Research Paper
Learning to live with multiple sclerosis cognitive impairment and how it influences readiness for group cognitive intervention

A poster was presented at the June 2015 Canadian Association of Occupational Therapists on preliminary findings of this work: Fogarty, D., Funk, S., Brown, C.L. Client-Centered Development of a Group Cognitive Intervention. Canadian Association of Occupational Therapists Annual Conference, June 2015, Winnipeg, MB.
https://doi.org/10.1016/j.dhjo.2016.04.010Get rights and content

Abstract

Background

Up to 65% of people with multiple sclerosis (MS) have cognitive impairment that negatively affects quality of life, social functioning, and work. Evidence is building to suggest cognitive rehabilitation is a helpful intervention strategy, and that a group approach can be effective for individuals with MS. Further exploration of how to maximize the potential of group cognitive interventions is warranted.

Objective

To describe how the psychological process of learning to live with MS-related cognitive changes influences participation in a group cognitive intervention.

Methods

A qualitative design with interpretive description approach was used to ask consumers with MS the important features of a group cognitive intervention. Ten females with self-reported physician-diagnosed MS participated in two focus groups. Focus groups were audio recorded and transcribed. Inductive analysis resulted in content and process categories and themes.

Results

The focus groups echoed the processes and relationships that occur in a group intervention program. The main three themes represented stages in a process of learning to live with cognitive changes. The three themes were: 1) coming to know yourself with cognitive changes, 2) learning to cope with cognitive changes and 3) living a changed life. Relationships exist between these stages and the extent to which an individual will benefit from a group cognitive intervention program.

Conclusions

Knowledge of group process and the psychological processes involved in behavioral change are essential skills for facilitating a cognitive intervention group for people with MS.

Section snippets

Methods

This study used a qualitative design with an interpretive description approach. Interpretive description is a methodology used to create a summary of the results that is guided by the researcher's professional view and knowledge.19 The researchers were occupational therapy practitioners (CB, MC), educators (CB) and students (DF, SF) at the time of the study; an interpretative description approach allowed the researchers to recognize their unique occupational therapy perspective in the

Results

The ten participants were Caucasian females ranging in age from 23 to 62 years. Time since diagnosis ranged from 5 to 31 years. The majority of participants had a self-reported disease course of relapsing remitting, although primary progressive and secondary progressive disease courses were also represented. Eight of the participants were living with a spouse. Seven of the participants had grown children; the other three participants did not have children. Two of the participants were engaged

Discussion

This study sought to understand the perspectives of people living with MS and cognitive changes to inform development of a group cognitive intervention that would address the needs of this population. This study confirms previous research on the experience of living with MS as well as research on the content that is important to people with MS for group cognitive interventions.15, 23 This study adds to the literature by highlighting that it is important to consider how individual psychological

Conclusion

The purpose of this study was to determine the perspectives of people with MS to assist the development of a group cognitive intervention. This study highlighted that the content and process of the intervention group needs to reflect the complexity of re-learning to live with a cognitive impairment. Learning to live with cognitive impairment is a process with several inter-related phases that includes re-establishment of personal identity and relationships. It adds to the literature by

Acknowledgments

Thank you to Jacquie Ripat for her coordination and support for the Master's of Occupational Therapy Independent Study course at the University of Manitoba and the participants of our focus groups.

References (35)

  • P.W. Thomas et al.

    Psychological interventions for multiple sclerosis

    Cochrane Database Syst Rev

    (2006)
  • F. Graziano et al.

    The effects of a group-based cognitive behavioral therapy on people with multiple sclerosis: a randomized controlled trial

    Clin Rehabil

    (2014)
  • H. Boosman et al.

    Evaluation of change in fatigue, self-efficacy and health-related quality of life, after a group educational intervention programme for persons with neuromuscular diseases or multiple sclerosis: a pilot study

    Disabil Rehabil

    (2011)
  • C.L. Hugos et al.

    Clinical trial of a formal group fatigue program in multiple sclerosis

    Mult Scler

    (2010)
  • M. Ennis et al.

    A randomized controlled trial of a health promotion education programme for people with multiple sclerosis

    Clin Rehab

    (2006)
  • J. Pöttgen et al.

    Managing neuropsychological impairment in multiple sclerosis: pilot study on a standardized metacognitive intervention

    Int J MS Care

    (2015 May-Jun)
  • E. Peled et al.

    Can a structured model for group intervention be responsive to group process? A proposal

    Clin Soc Work J

    (2012)
  • Cited by (6)

    This was a non-funded study. All authors have no conflict of interest to declare.

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