well as a poor employment outlook.
The researchers studied the effectiveness of a nursing intervention in promoting adjustment and symptom management in individuals with multiple sclerosis (MS). This was a 4-year longitudinal study to determine whether the 4-week intensive outpatient program was effective in increasing adjustment to MS and if the treatment effect would last over time. A sample of27 individuals with MS participated in the study. Treatment participants had significant improvements in symptom management at the 4-yearfollow up. This improvement was attributable to significant improvements in sleep and fatigue levels. Although adjustment and selfefficacy scores improved in the treatment group over time, this improvement was not superior to the control group. This was anticipated because the behavioral changes would precede improvement in adjustment to life following the diagnosis of MS. Keywords: multiple sclerosis; nursing intervention; psychosocial adjustment Article: This study tested a comprehensive nursing intervention designed to help individuals with multiple sclerosis (MS) gain better control of their symptoms and improve their adjustment to this progressive disease. The intervention was designed be provided by advanced practice nurses to supplement or augment medical management that these patients receive from their primary care providers. DIFFICULTIES IN STUDYING ADJUSTMENT TO MS MS is one of the most common causes of neurological disability in young adults. About 1 million adults are affected with MS worldwide (Williams, Rigby, Airey, Robinson, & Ford, 1995), making MS a significant health care problem. MS attacks white matter in the central nervous system, resulting in physical, sensory, affective, and cognitive difficulties (Devins et al., 1993), and it is characterized by uncertainty and a progressively disabling course (Stuifbergen, Seraphine, & Roberts, 2000). The severity of physical, emotional, and cognitive functioning varies widely between individuals and within individual MS patients over the course of the disease (Beatty, 1993). PSYCHOSOCIAL ADJUSTMENT MS often leads to changes in emotion and cognitive ability, to fatigue, and to pain that may challenge the ability of patients to adjust to their disabilities. As a chronic illness, MS requires varying patterns of personal and familial social adjustment. In a study comparing quality of life
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