The Relationship Between Career Thoughts and Adjustment for Individuals With Multiple Sclerosis

Abstract

Multiple sclerosis (MS) is a disease involving a normal immune system response that causes demyelination to the central nervous system. There are approximately 250,000 to 400,000 individuals with MS in the United States with about 200 new cases diagnosed each week (National Institute of Neurological Disorders and Stroke, 2015; National Multiple Sclerosis Society, 2015). The prognosis for individuals with MS is uncertain with approximately 80% experiencing a relapsing-remitting course where relapses are followed by remissions with primary progressive, progressive relapsing, secondary progressive courses accounting for the other 20% (National Multiple Sclerosis Society, 2015; Noseworthy, Lucchinetti, Rodriguez, & Weinshenker, 2000). A diagnosis of MS requires the individual to adjust to a variety of symptoms and stressful psychosocial issues. For example, individuals with MS experience both physical and psychological challenges such as fatigue, numbness, sexual dysfunction, memory problems, depression, and anxiety

A realist review of advance care planning for people with multiple sclerosis and their families

“…This new awareness led to an increased willingness to engage in ACP. This CMO was supported by ten studies; [ 20 , 46 – 49 , 53 , 56 , 62 , 64 , 67 ]. Lowden et al [ 20 ] explored the process of “coming to a redefined self” (p.e17) in nine participants with relapsing-remitting MS.…”

“…Of the 33 articles, 17 focused on MS exclusively [ 20 , 42 – 57 ] seven on MS in combination with chronic neurologic or non-neurologic illness [ 17 , 58 – 63 ]; one on MND [ 64 ] seven on neurological illness (non-specified) [ 18 , 19 , 65 – 69 ], and one on disability [ 70 ]. Nineteen were qualitative or quantitative studies [ 20 , 42 – 44 , 46 , 47 , 49 , 50 , 54 – 56 , 59 , 61 – 64 , 67 , 68 , 70 ]; one was a mixed methods study [ 19 ]; and 13 were case studies, literature reviews or discussion/opinion articles [ 17 , 18 , 45 , 48 , 51 – 53 , 57 , 58 , 60 , 65 , 66 , 69 ] of which seven were opinion or expert panel-based articles [ 17 , 18 , 48 , 51 , 53 , 58 , 66 ] three were case-studies [ 45 , 57 , 65 ] and three were lite...…”

“…The source articles reflect an international scope; two had an international authorship [ 51 , 60 ], seven from USA [ 43 , 44 , 46 , 48 , 66 , 68 , 70 ], seven from UK [ 17 , 18 , 52 , 56 – 58 , 65 ] seven from Canada [ 20 , 49 , 50 , 55 , 59 , 62 , 67 ], four from Germany [ 16 , 47 , 54 , 63 ], two from the Netherlands [ 61 , 69 ], one from Australia [ 64 ], Italy [ 53 ], Peru [ 19 ] and Turkey [ 45 ].…”

“…Similarly, Paterson et al [62] observed that decisions about the future were emotionally charged and "implied submitting to the progression of the disease rather than accommodating a temporary setback" (p. 67), a view shared by Lustig et al [46] that adjustment to loss was vital in people with MS. Murray et al [64] go further to suggest "ACP was easier for patients and caregivers who accepted encroaching death" (p.473) but was also present at other stages of the disease, albeit to a lesser extent.…”

A cognitive information processing approach.

“…The CTI (Sampson et al, 1996a), a measure of negative thoughts related to the pyramid and CASVE cycle, has generated the most research in vocational behavior related to CIP theory by examining relationships among variables that make decision making more difficult. Studies have been conducted on relation-ships among depression, career thoughts, and career indecision (Saunders et al, 2000;Walker & Peterson, 2012); negative career thoughts, depression, and hopelessness (Dieringer et al, 2017); mindfulness, career thoughts, vocational identity, and decision-making style (Galles et al, 2019); career thoughts, career decision self-efficacy, and vocational identity (Jo et al, 2016); career thoughts and disability adjustment (Lustig et al, 2018); career thoughts, meaning in life, and depression (Buzzetta et al, 2020); and worry, career thoughts, career decision state, and cognitive information processing skills . Other studies have provided evidence for the validity of the pyramid (Osborn et al, 2020) and the CASVE cycle (Osborn et al, 2020;Werner, 2019).…”